Patient complaints

Gooselady, BSN, RN · Jan 12, 2015

Sit down with your manager, initiate a talk with him/her yourself. You ARE concerned about this, and it will look 'good' for you to be taking the initiative here.

This is true for everyone -- we are largely unaware of how we come across, in some ways. For good and bad. I don't know how long you've been a nurse, but nursing itself is one of those gauntlets that puts a mirror in front of your face so you get to see yourself in all your glory whether you want to or not . . .

No, don't look for another job yet just because of these four complaints. Start looking for a new job if your manager is punitive about this (punishing rather than willing to work with you). I've known nurses who honestly did have 'issues' with being abrupt, seemingly callous or cold, or crossing boundaries, even getting in 'fights' with family or patients. First, they sat with the manager and went over the issues. If that didn't help (and for a couple, it didn't) then they were put on a behavior contract. That sort of DID help a couple of them :)

You are nowhere near that. But you are getting 'feedback' and there is some consistency in a couple of the comments. There's something 'there', but what it is and what to do about it is between you and your manager. It's not a big deal, it's something we ALL go through to some degree. Every nurse is confronted with something he/she does that is too much or too little to be appropriate, behaviorally. It's kind of part of the job in the first few years.

brrrr83 · Jan 12, 2015

Sit down with your manager, initiate a talk with him/her yourself. You ARE concerned about this, and it will look 'good' for you to be taking the initiative here.
This is true for everyone -- we are largely unaware of how we come across, in some ways. For good and bad. I don't know how long you've been a nurse, but nursing itself is one of those gauntlets that puts a mirror in front of your face so you get to see yourself in all your glory whether you want to or not . . .
No, don't look for another job yet just because of these four complaints. Start looking for a new job if your manager is punitive about this (punishing rather than willing to work with you). I've known nurses who honestly did have 'issues' with being abrupt, seemingly callous or cold, or crossing boundaries, even getting in 'fights' with family or patients. First, they sat with the manager and went over the issues. If that didn't help (and for a couple, it didn't) then they were put on a behavior contract. That sort of DID help a couple of them :)
You are nowhere near that. But you are getting 'feedback' and there is some consistency in a couple of the comments. There's something 'there', but what it is and what to do about it is between you and your manager. It's not a big deal, it's something we ALL go through to some degree. Every nurse is confronted with something he/she does that is too much or too little to be appropriate, behaviorally. It's kind of part of the job in the first few years.

Thank you so much for your response. I think you hit the nail on the head. I need another sit down with my manager to go over the issue. So far she has been very approachable and positive in my interactions with her. We will see how it goes.

jadelpn, LPN, EMT-B · Jan 15, 2015

I agree. To take the initiative in this is a good thing.

Make sure that you are documenting everything accordingly in real time as opposed to waiting to chart until the end of the shift, documenting hours behind--this will help prove that you are rounding accordingly, responding accordingly, and the like.

If a patient or family member starts complaining to you, I would gently stop the conversation, state that you are going to have your charge nurse discuss this with them, and let the charge handle it. If there's a patient that needs to be offered PO meds as an option and you have an order for that, then this is out of your control. If you are not hearing a bell go off and in another room, (which would be documented in that person's chart with the appropriate time and it would "prove" what you were doing) what are the CNA's up to? Who directs people to call light response if the primary nurse is not available?

Bottom line is that you need to protect you and your practice. Get malpractice insurance, today. So going forward that is an extra layer of protection for you.

Discuss with your manager how it is that you come across, and what strategies you can employ to change perception. Arrogant seems to be a theme. And that is so easy to do when a nurse is perceived to be in a position of "power" over a patient, no matter the intent.

"Let me make sure I am hearing you. You are want to/thinking that/upset because__________. I understand your concern. I am sorry that_____________. What I can do to fix this is_________. Does that sound reasonable?" Don't ever hesitate to discuss a change in the plan of care, discuss any orders that you need from an MD, or to use your resources and get other disciplines involved in the care of the patient. At the moment that it becomes a blame game, ask for assistance of your charge.

