My patient fired me!

Nurses General Nursing

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Specializes in Case Management, Home Health, UM.

Reminds me of a time many moons ago, when I was working as an aide on the night shift on an extremely busy medical floor. We were literally busting our butts, and this patient who was housed in one of the VIP rooms sat on her call light ALL night long. Finally, at 5AM, the Charge Nurse stormed down to her room, yanked the call light cord out of the wall (I'm not kidding!), brought it back to the nurses' station and threw it in a corner of the desk, as I and the rest of the staff looked on, with our mouths hanging open.

I don't remember if anything happened to that nurse, but that patient packed her bags and walked out AMA before the day shift came on, refusing to sign anything. I guess she fired ALL of us after that! :sofahider

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The fact that the charge nurse didn't spend too much time on the situation, talk to you about it or really take too much time with the patient regarding what was going on says one thing to me.

It says that she trusts your abilities and isn't concerned.

Even if she was busy with an ICU transfer, if she thought there was any merit to the patient's complaint, don't you think she would have sat down with you and discussed it? Sounds like she thinks you are doing well.

:)

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The fact that the charge nurse didn't spend too much time on the situation, talk to you about it or really take too much time with the patient regarding what was going on says one thing to me.

It says that she trusts your abilities and isn't concerned.

Even if she was busy with an ICU transfer, if she thought there was any merit to the patient's complaint, don't you think she would have sat down with you and discussed it? Sounds like she thinks you are doing well.

:)

Yes, when the charge nurse came to me with the issue, she mentioned she thought her complaints were baseless and didn't seem like I did handled anything wrong or out of the ordinary, but just to make it easier on both of us (the patient and I), she took up care of the patient.

I guess what kills me the most overall was that this patient generally was not a pain in the ass. I've had those kinds of patients, and if they complained about me...I think I could easily brush if off. But her complaints came as a complete shock to me because like I said, I had her the night before as well, and spent time talking with her about her situation, her family, etc. Its like she was just taking mental notes everytime I did something she didn't like, and then finally went to the charge nurse about it.

I was very hurt because she wasn't like this with the other nurses, and it really made me step back and question my abililties to take good care of my patients. I thought, am I really that oblivious? Should I do everything my patients ask me just to make them happy? One thing I can think of that may have made her not like me was that first night I had her, she refused to go to MRI because it was 9pm and she wanted to go to sleep. I tried explaining how important it was that she go because it would be hard to fit her in the next day in case they decided they wanted to do surgery, I even had the doctor go in to coax her into going....she ended up agreeing but by that time MRI refused her because they filled up again. Maybe she was just embarrassed by this situation, and when she saw that I was her nurse this second night, she didn't want to see me again? I have no clue....whatever the case, I thank everyone for their advice. Its making me feel much better.

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Last night was my first unprecepted shift. The nursing supervisor from days scheduled me a relatively heavy load, and counted me toward staffing points (we're supposed to be "extra" so that we can have a light load and a resource RN can have a light load and be available for help).

Anyway, I had a pt with a blood transfusion and one with pain out of control, one who needed trach care, CBG, meds and by the way had lt hemiparesis and weighed at least 350. One other pt is an unusual case I wont even get into, - oh and no CNA to take vitals or toileting - but my last pt was all over me about her coffee that I just brought her not being hot enough, the broth being disgusting, blah blah blah... it took everything I had to not say to her "do you realize how insignificant this is compared to the actual sick people who really need my help!!!!" I was borderline polite with her. I said "I'm sorry you like any of the things we have on the unit, but the kitchen is closed at 10pm" :rolleyes:

She was just upset b/c she had been npo all day for an upper gi scope that was cancelled at 8pm! Frustrating for both of us.

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:angryfire Has this happened to anyone? I'd like to hear some stories.....

It sounds like you really needed to feel liked by this patient, as if you had certain expectations of her based on your relationship of the night before and were hurt when she didn't meet your expectations. This may sound harsh, but that was about her meeting your needs. Wishing your charge had explained your side was all about you, too. If it was about her you would have been concerned that the charge had reassured her that her needs would be met. And it's great that you are inventorying your behavior toward her to see if you did anything wrong, but someone who blows you in for not emtying a Foley as she ordered you to and leaving her with a "floppy IV" is acting out her stuff. She did what she needed to get her needs met, as strange and unreasonable as they may have been. Most of our patients are polite as they get their needs met, but that's a courtesy they extend to us. You can't expect it. And of course we get surprised when people do off the wall things, like this, but for our practice's sake it's a good idea not to make it about us.

I dunno, I'm not going to say don't take it personally, but I will say that we need to be careful about getting our needs met through our patients response to us.

