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opinions on a nurse/patient interaction

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by livintall livintall (New) New

So recently I was requested by a family to take care of their father on any shift that I worked. I built a strong rapport with them and they were very comfortable in asking questions. One day the family approached me with the staff working that night and asked me about one particular nurse that they did not know. They asked what my thoughts were. I gave them a simple indifferent shrug. The family then asked me if I would want this particular nurse to care for my family member. I stated no. The family asked me why and I responded with that I don't care for her demeanor and her frequent lacking of complete patient care. The next day this family once again asked who was working that shift (I was not there) and in that discussion the family stated to the supervisor that they did not want this person caring for their family member. They further told the supervisor that I had said that I would not want this nurse caring for my family member. The other nurse in question has no idea any of this went on. So now I'm facing a disciplinary action with my facility. They have not been specific yet as to what they are disciplining me for and I will clarify it when I meet with HR.

So, what are your thoughts on this? I did not seek out an opportunity to demean someone nor did I do anything malicious. My perspective is that I honestly answered a specific question that was presented to me by a family member. To have answered otherwise would have been not only a lacking of honesty and integrity, but a compromising of my own self integrity and values. It was mentioned that this "disciplinary action" was happening because I had not up managed another nurse. I countered that it was wrong to compel someone to talk up another nurse if they do not feel comfortable doing so. It's no different than being a job reference for someone. Would you lie just to "talk them up"? Would an employer appreciate that quality about you or them? If I told a patient that the nurse taking over for me was "going to take great care of you" knowing that my past experiences that RN have shown otherwise, then I risk losing all that rapport that I earned with that family due to me looking dishonest or not forthcoming. Further, avoiding this would have required me to compromise my morals, ethics, and values. I would hope that others would not compromise their values to talk me up when they don't feel comfortable doing so. This other nurse has no idea any of this has happened so there is no damage done really. So please tell me what you think.

Ruby Vee, BSN

Specializes in CCU, SICU, CVSICU, Precepting & Teaching. Has 40 years experience.

You were wrong.

First, let me just say that paragraphs would have been helpful in reading you rather long, involved post. If you're still reading, let me explain what I think you did wrong (other than the paragraphs thing) and why.

You should never, ever run down a co-worker to a patient or family member. Running down a coworker to anyone is poor form, but there is no excuse for telling a patient or their family that a co-worker is sub par. There must be SOMETHING you find likable or admirable about that nurse. Maybe she skips right through her personal cares but is extremely knowledgable about the disease process. Maybe she's a whiz at starting IVs, time management or explaining the treatment plan to families. There has to be SOMETHING nice you can say about that nurse. (If there isn't, you're not trying hard enough.) THAT is what you say when patients ask about another nurse.

If a patient asks you if you would want your colleague caring for your family member and your honest answer would be "no way," then you don't give your immediate, "honest" answer. You deflect, change the subject, dig a little deeper to find out what is their real concern. Are they looking for another nurse to take care of Mamma when you're off? Maybe there's someone else that you could recommend who you think would work well with them. Excuse yourself to take a look at the roster, and then talk to your charge and/or whoever makes the assignments AND the other nurse you'd recommend and ask for their input. Then go back to the family and say "Jen is really good with stomas (or trachs or end of life care or whatever the real concern might be) and she's agreed to take care of your Mom tomorrow. I think you'll really enjoy working with her." There has to be some way to re-direct or deflect the conversation so that you don't have to lie, but you're still not speaking negatively about a colleague.

As far as the other nurse, if you really have concerns about her care, have you talked to HER about it? That's the place to start. Or perhaps the real starting place is to reflect upon your morals, ethics and values and how you can be true to yourself without disrespecting someone else.

TriciaJ, RN

Specializes in Psych, Corrections, Med-Surg, Ambulatory. Has 40 years experience.

When the family asked you about a coworker, they really put you on the spot. You don't have to give a knee-jerk response, no matter how honest. I would respond to that question by asking if they had any concerns and get them to tell me what their issue was. I would also bring in the charge nurse to help deflect such a loaded question, and work with the family to assign a nurse to them they felt comfortable with.

Put the emphasis back on the family and what they would like to have. Then try to help them get it, without casting a negative light on any one person. It's a bit of a diplomatic tightrope, but you can learn to walk it.

SionainnRN

Specializes in Emergency Room, Trauma ICU. Has 5 years experience.

You were wrong.

First, let me just say that paragraphs would have been helpful in reading you rather long, involved post. If you're still reading, let me explain what I think you did wrong (other than the paragraphs thing) and why.

