Parents and Firing Nurses

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Specializes in NICU.

Hello,

Just wondering how your units handle these difficult situations, where a parent ( for whatever reason) tells the manager they do not want this nurse taking care of their baby anymore AKA firing a nurse!:argue: Does your unit follow through and not allow the nurse to care for the child or do they use another strategy.

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Specializes in Level III NICU.

It depends on the situation. We have allowed parents to pick and choose their nurses, but our typical response is that "all nurses on this unit are qualified to care for your baby." If the parents have a legit reason (meaning that they aren't totally crazy and actually have a specific reason for not wanting a certain nurse), we will let it happen. Alot of times, it is more of a presonality clash rather than them feeling that a nurse is not qualified. When it starts to get out of hand, and people are having their assignments changed constantly, we put a stop to it. Also, if this issue comes up when there is a staff nurse in charge, we tell them that nothing can be done at the moment and that they have to talk to the nurse manager.

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Specializes in NICU.

Our admin lets parents fire whichever nurses they feel like. For any reason. We actually have a family right now who has specified that no nurse with an accent is to care for their baby, and admin rolled over for it. We've had a patient whose mother (who was at bedside 24/7 except for meals and showers) was permitted to dictate her baby's nurse's assignment - as in which OTHER patients that nurse was allowed to have. They've allowed "no male nurse" blanket rules. It's completely out of control.

I would like to say, though, that the one time I've been fired from a baby, I was so very very happy about it. Your standard "family member claims to be a nurse and sits on the back of your neck all shift" scenario. I was like, oh, I can't take care of the baby anymore? Sweeeeeeet! Freedom! I find that once a family really gets going, anyone fired from the baby is perfectly happy to not have to deal with them.

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Specializes in Level III NICU.
I would like to say, though, that the one time I've been fired from a baby, I was so very very happy about it. Your standard "family member claims to be a nurse and sits on the back of your neck all shift" scenario. I was like, oh, I can't take care of the baby anymore? Sweeeeeeet! Freedom! I find that once a family really gets going, anyone fired from the baby is perfectly happy to not have to deal with them.

Yeah, usually those families are the ones that nobody wants to deal with. We have a family right now who wanted to pick nurses. I asked to be put on the "bad list," with no such luck.

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Specializes in NICU.
Yeah, usually those families are the ones that nobody wants to deal with. We have a family right now who wanted to pick nurses. I asked to be put on the "bad list," with no such luck.

I did once fire myself from a baby because the dad (who is no longer involved with MOB) made a comment about how pretty I was and later put his hand on my back to get my attention and I nearly jumped out of my skin. I return after 4 days off... guess who I have? Sigh. We were short that night so I didn't fight it, but made it very clear to my charge nurse that I would NOT be taking care of that baby the next night.

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Specializes in NICU.
I did once fire myself from a baby because the dad (who is no longer involved with MOB) made a comment about how pretty I was and later put his hand on my back to get my attention and I nearly jumped out of my skin. I return after 4 days off... guess who I have? Sigh. We were short that night so I didn't fight it, but made it very clear to my charge nurse that I would NOT be taking care of that baby the next night.

Ewwwwwww

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Specializes in Nurse Scientist-Research.

Thankfully our manager will not allow the parents to "fire" a nurse. In the past when there have been difficulties; the manager has conceded to the parents by allowing to basically request primary care, though unlike is usual (we don't generally do primary nursing) the parents pick a list of nurses they would like to have care for their infant if they are available with the understanding that no nurse is forbidden from caring for their infant and the nurses on the list are not obligated to do this and unit staffing needs supersede their preferences.

Most of the time the list is followed because these parents are generally difficult or at least high maintenance and it's just not worth the bother of fussing with them if they don't get what they want.

We have had many parents ask to have a list of nurses that can't take care of their infant, this is not allowed but most of the nurses would like for them to have it so we can all get on it.

I've never been "fired" from an infant, though had a complaint once from a totally unreasonable dad who routinely made complaints about 4 + times a week. I fired myself and didn't even take an assignment in the same room with them for the remainder of this child's hospitalization. This poor infant wound up back at the children's hospital next door a few weeks after going home and the dad stopped over to visit with us and tell us how much better he liked us than the new hospital. Yea, whatever. . .

I pity the poor teachers here in a few years. . .

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Specializes in Level III NICU.
This poor infant wound up back at the children's hospital next door a few weeks after going home and the dad stopped over to visit with us and tell us how much better he liked us than the new hospital. Yea, whatever. . .

Yeah, we've had a few parents of chronic babies complain about this, that and the other thing and all we can think is, "just wait til your first re-admission to peds/PICU after you go home." Not that they aren't good up there, it's just a totally different world than the NICU.

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Specializes in Maternal - Child Health.
Hello,

Just wondering how your units handle these difficult situations, where a parent ( for whatever reason) tells the manager they do not want this nurse taking care of their baby anymore AKA firing a nurse!:argue: Does your unit follow through and not allow the nurse to care for the child or do they use another strategy.

Having managed a NICU, I find this practice to be generally bad for the unit and individual nurses.

During my time as nurse manager, there were 2 incidents in which I would have agreed with parents that a particular nurse should no longer be involved in caring for their baby, had they brought it up. One set of parents did, and I explained to them that while I agreed with their assessment, I could not guarantee that Nurse B would never be assigned to their child again. It was a small unit, and staffing demands did not permit me to make such a blanket statement. I assured them that I would do all in my power to avoid assigning B to their baby, and they were satisfied. I did not ever go so far as to allow parents to "choose" their baby's nurse, though. I don't think that is reasonable.

In the other instance, much to my surprise, the parents did not request that Nurse D be removed from their baby's care team. They would have been perfectly justified to do so, but they seemed to shrug off the incident much more readily than the staff or I did.

The problem in my unit was that we had a few utterly incapable staff nurses who were protected by administration. I couldn't get rid of them no matter how much I documented, or how much parents complained. I ultimately left the job because I would no longer accept 24 hour accountability for a unit staffed by 18 excellent nurses and 2 idiots.

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I am not a nurse at UAB, but my baby was there for 8 weeks. I had a couple of nurses that had my baby ALOT and I loved them so much...I had gotten really comfortable with them and they were so good to call me an tell me he just ate really good....or he had a really good BM or he took all of his food without a residule(sp?) and that made me feel so good that they took 2 seconds out of their really busy schedule ao tell me little things...that really HUGE for me to hear!!! So I would constantly ask them will you be here tomororw will you have him the next time you work..and they told you know you can get the nurses you want if you see the charge nurse...and that was so great..then they asked me to please go to tell the charge nurse to be their names down becaused they loved him so much...so I know UAB does that. I think it is a great thing!!!! The experience for a parent in the NICU is hard enough but to have someone that you completly trust and someone that you can really sit down and have a heart to heart with...it does make it a tiny bit easier or easier to cope with. I had one of his nurses sit down and cry with me..she had been through the exact same thing with her baby.

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Specializes in Maternal - Child Health.

2bnurselove08,

You make an important distinction about parents who request certain nurses because of a special bond, mutual respect or excellence in patient care. Those are important considerations in making patient assignments that most charge nurses will honor.

I think that is a whole different ball of wax than those who insist on certain nurses for less positive reasons such as race, gender, personality or the over-reaching desire to "control" the unit.

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Specializes in NICU.

Unfortunately we have had these situations...usually its a personality issue. I think it hurts the unit overall if parents are allowed to dictate who cares for their babes, especially if the issue isn't really a matter of care given, then its ridiculous. I think management should step up and support the bedside nurses in most circumstances, I can't imagine such a thing happening in an adult ICU.

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