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I feel so awful, and I know I shouldn't take it personally, but I can't help it! This was the second night I took care of this woman, and I thought I developed a decent relationship with her. I always brought her pain meds right when she asked, paged the doc when her pain meds weren't helping her...really advocated for her. The second night I had her though, she must have been in a bad mood...or something? I get in there at 8pm to see how she is doing, she mentions her foley bag, and does it need to be emptied. I say its only about 1/4 full, and the nursing assistant will be around about every 4 hours to empty it...not to worry, it wouldn't overfill. I suppose I could have emptied it right then, however it was not necessary....it was 8pm, a very busy time on the unit, I'm busy trying to check up on all of my 7 patients, do assessments on some of them, and give out meds, etc. Plus I had already delegated this task to someone else, it just wasn't priority. I also thought I explained this to her in a kind enough manner so that she would understand....apparently this pissed her off? Also, she mentioned to the charge nurse how her IV was "flinging about" and I didn't bother to tape it down "when it was obvious that should have been done"...I really don't think I'm oblivious to these things, and I never would let her be uncomfortable, how could she think that I was deliberately ignoring her needs? I was just so shocked that come 11pm she is telling my aide that she wants to talk to the charge nurse, then "tells on me", and then I have to give up care of her to the charge nurse....its so embarrassing! I'm so hurt! Its so frustrating too...does this woman have any clue that emptying her 1/4 full foley bag really does not even compare in priority to solving this patients nausea or that patients pain? Sometimes I just wish I could say that to my patients...but I know I can't.... :angryfire Has this happened to anyone? I'd like to hear some stories.....

Consider yourself lucky. Not to mention the fact that she should have spoken directly to you, rather than to the aide. Let it roll off your back. I know it is easy to really atke something personally, but try and let that go.

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One thing I might have done a little differently would have been to explain that a Foley is inherently uncomfortable to many people, and that it had nothing to do with the urine in the bag. But I agree with the others that you did fine, and shouldn't let it get you down.

I'm in orientation, and I'm still pondering last Monday night, and how best to deal with The Patient Who Ate My Whole Shift. I only had two, and one of them kept me so busy that I missed a potentially serious problem with the other. It all worked out okay, but I can see this is going to be one of my hurdles.

We refer to that type of person as one who has "used up her nurse cards" say too early!

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Specializes in PeriOp, ICU, PICU, NICU.

I am not a nurse, but do know that each mind is a world of its own. You will NEVER please everyone. I can just imagine the pain and hurt feelings she caused you, but also you can't take things to the heart or you will shrivel up into a ball and they will not care about you.

Glad you shared your experience so that you can see that you did nothing wrong and that it might be more common than we think. Heck, my aunt is dark skinned and she has had patients in critical conditions who refuse her care because she's colored, she's been bitten, spit at and threatened. She loved her job as an RN and says the good one's usually make up for the bad ones.

It is easy to judge but no difficult to be judges. This woman obviously (weather under pain meds or not) had her priorities set differently than yours and that was just too bad. For every incident that happens like this you will gain a valuable lesson, and that my friend makes you a stronger person. Best of luck to you.

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Don't feel bad about pts. who seem to live to cause people grief. I even get this as a volunteer. You learn real quick which pt's hit the call light because they really need something & which ones are on every 2 minutes just to see someone come. I get pts. with legitimate problems mostly (e.g., they're having chest pains, which I need to report to a nurse immediately, they want pain shot, etc.). The ones who call every 2 minutes ( I need my phone closer, now I need it farther away, now I need a trash bag, this time I need another box of tissues) eventually don't get answered as often. Sad thing is, if they ever have a real need, they'll not get as quick a response as otherwise. Some pts are even known to be trouble whenever they show up, which is frequently. If they give me trouble, I can only imagine what the nurses go through with them. On rare occasions, I have been told by the charge nurse, "stay out of -------'s room, she spits at people, tries to bite the nurses, etc.".

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Specializes in Nursing assistant.

I know how hard it is when your whole purpose is to serve the patients as best you can.

People tend to react to circumstances based their internal baggage. This had nothing to do with you, and alot to say about her own struggles.

For the future: Don't measure your performance based on others reactions. Step back and ask yourself: were my actions appropriate? is there anything I can improve on? Be objective. How would you judge another nurse in this circumstance.

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Ahhhh...the fond memories. Shortly after I graduated I worked ortho/neuro. I had a long time alcoholic female who broke several of her favorite body parts--arm, pelvis, and something else. So I was in there giving meds and the family, including grandkids, were present also. One of her meds was librium and the son asked what it was for. So being a new grad I had to struggle to give him the reason for the med without saying something that would cause the grandkids to ask a million questions. I think in the end I stuttered out something about it keeping her relaxed (I think I avoided the word alcohol in my explanation). And it's not like I could say, well...granny's a lush; she drinks too much. So a bit later the son came out and asked me a few more things and was seemingly understanding of how difficult of a question it was for me to answer (in fact he said so). Sure enough the next night I was "fired" by that patient because per the unit manager, the family said I was "too standoffish" about answering their questions. I was shocked; mouth dropped to floor, but what can you do?

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Specializes in Med-Surg.

Aww, I am sorry that happened to you and that you feel so bad about it. I am not an RN yet, I'm in nursing school now. I am a CNA and have been for 3 years and let me tell you the number of patients that complain to us about some RN's. I am also sure it goes the other way, patients complaining about CNA's to RN's! I am sure you aren't thee first to be wrongly "fired" but I have never seen them take a patient away from a nurse mid shift. Boy if she freaked about you not emptying her Foley then and it was going to be done in 4 hours, she would have really freaked at our hospital! We do them once per 12 hour shift (unless of course they need to be emptied sooner!)

Shannon

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