You should never, ever run down a co-worker to a patient or family member. Running down a coworker to anyone is poor form, but there is no excuse for telling a patient or their family that a co-worker is sub par. There must be SOMETHING you find likable or admirable about that nurse. Maybe she skips right through her personal cares but is extremely knowledgable about the disease process. Maybe she's a whiz at starting IVs, time management or explaining the treatment plan to families. There has to be SOMETHING nice you can say about that nurse. (If there isn't, you're not trying hard enough.) THAT is what you say when patients ask about another nurse.

If a patient asks you if you would want your colleague caring for your family member and your honest answer would be "no way," then you don't give your immediate, "honest" answer. You deflect, change the subject, dig a little deeper to find out what is their real concern. Are they looking for another nurse to take care of Mamma when you're off? Maybe there's someone else that you could recommend who you think would work well with them. Excuse yourself to take a look at the roster, and then talk to your charge and/or whoever makes the assignments AND the other nurse you'd recommend and ask for their input. Then go back to the family and say "Jen is really good with stomas (or trachs or end of life care or whatever the real concern might be) and she's agreed to take care of your Mom tomorrow. I think you'll really enjoy working with her." There has to be some way to re-direct or deflect the conversation so that you don't have to lie, but you're still not speaking negatively about a colleague.

As far as the other nurse, if you really have concerns about her care, have you talked to HER about it? That's the place to start. Or perhaps the real starting place is to reflect upon your morals, ethics and values and how you can be true to yourself without disrespecting someone else.

Could not have said it better, all of this! OP do you even see that what you did was wrong? You are so blasé about it and I find that very concerning. You talked smack about a coworker and now you have to deal with the consequences.

C

Emergent, RN

Specializes in ER. Has 28 years experience.

It sounds to me like you had already crossed professional boundaries with this family. You are not friends with them. Yes, you can have a great rapport with some people, but you aren't supposed to be sharing confidences. You are first and foremost a professional. Plus, you owe a loyalty to your employer and co-workers. Instead, you allowed yourself to be emotionally manipulated by this family who, then, essentially threw you under the bus.

Rose_Queen, BSN, MSN, RN

Specializes in OR, education. Has 16 years experience.

This other nurse has no idea any of this has happened so there is no damage done really.

You'll be singing another tune soon, I'm sure. Yes, disciplinary actions are supposed to be confidential, but information usually gets out- from the one who was disciplined. Not only have you maligned a coworker, you've also shown your supervisor some unsavory traits (talking in a derogatory manner about a coworker to a patient/patient's family). No, not every nurse is perfect. No, I don't want everyone I work with taking care of me. But I would never, ever say that to a patient- there is always something positive to say about everyone. Address concerns with management, yes. But that is really none of a patient's business. If management sees a need for correction, that is their call to make, not yours. You've pretty much just painted a target on your back and I would not be surprised if you see all of your coworkers treating you differently.

GrumpyRN, NP

Specializes in Emergency Department. Has 39 years experience.

I know this is supposed to be a supportive area however I think your behaviour has merited my response.

How dare you demean a colleague in front of patients like that. It is mean, nasty, and unprofessional. As a charge nurse I would do everything in my power to have you removed from my area. You have proven yourself untrustworthy and I would be very surprised if any of your colleagues will want to work with you in the future.

This could have been handled in so many better ways.

Just realised - 'livintall' joined in AUGUST 2014 i.e today and post a thread like that. Here we go again, stupid questions about stupid scenarios. They may be genuine which is why I posted this, but......

Karou

Specializes in Med-Surg. Has 1 years experience.

As useless as I found AIDET training, this does prove that there are people who can benefit from it :cheeky:

You should never put down a coworker in front of a patient or family member. It is extremely unprofessional. It makes not only your coworker look bad but also your facility. Because why would a hospital employee such a poor nurse? That's what the family could be thinking after such a comment.

When asked your opinion of a coworker you should be able to find at least one nice thing to say about them. If not, then you should have approached your supervisor about this coworker a long time ago. You could praise her experience, her length of time on your unit, or you could just state, "I do not personally work with this nurse, but this is an excellent hospital who employees very qualified nurses. If you ever feel your loved one is receiving less than excellent care, please speak to the charge nurse about this or our manager". All smiles. You don't have to say some exaggerated lie, but you should never say something negative.

If they ask you "Would you want your loved one having this nurse?" You can respond, "I trust this hospital and know that if you are unhappy with the care you revive that they will correct it" You do not have to directly answer their question.

We have a physician that I personally dislike and feel is apathetic and lazy. When a patient asks me what I think about him I tell the patient that this physician has been with our hospital for a long time and has years of experience in his speciality, also that I will ensure the patient receives excellent care. Did I lie? No. Did I tell the patient that I dislike this physician? No. Now the patient has a sense of comfort about this physician and feels better about her care.

ALWAYS build "up" your coworker. You already have rapport with your patients and it's an excellent way to have them start building rapport with their next nurse/PCT/physician.

