My patient fired me!

chadash · Jul 23, 2005

I haven't read all the posts here, but my feeling is why didn't the charge nurse support and back up the OP instead of taking the patient's words verbatim and just taking over her care instead? Was that maybe the easier way to deal with this instead of the right way? Yes, the customer comes first, but, aren't we enabling the patient to continue to attention-seek inappropriately?

I really thought about what you said here. How do we manage inappropriate attention seeking behavoir in a patient? probably in a hospital setting, this is as good as it gets. you give the pt what they want as much as possible, and go on. I dont think this pt demands were reasonable, but you cant change a person's personality in a hospital stay!

In LTC facilities, possibly the charge nurse could have taken a more longterm approach to dealing with this, but heck, you cant change people, can you? In LTC the charge nurse could develope a plan to ease the patient out of their dependency on continual attention from staff by setting limits and providing as secure and as reassuring of an environment as possible. People come into the healthcare system with a butt load of stuff, it can't be perfect!

lossforimagination · Jul 23, 2005

Dont drive those big rigs!
There will be great nights and there will be times no one is pleased: YOU ARE NOT THERE TO PLEASE THEM but to give them great compassionate care!
There is a verse in proverbs that states 'the fear of man is a snare'...be fearless!
From a formerly scaredalot CNA

After working med/surg for 12 years; I personally don't give a damn anymore about the patient's petty demands and "needs". I'm far more concerned about not allowing myself to be abused anymore by management, patients, families, MDs, etc. etc. (which of course, required getting out of the hospital). So, I really have to say ......I'd recommend driving a big rig over nursing if you're having second thoughts.

Danianne · Jul 23, 2005

After working med/surg for 12 years; I personally don't give a damn anymore about the patient's petty demands and "needs". I'm far more concerned about not allowing myself to be abused anymore by management, patients, families, MDs, etc. etc. (which of course, required getting out of the hospital). So, I really have to say ......I'd recommend driving a big rig over nursing if you're having second thoughts.

wow.......

Mulan · Jul 23, 2005

After working med/surg for 12 years; I personally don't give a damn anymore about the patient's petty demands and "needs". I'm far more concerned about not allowing myself to be abused anymore by management, patients, families, MDs, etc. etc. (which of course, required getting out of the hospital). So, I really have to say ......I'd recommend driving a big rig over nursing if you're having second thoughts.

Agree 100%!, and if I thought I could drive a big rig that's what I'd be doing instead of nursing!

mydesygn · Jul 23, 2005

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.....

Beleive it or not, this happens to every nurse at one time or another. Sometimes it is absolutely nothing that you have done. You happened to be the nurse assigned to that patient after a particularly bad day and thereafter any minor annoyance is amplified to the point that you are incompetent. I can't tell you how many times as a charge nurse, I have had to listen to someone complain because their 8:00 med arrived at 8:15 -- Gimme a break! Some people are natural complainers and being in the hospital won't change that and nurses are easy and accessible targets.

However, as a charge nurse I would not have changed your assignment unless you as the nurse asked for it. If a compliant is as minor as that, I would have explained to the patient the typical procedure for emptying a foley, assured them that I would check with them later, stated that I would bring those concerns to you, but I typically do not change assignments mid-shift because it would compromise continuity of care but would assure them that all our staff are qualified to care for them. Actually, I can only remember once being asked by a familly to change a nurse (it was the end of the shift so I did not need to). I wonder if the patient asked to have the nurse changed or did your charge nurse decide to do that?

One of my favorite stories: Had a mom whose child had chickenpox. We had a very nice converstion, never expressed any complaints or indications that there was a problem. I come back the next day and my manager had just listened to this mom grumble and complain where she stated that I said "it was good that her child got chickenpox" what I actually said was "chickenpox can be very hard on you when you are an adult, if you have to get chickenpox, you do better if you get it as a child" If you want to complain you will always find something. Suffice it to say, sometimes you can't win for losing

DG5 · Jul 23, 2005

mydesygn, you would be a real asset on our floor. It is so good to know that there is real team leading. To lead doesn't mean to take over.

psalm, RN · Jul 23, 2005

...just a thought on frequent flyers who cuss out nurses or NAs or any staff. I have taken to writing incident reports of the more abusive pts. Just last week I documented the cuss out from a pt. in his nursing notes, then copied the nn and stapled it to my incident report under "other". If we have potentially violent situations brewing it is good to have something in black and white, also, let the doc know. I have also documented thru incident reports "family dynamics" that are potentially dangerous or unhealthy for pt. and staff well being. Talking to the doc and charge helps, too.

