Nurse who needs to retire!

[e-nurse]

I work rotating days/nights Cardio-Thoracic stepdown and we have a nurse on the night shift who is in her late 60's who regularly mis-treats patients and who is a very toxic and disfunctional personality w/in the staff. First of all, noone likes her b/c she is loud, obnoxious, over-opinionated, argumentative, she talks down to everyone, she accuses everyone of being an alcoholic or drug addict, and she calls out sick ALL the time . I refuse to speak to her /x in report b/c whenever I try to talk to her she argues w/ me or laughs @ me as if I know nothing ( I am a male c/ one year experience, she has been on the unit a little over a year after being a traveler). The difference between working w/ her or not on nights is emmence. When she works everyone is tense and stressed and depressed, and when she doesn't work it's much looser, more fun, more teamwork. We have this one male noc nurse who has the charisma of 10 charasmatic people who is knowledgable beyond beleive and this evil nurse has latched on to him and is sucking the life out of him. He has learned to deal w/ her and deals really well (if I was on speaking terms w/ her, none of the words would be kind ones). She's just simply toxic to the Nth degree.

So I picked up a patient from her this AM who had an emboli to her spine and who can't really move her legs. She also has Breast CA, receiving Chemo and all. She is the sweetest thing you'd ever want to meet. I had had her for a couple of days so evil nurse starts telling me how she used to be an alcoholic and that she can really move her legs fine, she just needs encouragment. I go to see her (the pt) and for the hell of it (I don't usually do this) I asked her what she thought of her nurse during the night. Apparently the pt had asked for the bedpan a couple of times and didn't have to go, so evil nurse tells her that since she had a couple of false alarms she wasn't going to give her the bedpan anymore and she stuck a towel between her legs. So when I went to see her in the morning she was crying and soaking wet w/ urine. Her 2 small stage 2 ulcers on her bottom that I had put dressings on the day before were undressed. So I got her cleaned up, told her to call for the bedpan and not listen to what evil nurse had told her, and I arranged w/ the charge nurse for her to get an actual qualified RN to care for her tonight, otherwise evil nurse would have had her again. I also told her to have her family write a letter to our manager to tell how she was mis-treated by evil nurse. She needs to retire, end of story! This sort of thing is a regular occurance.

[traumaRUs, MSN, APRN]

This woman needs to get out of the profession and retire from life, I think. My two cents worth is that YOU are responsible for reporting this evil person!! If you don't, you are tacitly going along with it. Please don't hesitate another moment!!! Report her!!!!

[VAC]

e-nurse,

PLEASE tell us you wrote that up!!!

[e-nurse]

Notes get put under our manager's door all the time regarding this nurse but nothing ever happens. It's really frustrating for all of us.

[pebbles, BSN, RN]

Originally posted by e-nurse

Notes get put under our manager's door all the time regarding this nurse but nothing ever happens. It's really frustrating for all of us.

I don't know how "the system" works where you are - is anyone willing to ask your manager why nothing has been done, and have people tried to go further up the chain of command? This is not just poor inter-personal staff relations, this is bad/negligent patient care, bordering on abuse. Encourage the patients and their families to ask to speak to the manager or write letters to the hospital administration - lord knows the big bosses listen to the public more than they listen to us!

You could report her to the regulatory body in your area, but if she is toxic enough to retalliate, every mistake you ever made could also be up for scrutiny (which I've seen happen, and it is ugly).

[Andy S., BSN, RN]

OOOOOOOOooooo!!!!

She needs to get the heck out of there. (Fired, invited to leave, quit, whatever it takes!)

I think it has gone beyond being evil!

[P_RN, ADN, RN]

I hope it's not her age that you are saying is the bad part! I've worked with OLD ones who were fantastic and have worked with NEW ones who were evil! And vice versa.

2 words for you. Occurrence report.

"Found patient's 2 stage 2 skin breakdowns undressed. Patient lying in urine." PERIOD!

"Found patient etc. etc. etc." PERIOD. no names, just the facts.

Your NM is probably hoping that you will give up on the note idea and just go along with it not to rock the boat. That way she won't have to deal with it, and won't have to fill that "hole" in the night schedule.

NO!

TPTB need to know. Occurrence reports. Family letters.

Does your place have a Guest/Patient Relations Dept? Call them. Have someone come talk to the patient.

P

P

[NicuGal, MSN, RN]

Notes under the manager's door...that is not really effective I would think...you need to write it up, make copies..one to her, one to the DON and one to your personnel department. And you need people to back you up....not just SAY they are going to. Good Luck!

[Teshiee]

That is so wrong! If you can't get anything from the managers what about the board of nursing. She neglected that patient. She needs to retire. We have some dinosaurs in our unit that can be very brash with the moms. I agree with other nurses WRITE HER UP AND REPORT HER. :(

[prn nurse]

I would write you up for asking the patient, ""What did you think of the nurse who took care of you last night?"" This while you are tsk! tsk!' ing over the "lying in urine and the little dressings were off". Not exactly an unbiased question that you asked, was it? (Have you ever read about polls? And how the responses are manipulated by the wording of the questions?)