Do NOT believe for a minute that your coworker won't find out what you said about them. Do not be surprised when he/she is upset. Word, especially of this nature, travels fast.

You deserve disciplinary action for your comment, and possibly need a good lesion in professional behavior.

meanmaryjean, DNP, RN

Specializes in NICU, ICU, PICU, Academia. Has 44 years experience.

No damage done really?

You are gravely mistaken. You damaged the other nurses's reputation (and he/she WILL find out). More importantly, you damaged yourself. by so cavalierly dismissing your co-worker. Are YOU perfect? You co-workers will likely never trust you again.

You are facing disciplinary action, and frankly, you deserve it.

OP, the story is going to get out, to the coworker you maligned and all the other regular staff on the unit, and no one there is going to trust you or want to work with you from now on. There's no place I've ever worked in my (lengthy) career that would not have disciplined you for what you did. It was unprofessional on soooo many levels ...

I hope you can learn from this experience going forward. Best wishes --

You stated you didn't do anything malicious. You surely did!! If you don't believe this nurse is competent enough to care for anyone, including your family, then take that issue up with management, otherwise "manage up" and speak kindly of your coworkers. EVERYONE has strong points.

This has got to to be an HCA facility- they are so big on that ridiculous "up managing."

I would have said "I don't know. I'm not really familiar w/ her work." Or something similar.

You did cross boundaries.

This has got to to be an HCA facility- they are so big on that ridiculous "up managing."

I've worked a lot of places over the years, none of them HCA facilities, and I've never heard the term "up managing" before, but, any place I've ever worked, a staff member would be formally disciplined for doing what the OP did.

"Well thankfully I've never been a patient here to really know how any of the nurses treat their patients!"

"We have so many great people working here!"

You can deflect without lying. Not to mention, if this is a nurse that your patient or your family member can't make it through a shift without ending up in worse shape than when the shift started, then you need to be talking to management, not defaming them to your patients.

edmia, BSN, RN

Specializes in Emergency, ICU. Has 10 years experience.

I'm sorry, you said what?!?

No matter what your personal opinion of a colleague may be, you never share those thoughts with a patient or family member. You crossed a professional boundary and are being called on it. I'm sorry this will be a tough lesson to learn, but best to learn it than continue down this road.

Good luck with your co-worker. I might start looking for another floor or hospital to work for...

It is annoying to have to "manage up" another nurse. Especially if you are feeling less than thrilled over their practice. Nurses should stand on their own practice, and others shouldn't have to talk them up to patients.

With that being said, here's where I think you made an error in judgement. First off, you should never, ever get in a boundry issue with patients and/or their families. You can be a stellar nurse, practice well, show compassion and all the other parts of nursing that show you are ethical and have high standards and not get emotionally involved in caring for a patient.

Secondly, if asked the question, i would respond with a "I am not really sure how to answer that, as I am not sure what the question means. Nurse XYZ has been with the facility for ____years. Should you have any questions, each shift has a charge nurse--this shift it is Nurse PDQ, so if you need to speak with someone regarding your father's care, questions can be directed to the charge nurse."

If you have malpractice insurance, call them for guidance. If you are a union facility, speak with a delegate. At the end of the day, this patient will still be in the facility requiring care, and you may be in a position where you will not be given that patient as an assignment.

Never base your nursing practice on the fact that you are the preferred nurse of a certain patient/family. It can make a nurse feel good that patients have so much trust in their care. But it can and does backfire, mostly at the expense of the nurse and possibly their job. Learn to set boundries in your practice. It does not make you any less of a nurse.

Esme12, ASN, BSN, RN

Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma. Has 41 years experience.

Welcome to AN!

Well...that is quite the story. Typically facilities do NOT allow nurses to make disparaging and liable statements about other staff members. It is not professional to bad mouth fellow workers to the patients or families. Just because the family "LOVES" you doesn't make you the better practitioner. I fact I have seen many times, especially physicians, that are "LOVED" by their patients are amongst the scariest of MD's.

The proper, professional way to handle these situations and keep your self proclaimed integrity intact...is to respond politely.

You say things like..."We have many great nurses here...what is making you concerned? Let me get the supervisor/patient advocate for you to discuss your concerns" But never and I repeat NEVER do you say that someone isn't competent and walk lawsuit in the from door....administration frowns upon this kind of behavior.

I hope you learned from this.

Nursing, or any field for that matter is not just about mastering the technical knowledge, but also having some degree of social grace and political savvy. Your rationalizations for having done this will not fly with HR or others that will be looking into this, so I'd just take it as a learning experience and think back on it should a similar experience present itself in the future. Your job is to take care of your patients and keep them safe, but your allegiance should be to your employer and colleagues.