Physically threatened by family member

[mj2012]

Hi. I'm dealing with a situation I have never had to deal with in over a decade of nursing. I work on an adult care unit at an acute care hospital. I had a very grumpy, irritable, elderly male patient for a couple of days who complained to me when I came on shift a couple days ago that "the girl who took out my Iv ripped it out and my arm hurts and she threw a hissy fit like a two year old girl." I told him I was sorry about that and I didn't know what else to do because I did not know who took out his IV, the RN or the tech from the previous shift. I inspected his arm and found it red, swollen, and warm, and he complained of pain upon touch and movement. (I gently removed the coban from his prior IV site so I could inspect his arm more closely)I notified the MD and he eventally came to see the patient. A d dimer was done, which was positive, and doppler ordered. Like I said, this was a very irritable, grumpy pt who can sometimes be confused who was probably the meanest one I've had in a long time, but I'm a professional and I don't take things personally and I don't get upset or defensive. In fact, the more worked up people are, the calmer I tend to become. He asked to see the charge nurse in the middle of the night, who came to see him and spoke to him (I wasn' t there), and she came out and told all of us to be careful with his arm. Which I had barely touched at all. So, his daughter comes in at shift change and I started trying to explain about his arm and she lit into me, saying "My dad said you were really mean and cruel to him and you ripped something out of his arm and you threw a fit like a two year old." I tried to explain calmly that I didn't take anything out of his arm and he must be mistaken because I was kind and respectful to him and that he had had the same complaint to me about another staff member. This was in the presence of another nurse, who I was giving report to. The daughter than said, "You were mean to my dad, I'm gonna take you outside" which was an obvious physical threat, so I went and got the day and night charge nurses, told them about the threat and the pt/dtr's complaint, and then left. This was 15 min after my shift should have been over. I should have called security, but I didn't. I did make a report w/ security the next day. The patient has been discharged, but Pt relations is involved as well as my manager, and I have to have a meeting with them the next time I work. I am afraid that my manager is not going to support me since they tend to believe anything patients or families say. I am going to tell them exactly what happened, but if they don't believe me or they try to discipline me for something I didn't do I'm afraid I'm going to have to get another job. I also am weighing the possibility of filing charges, as I have never been physically threatened by a family member before and I feel that should not go on without dealing with it in some way. Does anyone have any thoughts or opinions on what I should do? I should also add I've been working at this job for almost half a decade and have been a nurse in good standing. All my coworkers know I am kind and professional with my patients, but you never know how management at my work is going to treat you. Thanks for any input.

[FlyingScot, RN]

Is it policy at your facility to document when you remove an IV? If it is the manager needs to review the chart and query the person who did it. Can't tell you how this is going to turn out. I hope you documented the heck out of the situation. Whenever I have a difficult patient I always document word for word (in quotation marks) everything they say including foul language. If there is a negative exchange I also notify the charge nurse immediately and tell them what's going on. It doesn't hurt to be pro-active.

[mj2012]

Yes, it is definitely policy for us to document who removes IV's, whether the cathether was intact, etc. The pt never accused me personally as I was caring for him, and he even thanked me for getting him pain medicine, and thanked me one other time for checking on him and having him elevate his arm on a pillow. The charge nurse was already aware that he was upset with whoever took out his IV earlier in the day, and I did not document that. I did document that his mood was "irritable" as had other nurses. But I am not the kind of nurse to document every little single thing that happens, only if it is clear it is going to become an issue, which this wasn't clear at all. This whole thing happened at shift change, at which time the only thing I can think of is he was confused as to who took out his IV. Although he was grumpy and mean, we never had "words" and I never would have guessed that he would have complained about me based on the shift we had and the fact that I gave my usual excellent care. It is very frustrating to work so hard to care for people and treat them with respect and to get treated this way in return. It makes me feel very down about the state of nursing. Has anyone ever charged a person with making a physical threat towards them? I feel it is within my rights to do so, but I don't really want to make the situation worse. I guess I'll just see how things work out after my meeting and go from there, but this really disheartens me. I work so hard and I give so much and this is what I get.

[FlyingScot, RN]

What I was getting at is that if there is documentation that another caregiver "ripped something" out of his arm you are in the clear for that. I think filing a report with security was the right thing to do. I don't see much value in escalating at this point. I probably would have had security remove the daughter at the time due to her threatening behavior. Personally I would not show up to the meeting alone. I would get an attorney. These meetings never go well for the accused. And yes this is one of the many sucky aspects of nursing.

[johnny depp23]

These stories make me glad I was raised by a bunch of lawyers lol. Long story short, tell whoever it is in your meeting that you want an attorney present with you. This will either: get them off your back, or delay the inevitable. As long as you documented everything and have witnesses, you will be good to go.

I think all nurses should be required to take a course in Introduction to law and legal process and/or law and ethics.

Knowledge is power my friend -

[Ruby Vee, BSN]

i would have documented the patient's complaint that someone "ripped the iv out of his arm" about the time i was documenting the condition of the arm and that i'd notified the physician. that would at least document that you weren't the one who removed the iv. but i'm guessing that since the guy was mean and his family given to threats, "ripping out the iv and throwing hissy fits like a 2 year old" probably wasn't what the other nurse did, either.

i think taking the attorney to a meeting with the nurse manager is just overkill. at this point, i think she probably just wants to talk to you and get your side of the story. she's obligated to look into things to see what happened, and you surely want her to hear your side of the story when she's doing so, right? if you're part of a nursing union, taking your union representative with you would not be out of line, though.

[xInspiredx]

I am curious to know what happened with your case, mj2012. Hopefully it was resolved peacefully.