Nurse Neglect/Abuse?

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Hey nurses,

I hope this is in the right thread. Sorry if its not! :( Anyway, I'm still a nursing student in my first year, so I don't know much about Neglect or Abuse, but I'm pretty sure I just witnessed it at my husbands doctor appointment yesterday? I'll just quick a quick pt history.

He has had diabetes since he was a kid (but in good health with a normal BMI), and now at the age of 26 he is having nerve pain and decreased sensation in his right foot. His primary doctor sent him to a specialist a few months ago who put him on steroids for a month while he waited for approval from our insurance for an MRI. Well, the insurance won't cover it so we decided to just pay out of pocket because his pain is getting unbearable (he has an addictive personality and he refuses to take Vicodin due to substance abuse in his teenage years - hes three years older than me - and says once he feels the euphoria he wants to take more, so we keep it away from him).

Now, here comes my question. The doctor was very polite, however his nurse must have been having a bad day since she started to get lippy from the beginning - after he told her about refusing the vicodin prescription. He also stated he couldn't afford a full back and foot MRI, that he could only pay for the foot. They exchanged some words after her protest of "just the foot", and I just put in some input to help ease the situation (we're paying for my school tuition, we can't afford a $2,000+ test, etc..). Well, then she decided that the MRI he needed wasn't urgent since he wasn't willing to get everything done (even though his pain is almost a constant 9/10) and told the MRI agency it could put "put off" - she scheduled it for 3 months away. I pulled the doctor aside and explained what happened, and she said she would reschedule the MRI for as soon as possible and call us when she got word of a sooner opening.

So is that nurse abuse, or standard practice of "subjective data" i.e., he doesn't want both so it can't be that necessary or urgent? Would just like some feedback from other nurses on the process. I'm not worried about reporting the nurse or anything since his doctor fixed it and thats all we really wanted, and he still has to go back for another appointment to go over the MRI results and he doesn't want to be "that patient" that is dreaded at the office :unsure:

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Well the Nurse may have been out of line, but I don't consider this to be abuse. I am sorry to hear of your husband's problem though. Chronic pain wears away at you.

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I wouldn't say abuse or neglect. You didn't like her, but she didn't abuse you. She set up the appointment so she didn't neglect you, either.

What you could call her on would be access to care standards and standard of care. If she intentionally scheduled you for 3 months out as you've implied, that's one thing. Keep in mind that you spoke to the doc about it, though, and a doc calling for an appointment may have more pull than the nurse. The doc may be able to get you in earlier anyway.

So perhaps there was an earlier appointment, perhaps not. You have no way of knowing.

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I never said I didn't like her. Said she was probably having a bad day. And she told us she set it up 3 months away because she deemed it as a non-priority, regardless of his pain, which she was very blunt about - something the actual Physician said was not acceptable. So, this is "okay" practice - Nurses abusing their power over patients that they don't like? Because according to Ohio State Boards: "Neglect" - failure to provide goods and services necessary to avoid physical harm, mental anguish or mental illness." The MRI was necessary to prevent his pain and provide comfort as soon as possible. She delayed it for her own personal reasons against the patient. If that's not really abuse/neglect, than I don't know what is?

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Well, I'll start with the "nurse"... Not too many nurses are scheduling stuff in MD offices... Probably an MA or office help, not a nurse.. Unless you saw an RN or LPN on her badge.

Regarding the doc, I routinely hear them making statements to patients that can't be backed up... Docs are generally clueless about *how* their orders get implemented and even more so about scheduling and timing.

Truth is, it's an elective, non-emergent study so it *can* wait... And hubby's refusal to take meds doesn't change that. If MRI resources are limited, 3 months out isn't extreme... Particularly given that the MRI of his foot isn't likely to yield anything helpful... Diabetic neuropathy... Nothing likely to come out of the MRI... Which is why the insurance company won't cover it.

To answer your question, if in fact the MRI date was intentionally pushed back out of spite then... Not OK... Not sure I'd go with abuse or neglect, though.

I'd probably want a 2nd opinion before I popped good money on an MRI of the foot for what you describe, though.

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I never said I didn't like her. Said she was probably having a bad day. And she told us she set it up 3 months away because she deemed it as a non-priority, regardless of his pain, which she was very blunt about - something the actual Physician said was not acceptable. So, this is "okay" practice - Nurses abusing their power over patients that they don't like? Because according to Ohio State Boards: "Neglect" - failure to provide goods and services necessary to avoid physical harm, mental anguish or mental illness." The MRI was necessary to prevent his pain and provide comfort as soon as possible. She delayed it for her own personal reasons against the patient. If that's not really abuse/neglect, than I don't know what is?

Sorry. I still wouldn't go with abuse or neglect. As the PP indicated, your husband's MRI isn't emergent, which doesn't mean she was barring you access to care. Proving that she was delaying access would be one thing, but I wouldn't call it neglect or abuse after some of the **** I've seen. If you think that's neglect or abuse...well, good luck.

Mental anguish...that's oh so difficult to define...intentionally. Otherwise lawyers would be backed up on cases.

Whether you liked her or not, you can't assume what she thought of you. You observed behavior that rubbed you the wrong way and you didn't appreciate it. That's not to say that she did any of this on purpose, and you'd be hard-pressed to do so.

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Mental anguish...that's oh so difficult to define...
Every person refused Dilaudid could/would claim 'mental anguish'
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Oh no, he wouldn't claim mental anguish for refusing medication. He's on healthcare's side, not against it or one of those patients where "Doctor doesn't know best". Like I said, I'm not one for reporting anyone for not getting my/their/anothers way. I'm also aware nurses are just people, and people have bad days. Just curious others opinions and what defines abuse/neglect when nurses get personal.

On the plus side, his doctor called him earlier and his MRI is scheduled for Friday morning. She apologized for the nurse (found out it was the nurse, not an MA or anything) and said to call back if the pain gets worse and to set up a sooner follow up appointment after the MRI, since it was scheduled for September after the first MRI appointment. I should have implied that his foot pain is suspected to be something to do with his achilles tendon from losing sensation. She thinks the lose of feeling caused him to cause harm to it unnoticed from limping. The facility also had multiple openings (our city is small), thats why I had my suspicions though.

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Specializes in MDS/ UR.

The nurse was definitely rude.

It'd be a long shot proving neglect or abuse but if you have it hot on your agenda, call the board.

You could also discuss it with the office manager.

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I responded before I saw your last comment. If the doc is worth anything they will reprimand her.

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No, it was not abuse. Doctors order the tests. Your husband said he can't afford what the dr. Ordered, and now you want to blame the NURSE, accuse her of ABUSE and NEGLECT simply because you didn't like her tone when she was in the midst of trying to appease you people? ! Oh, this is rich. I'm sure, that with all your intuitive thoughts and nursey aptitude, you will be sooooo much better than her when you're done with school!!!!

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Specializes in LTC,Hospice/palliative care,acute care.
No, it was not abuse. Doctors order the tests. Your husband said he can't afford what the dr. Ordered, and now you want to blame the NURSE, accuse her of ABUSE and NEGLECT simply because you didn't like her tone when she was in the midst of trying to appease you people? ! Oh, this is rich. I'm sure, that with all your intuitive thoughts and nursey aptitude, you will be sooooo much better than her when you're done with school!!!!
I agree on this one-any patient intent on picking and choosing which recommendations they wish to comply with tends to pluck a nurse's last nerve.
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