Patient’s family threatening to report me to BNE

[GilligansPlace]

So, long story short, my patient’s daughter (also a nurse) threatened me and informed me She was reporting me to the BNE. The patient had a hypotensive episode and she was upset I called the physician (who then said he would come see her right away) versus calling a Rapid Response. I implemented the physicians orders and then I did actually end up calling a RR because he did not arrive as quickly as I expected. The whole incident from onset to RR was 27 minutes.

The physician’s progress note states (in his own words) that the daughter was upset but he informed her that the nurse had called him and he was en route to see her when I called the RR. Nothing was done in the RR except labs being drawn because I had already started a fluid bolus prior to calling it per the orders received from calling the physician. The physician was actually going to leave the patient on the OBS floor, but ended up transferring her to IMC to appease the family essentially.

Myself, the charge RN and the physician all documented the aggression of the patients daughter, but I’ve never been threatened before and I’m honestly more upset of being accused of being a bad nurse than anything else.

I did tell the daughter that I would not stand backed into a corner while she yelled at me (my tech actually came in from three doors down to see if she needed to call security because she was yelling so loud) and I think that really set her off.

The family ‘fired’ me and I left the room (patients pressures were 90s/60s at this point and literally everyone else had left the unit from the RR, including the doctor). I charted her threats, quoted some of her comments and noted that she was extremely aggressive and displaying threatening body language (leaning toward me, waving her hands and pointing at my face).

I guess I’m just wondering if anyone else has been threatened with report to the BNE and what happened? The physician said he thought I acted appropriately, the charge nurse said she could see the daughter’s point (and honestly I do too, I’m more upset about the confrontational aspect of it than the actual criticism I think). Thoughts or advice?

[karmax1]

On 1/28/2020 at 8:08 AM, GilligansPlace said:

So, long story short, my patient’s daughter (also a nurse) threatened me and informed me She was reporting me to the BNE. The patient had a hypotensive episode and she was upset I called the physician (who then said he would come see her right away) versus calling a Rapid Response. I implemented the physicians orders and then I did actually end up calling a RR because he did not arrive as quickly as I expected. The whole incident from onset to RR was 27 minutes.

The physician’s progress note states (in his own words) that the daughter was upset but he informed her that the nurse had called him and he was en route to see her when I called the RR. Nothing was done in the RR except labs being drawn because I had already started a fluid bolus prior to calling it per the orders received from calling the physician. The physician was actually going to leave the patient on the OBS floor, but ended up transferring her to IMC to appease the family essentially.

Myself, the charge RN and the physician all documented the aggression of the patients daughter, but I’ve never been threatened before and I’m honestly more upset of being accused of being a bad nurse than anything else.

I did tell the daughter that I would not stand backed into a corner while she yelled at me (my tech actually came in from three doors down to see if she needed to call security because she was yelling so loud) and I think that really set her off.

The family ‘fired’ me and I left the room (patients pressures were 90s/60s at this point and literally everyone else had left the unit from the RR, including the doctor). I charted her threats, quoted some of her comments and noted that she was extremely aggressive and displaying threatening body language (leaning toward me, waving her hands and pointing at my face).

I guess I’m just wondering if anyone else has been threatened with report to the BNE and what happened? The physician said he thought I acted appropriately, the charge nurse said she could see the daughter’s point (and honestly I do too, I’m more upset about the confrontational aspect of it than the actual criticism I think). Thoughts or advice?

Don't worry about it! It is her right to report it. BON receives hundred of thousands of c/o every year.

You will be safe!

[2BS Nurse, BSN]

This is exactly why I won't work in patient. You're damned if you do, you're damned if you don't.

[BSNbound21, BSN, RN]

On 1/28/2020 at 9:34 PM, GilligansPlace said:

Her daughter was not present until afterward. She was on the phone with her father and when I left to get the fluids to start the bolus he handed the phone to my tech who was still at the bedside said the daughter was yelling at her to ‘call a ****** rapid response right now’. Once she got there, one of her accusations was that I ignored her direct request. I had to explain to her that she hadn’t spoken to me on the phone at all.

She was then upset I left the bedside to first, get my manual BP cuff and then to get fluids out of the Pyxis. The tech was at the bedside and I can’t summon things with my mind so I’m not sure what else I could have done? Calling another nurse would have delayed it longer.

Sounds to me like she was sitting around at home, her father called, and she immediately jumped to conclusions without getting any information, falsely assumed she was a better nurse than everyone working at the time, and decided she needed to go there in person to micromanage everything. She then shows up and continues her mission while still not having all of the information and jumping to conclusions, the whole time assuming that you and everyone else are incompetent. She clearly has some personal issues and is probably a terrible nurse.

[Creamsoda, ASN, RN]

You literally did nothing wrong and everything right. IF she does report you, which I doubt she will, its likely just threats and intimidation, you documentation will back you up. You followed all hospital procuedures appropriately. Not sure what else she could have wanted from you. Some familys are just delusional.

[Jory, MSN, APRN, CNM]

Depends..exactly how hypotensive?

In our hospital, rapid responses are performed under protocol until the assigned attending can arrive. I don't think it is appropriate for floor nurses to call the physician first when the patient truly warrants a rapid response.

[KeepinitrealCCRN]

A BP of 90s/60s is not a rapid response (maybe there was more to it). It seems like you did all the right things and I would not be worried at all. I wish certain family members would fire me!

[subee, MSN, CRNA]

For the OP: It's not the blood pressure numbers that count; it's the patient's response to that number. 90/60 can precipitate symptoms that would require RR team but usually it doesn't. Anyway, what I REALLY wanted to say was that I would have told her to back away or I would call security. I've been threatened with bad consequences three times; the last one promised to come back with a gun. This was around Christmas time and I'm thinking "Oh great. This nut job has access to a gun and is going to get angry in a mall the just let it loose". It turned out that he was a police dispatcher, a jerk and had a gun permit. The cop actually suspected who he was when I told him the story and he had the right guy in mind. He no longer has a gun permit. Don't ever let family members make you feel physically unsafe. Get back to your job and let security handle them. I was recently in a hospital room with a dying friend and I was really upset when the NP decided to discontinue the Fentanyl drip (???) and my friend woke up in terrible pain. I was angry and in emotional distress but it never occurred to me to flail my arms at the stupid NP. She turned it back on after she came to evaluate him. I guess maybe she was young but this is a CANCER only hospital. Geez. You handled the situation just fine. Move on but don't allow people to threaten you....ever. A little talking down from security is a logical consequence of that kind of behavior.

[Amshaka]

I feel that your response to the family member was very appropriate. If those types of behaviors are not put into perspective immediately then the family may continue them. In my experience I've found that being understanding with a hint of aggression goes a long way, especially with those family members who try and bully staff members. It also seems to me that you did everything appropriately to safely care for the patient.