Nurse as a Patient?

[beekindRN, ASN, RN]

Hello all! I recently had a shift that left a bitter taste in my mouth. One of my patients was a coworker from another unit. Let's call her "Claire." Claire works in the ED and is a well-regarded nurse. She received many gifts from colleagues and doctors offices, and I responded to many calls during my shift of physicians "just seeing how she's doing." I know Claire fairly well, and she's a very kind person.

I did NOT know she was a terrible patient. She kept a list at the bedside and made note of all the "errors" I made during my twelve hour shift. For example, she was due an antibiotic. I scanned her bracelet, asked her name and DOB, scanned the med, administered the med. Then, she asked for a tylenol for fever...and then a pain pill...and don't you know she can't take her pain pill without Zofran? So after my FOURTH trip to the med room, I scanned her bracelet, scanned the med, and administered. She claimed I made an error by not asking her name and DOB the fourth time.

Another time, she claimed I entered a drug into the IV pump incorrectly and reprogrammed it herself. It was a med you could give over a 1.5 hour to 3 hour window. I programmed it for 1.5 hours. She had a TON of IV antibiotics and with her IV being a 20 in her forearm, I figured 1.5 hours would be fine. My charge nurse agreed with me.

She then requested I bring in new IV flush bag, primary tubing, and secondary tubing with every antibiotic. She would stop the programmed flush after the abx administration, and even once claimed I caused phlebitis by running two abx one right after the other. However, there was a 20 cc programmed flush, and I even alternated IV sites with every antibiotic.

She has already gotten a colleague of mine fired due to the "errors" she made. I made a ton of narratives regarding the situation, and the nurse and house supervisor were both aware during the situation.

Has anyone else experienced this? No matter what I did, I was wrong in her eyes. I'm not really worried about it, I just wished I had handled the situation better.

[Crash_Cart]

These are symptoms of another underlying problem that needs to be identified.

[caliotter3]

You might become worried about it should she get you fired too. There are toxic nurses who survive in spite of being poison to their coworkers. Watch your back and don't turn your back to her. Don't let her psych problems turn into your problem.

[Jedrnurse, BSN, RN]

It's scary to think of someone so twisted having free reign in an ED.

[River&MountainRN, ADN, RN]

1 hour ago, Jedrnurse said:

It's scary to think of someone so twisted having free reign in an ED.

YES, it is very scary! They exist and they walk among us as coworkers that subtly (or not-so-subtly in the OP's case) try to sabotage us in our day to day shifts together.

[LibraSunCNM, BSN, MSN, CNM]

5 hours ago, beekindRN said:

I know Claire fairly well, and she's a very kind person.

Based on your description of her actions towards you and your colleagues, I'd have to beg to differ. She sounds borderline, if I'm being an armchair psychiatrist. Sorry you have to deal with this, it sounds incredibly frustrating.

[egg122 NP, MSN, APRN]

Your management and patient relations should be getting involved at this point. I'd advise requesting that you not be assigned to this patient multiple days, or at all if possible. If this does not end up happening, see if you can get a witness for med administration and document the witness. Focus on protecting yourself at this point since this is not a patient that you (not due to anything personal to you) will win over.

[JKL33]

5 hours ago, beekindRN said:

Another time, she claimed I entered a drug into the IV pump incorrectly and reprogrammed it herself.

Incident report and immediate referral to management. Document accurately in chart, including acts like these.

5 hours ago, beekindRN said:

She then requested I bring in new IV flush bag, primary tubing, and secondary tubing with every antibiotic.

Refer to management. Again, in real time. Incident report if appropriate. Document accurately in patient chart. Example: "IV abx infusion discontinued by patient prior to programmed flush...." etc.

Of course, make appropriate referrals, report to provider (if appropriate) etc. Try to develop a rapport and remain therapeutic as much as possible.

At the same time, all care should be provided in tandem and I would probably decline to provide care without a witness.

[L-ICURN, BSN, RN]

35 minutes ago, egg122 NP said:

Your management and patient relations should be getting involved at this point. I'd advise requesting that you not be assigned to this patient multiple days, or at all if possible. If this does not end up happening, see if you can get a witness for med administration and document the witness. Focus on protecting yourself at this point since this is not a patient that you (not due to anything personal to you) will win over.

This! Personally, I'd do whatever I had to do to avoid a repeat of this assignment. But a witness will help, and an incident report of every time she touches the IV pump should be done too. Any time family changes the settings in a patient's room on anything, I document it. Same thing for this situation. Good luck!

[Luchador, CNA, EMT-B]

50 minutes ago, JKL33 said:

Incident report and immediate referral to management. Document accurately in chart, including acts like these.

Refer to management. Again, in real time. Incident report if appropriate. Document accurately in patient chart. Example: "IV abx infusion discontinued by patient prior to programmed flush...." etc.

Of course, make appropriate referrals, report to provider (if appropriate) etc. Try to develop a rapport and remain therapeutic as much as possible.

At the same time, all care should be provided in tandem and I would probably decline to provide care without a witness.

This is great advise. I'm in my final year of RN school and I was horrified by the original post. What a nightmare.

[beekindRN, ASN, RN]

Update: I'm back in this unit but do not have her as a patient. I have been commended by two house supervisors and three nurses on how I handled the situation. Management is VERY aware, everything was documented as close to real-time as possible, and incident reports were filed. She apparently tried to get another nurse fired during dayshift yesterday...yikes!

Y'all wanna know the real kicker? She put in for a work transfer to our unit....heck no!

Thanks for all your advice! Our Dean of Nursing had a loooong talk with her earlier today.

[Crash_Cart]

1 hour ago, beekindRN said:

Management is VERY aware, everything was documented as close to real-time as possible, and incident reports were filed.

Excellent. You're on the right track. ?