Also, assess the verbally threatening pt. Is this a possible unknown detox going on? A bi-polar pt off meds? Or just a mean complainer? But document, at least in the nursing notes. Hope this isn't too off subject.

BabyRN2Be · Jul 23, 2005

I really don't think you did anything wrong. Some pts don't understand that they aren't the only one in the hospital and that their top priorities are not YOUR type priorities. You are a busy nurse and a 1/4 full foley is not a top priority at the moment. She also has to get it that this is a hospital, not a hotel.

I think that when people are in the hospital, they don't act their normal selves. They have most of their control taken away from them and they try to take a little control of that back by harping on small things that they really wouldn't care about if they weren't in the hospital.

Anyhow, it sounds like you did the best that you could and don't take the situation personally. If it wasn't you, it probably would have been some other nurse who would have taken her complaints and then fired by the pt. Sorry that you had a bad night.

Also keep in mind that there are probably tons of other pts singing your praises, though I think you wish that they'd sing a little louder, huh? :)

mydesygn · Jul 23, 2005

...just a thought on frequent flyers who cuss out nurses or NAs or any staff. I have taken to writing incident reports of the more abusive pts. Just last week I documented the cuss out from a pt. in his nursing notes, then copied the nn and stapled it to my incident report under "other". If we have potentially violent situations brewing it is good to have something in black and white, also, let the doc know. I have also documented thru incident reports "family dynamics" that are potentially dangerous or unhealthy for pt. and staff well being. Talking to the doc and charge helps, too.

Also, assess the verbally threatening pt. Is this a possible unknown detox going on? A bi-polar pt off meds? Or just a mean complainer? But document, at least in the nursing notes. Hope this isn't too off subject.

I,too, think it is important to document that behaivior. You have to be very careful to present in a very objective manner.

mydesygn · Jul 23, 2005

mydesygn, you would be a real asset on our floor. It is so good to know that there is real team leading. To lead doesn't mean to take over.

Thank You. I think most complaints come from false expectations. It's very important to ascertain what the patient expected rather than naturally assume the nurse is at fault. When you automatically change assignments without paying due diligence to discovering the real reasons behind the complaint, You basically have admitted fault and shown the patient that you have nurses that are so incapable that you must assume care. You have also shown the patient that this is the way complaints can be resolved. It won't be long before this patient uses up all their "nurse cards" because they continue to have unrealistic expectations of care.

nitenurse7 · Jul 23, 2005

I have a story well I didn't get fired but the patient was pretty angry... This happened years ago one night I had seven patients and they happened to be on two different halls. I had a blood transfusion, and an new admit, When this patient of mine kept calling on the light for a cup of coffee. The charge nurse who was putting in orders simply said someone will be there in a minute. The PCT's ignored the light. and I was just too busy but made a mental note @ the bottom of my priority list. That had actually been the second or third time she had called according to her, and before I knew it I came out to grab something from the station and that patient was right in the window at the nurses station yelling at every one about how she hadn't been able to get any service, cursing and just acting crazy! But, just six feet next to our nurses station was the coffee room, and then she walked back to her room angry (coffeeless). That's so true physically ill patients are often mentally ill patients even if they aren't usually!

:bugeyes:

nursemike, ASN, RN · Jul 23, 2005

Agree 100%!, and if I thought I could drive a big rig that's what I'd be doing instead of nursing!

Uh, I was just kidding about the big rigs, although it might have been something I would have enjoyed when I was younger. So far, I'm loving nursing, although there have definitely been times I've thought that the next time I feel my life needs some new challenges, I'm going to look for easy ones.