Best wishes!

brrrr83 · Jan 16, 2015

I agree. To take the initiative in this is a good thing.
Make sure that you are documenting everything accordingly in real time as opposed to waiting to chart until the end of the shift, documenting hours behind--this will help prove that you are rounding accordingly, responding accordingly, and the like.
If a patient or family member starts complaining to you, I would gently stop the conversation, state that you are going to have your charge nurse discuss this with them, and let the charge handle it. If there's a patient that needs to be offered PO meds as an option and you have an order for that, then this is out of your control. If you are not hearing a bell go off and in another room, (which would be documented in that person's chart with the appropriate time and it would "prove" what you were doing) what are the CNA's up to? Who directs people to call light response if the primary nurse is not available?
Bottom line is that you need to protect you and your practice. Get malpractice insurance, today. So going forward that is an extra layer of protection for you.
Discuss with your manager how it is that you come across, and what strategies you can employ to change perception. Arrogant seems to be a theme. And that is so easy to do when a nurse is perceived to be in a position of "power" over a patient, no matter the intent.
"Let me make sure I am hearing you. You are want to/thinking that/upset because__________. I understand your concern. I am sorry that_____________. What I can do to fix this is_________. Does that sound reasonable?" Don't ever hesitate to discuss a change in the plan of care, discuss any orders that you need from an MD, or to use your resources and get other disciplines involved in the care of the patient. At the moment that it becomes a blame game, ask for assistance of your charge.
Best wishes!

Thank you for your input. We often don't have CNAs fully staffed at night or a secretary. The ones we have are generally not "on the ball" as it is with that sort of stuff. Additionally, 3/4 of these patients did not complain to me or during my shift but after the fact so I had no opportunity to address the issue. That makes it much harder to address the issue with the patient.

As for malpractice insurance, I work for a huge medical center that has coverage. Do you think it is necessary to get my own?

Here.I.Stand, BSN, RN · Jan 16, 2015

As for malpractice insurance, I work for a huge medical center that has coverage. Do you think it is necessary to get my own?

YES!!! Their coverage will be of no help if something comes up down the road after you don't work there anymore. Or if you're still working there, but the hospital decides to throw you under the bus. The medical center's coverage is there to protect the medical center--not the individual RNs.

icuRNmaggie, BSN, RN · Jan 16, 2015

Four complaints in one week is not a coincidence.

Either you have been very abrasive to everyone, or someone has been prompting your patients to complain about you. There are coworkers who will do this to be vindictive or just for their own amusement.

Keep track of who you report off to, and who the CNA is and a pattern might emerge.

If you suspect you have one of those in your midst, you need to let your manager know of your suspicions.

brrrr83 · Jan 16, 2015

Four complaints in one week is not a coincidence.
Either you have been very abrasive to everyone, or someone has been prompting your patients to complain about you. There are coworkers who will do this to be vindictive or just for their own amusement.
Keep track of who you report off to, and who the CNA is and a pattern might emerge.
If you suspect you have one of those in your midst, you need to let your manager know of your suspicions.

Thanks for the insight. One of these I believe was isolated with regards to a patient who was not mentally well. The other three are a different story. Before I heard about the reports to my manager, I had a bad feeling about two of the nurses who I had been trading patients with that week. Both were rude during report to a point where they left me flustered. They also did not give me a heads up that a patient requested to not have me back. Rather than start drama, I'm going to keep an eye on that situation and attempt to steer clear of those two as much as I can. I couldn't imagine why anyone would want to cause trouble for me.

Not sure what else I can do in this situation. I've always been complimented on my bedside manner, so this situation is really hard for me to wrap my mind around.

Gooselady, BSN, RN · Jan 16, 2015

Even if the 'source' is unprofessional co-workers, the best way to approach these issues is always to accept responsibility AT FIRST.

Most seasoned managers/leaders see a red flag thrown up when fingers start pointing at other people as the source of your problems. I know you are not doing this! This is just a free tip that will get you where you need to go :)

caliotter3 · Jan 16, 2015

Sometimes patients pick up on scuttlebutt that they overhear from others and allow that to influence their own perceptions. Is there even a faint possibility that a coworker could have planted a seed, intentional or not, by being overheard, or making a direct statement, about your "arrogance"? Arrogance is not a trait that I look for 100% of the time when I am interacting with others, so I find it a little circumspect that two people just happened to independently accuse you of arrogance in such a short time frame.

Be willing to be open to constructive criticism when you have that talk with your supervisor, but also be aware that you may not be 110% responsible for your dilemma. Good luck.