Did this nurse have a nursing assistant? Did the nursing assistant check the patient for urine? When you have had more experience, you will learn that a patient can be scrupulously clean at 6 a.m. and soiled/soaked in urine at 6:30 a.m. I have cleaned many a patient 4-5 times a night and think I was leaving them clean to have them pee a gallon an hour before shift change. And , guess what?? Last night , I had a diaper on a patient and two towels in the diaper !!!! It is not that uncommon to have a towel between the legs of a female, many request one, (many wear pads all day at home for urine leaks), and many aides/assistants place towels on /under females. I do not see anything wrong with saying to a female, who has asked for the bedpan twice, but did not pee, "I will just leave this towel here in case you do go while I am gone"...(it wouldn't feel so hot to sit on the bedpan 1/2 the night til the actual voiding occurs, however, a towel or two is not uncomfortable......as far as the dressings on the decubiti, , hello?,, bedridden patient...turning to put off and on bedpan, etc. all night....yes, they do come off.... I repeat, you did a hateful thing, very unprofessional, manipulative, (elicited the ""correct"" response you wanted from the patient,.)...I would write you up in a New York minute. You are IMHO, a control-freak and a major trouble-maker in the making. You were not behaving as a patient-advocate. Nor were you behaving as a professional or as an advocate for nursing. You instigated and elicited the complaint.

[e-nurse]

I think you are way out of line, maybe even trying to be an agitator (if that was your aim it worked very well) You're making assumptions about myself and the situation I wrote about when you know nothing about my character and how completely awful the nurse that I wrote about is. I get patients from M all the time and don't usually ask what pts think of her. Pts offer their complaints of M on their own accord usually. They plead to not have to have her as a nurse anymore. I usually try to blow it off so I don't have to speak ill of her. I could have gone running to my manager and being a "tatle-tale" (as you put in another post) dozens of times due to her treatment of patients, myself, and the rest of the staff, and haven't. She is the one who goes trying to get our aides and environmental assistants fired for no reason after she drives them crazy all night demanding they do everything she asks immediately.

And what is this business of "when you have more experience blah blah blah. You're sounding awfully elitist. I've got enough experience to know that a bedridden patient should have her pressure ulcers covered w/ some sort of dressing that will keep the areas dry, and if they fall off then, hmmm, should I maybe change them?

This is the only the only time I will reply to you b/c you are rude and don't deserve my attention so go ahead and continue to agitate if you like. I stand by my post and that I "dared" ask how my patient thought her care was through the night. You DO NOT know enough about me to criticize and insult me the way you did. I was going to end this w/ a big slam but I won't. Maybe you don't really deserve it.

[live4today, RN]

Dear enurse,

Whenever you suspect or know of a nurse who may be (or actually IS) mistreating patients in his/her care, it is your responsibility to report the mistreatment, but I would FIRST speak to the nurse in question about your observations or patient comments about a particular nurse BEFORE writing him/her up.

Secondly, if your talk with the nurse is "ineffective" and you still notice the nurse mistreating his/her patients, let that particular nurse know that you are going to request a meeting with the Nurse Manager so that the THREE of you can discuss your findings, etc. If that meeting does not effectively improve matters, THEN let the nurse know that you are going to report his/her mistreatment of patients to your Nurse Manager's Supervisor, as well as your hospital's Patient Representative Office (if your hospital has one of those).

I agree that you should not ignore your findings of a nurse who is not behaving professionally to his/her patients, but I also think it is a common "professional courtesy" to give fair warning to the nurse in question. I would NEVER write someone up without first having a talk with that person about their behavior, etc.

In the future, perhaps you can enter your assigned patients rooms and say "Good morning Mr. or Mrs. or Miss or Ms. "B", my name is enurse and I'll be your nurse today. How was your night last night? Did you rest well? Is there anything I can help you understand about your treatment during the night or what we will be doing for you today?"

There are ways of "hearing" how your patients previous shift care was performed without mentioning anything in reference to the nurse who cared for your newly assigned patients during the shift before you came to work. Professional thoughtfulness and clarification goes a long way to improving the workplace and peers you work with. Of course there will always be those cases that will not cooperate, no matter how much "room for error" you give them, but always try to at least extend that professionalism no matter how you are treated. There are ways of seeing discipline in action with those employees who continue to act unbecoming as nurses while at work and in the care of patients.

Best of luck to you, enurse. You are on the right track, and I'm sure you handled the situation as best you could with your current nursing experience, so don't beat yourself up over this. We have ALL mishandled a situation where down the road we come to learn much better ways to deal with matters like you are dealing with. Sometimes a nurse acts out for attention, and by your bringing his/her actions to the forefront in a private conversation with them BEFORE involving the Nurse Manager or others, is all that person may need as a reality check. You are young now, but one day you too may be a sixty year old nurse who is fed up with "whatever". Also, "bad attitudes and unprofessionalism" are not just characteristics of the aging population, but also of many young people. Of course, there are NO excuses for mistreating patients, so don't think I'm making any excuses for that nurses behavior because I'm not. I'm simply offering you another possible way of handling problems like this in the future because "there WILL be others"!