Please bear with me while I try to explain my dilemma.
I'm an RN student, doing rotations in a large hospital. I've rotated off and on a med/surg unit over the past few weeks. There is a nurse (Nurse R) on the unit that has been assigned as a preceptor (of sorts) for the students while we are there.
Here's my "issue." Nurse R seems a bit psychotic. During report she makes comments (judgements really) about the patients social situations. Some of the remarks are based on ethnicity, some are about class, stupidity, being sleezy, being an annoying patient... you get the idea.
She is projecting an attitude of that care (or lack of) is based on if SHE thinks the patient is deserving. Poor patients that make bad choices in life, lower class people, needy elderly, obese, minorities, certain ethnic groups are put into her category of "bad" patients. Bad patients don't deserve the same level of care as good patients. She even goes so far as to look up history (including social work reports, financial information, etc.) on patients she is not assigned to take care of "just in case." She gossips in a way that is mind boggling. I've actually had to just get up and leave the area. I feel sick to my stomach sometimes when she starts a rant about a patient.
Am I naive? Is this normal? I heard the other nurses doing it to a minor degree, but nothing anything near this level. Maybe the everyone does it, maybe I just don't hear them. This nurse talks badly about patients in front of other nurses in the med room, the break room, at the desk -- EVERYWHERE!!! I am mortified. I want to crawl under a rock.
I guess what I'm trying to say is ... what do I do .. as a student when my preceptor seems borderline psychotic and is behaving in morally and ethically inappropriate way? Talk to someone at my school? Talk to someone at the hospital? Write up an anonymous comment and send it to HR a few weeks from now. Oh and she's not new. She's been a nurse at this facility for 10+ years. Please don't tell me this is the reality of nursing in a big hospital. I'll just quit now.
nothing in your original post actually pointed to any neglectful care on nurse r's part, and other than reading other patient's charts, all you stated was that she talked negatively about ppl.
either we read two different posts or we just don't see things the same way because i do not agree with your comment above. there is a lot in the original post that actually points to neglectful care on nurse r's part. the op goes on in later posts to clear up misunderstandings that this thread was started due to a preceptor giving substandard care based on her bias against certain types of patients.
and the op makes an impassioned plea for help in understanding this.
from the original post:
"she is projecting an attitude of that care (or lack of) is based on if she thinks the patient is deserving. poor patients that make bad choices in life, lower class people, needy elderly, obese, minorities, certain ethnic groups are put into her category of "bad" patients. bad patients don't deserve the same level of care as good patients. she even goes so far as to look up history (including social work reports, financial information, etc.) on patients she is not assigned to take care of "just in case." she gossips in a way that is mind boggling. i've actually had to just get up and leave the area. i feel sick to my stomach sometimes when she starts a rant about a patient.
am i naive? is this normal? i heard the other nurses doing it to a minor degree, but nothing anything near this level. maybe the everyone does it, maybe i just don't hear them. this nurse talks badly about patients in front of other nurses in the med room, the break room, at the desk -- everywhere!!! i am mortified. i want to crawl under a rock."
Disagreeing with me is one thing, I accept disagreement and internalize it, think about the other side and whether my way of thinking could be improved. I appreciate your comments, and have enjoyed reading these posts. I am wise enough to realize that unless I actually hear or see a situation, that there is always a "gray" area somewhere in the middle of what each person says is the truth. Put 5 people in the car on the same trip, and you get 5 different versions of the trip!
Anyway, I am mostly speaking from my experience in nursing school. I didn't feel like my opinion mattered much, and quite frankly, I just wanted to finish and GET OUT because of that. Furthermore, now that I have been working, I see very different personalities, races, ways of thinking, bad work ethic, good work ethic, comedians, and wonderful people where I work. That being said, knowing how I thought in school, and being in the trenches now, I see things that could be misconstrued words, that as a student, I would have been offended by. But working day in and day out with the same people, have realized that's just who they are, and really are great nurses.
I just don't get snarky and combative about people disagreeing with me, and on some level it kinda hurts my feelings because i truly try to look at a situation from that person's shoes, and in no way mean to belittle them. My whole attitude in this world is to try to "help" people, because I know that is the only way to be. I'm not perfect, I don't know everything, and I welcome opposing opinions. Realizing that all we are giving is our "opinion."
Disagreeing with me is one thing, I accept disagreement and internalize it, think about the other side and whether my way of thinking could be improved. I appreciate your comments, and have enjoyed reading these posts. I am wise enough to realize that unless I actually hear or see a situation, that there is always a "gray" area somewhere in the middle of what each person says is the truth. Put 5 people in the car on the same trip, and you get 5 different versions of the trip!
Anyway, I am mostly speaking from my experience in nursing school. I didn't feel like my opinion mattered much, and quite frankly, I just wanted to finish and GET OUT because of that. Furthermore, now that I have been working, I see very different personalities, races, ways of thinking, bad work ethic, good work ethic, comedians, and wonderful people where I work. That being said, knowing how I thought in school, and being in the trenches now, I see things that could be misconstrued words, that as a student, I would have been offended by. But working day in and day out with the same people, have realized that's just who they are, and really are great nurses.
I just don't get snarky and combative about people disagreeing with me, and on some level it kinda hurts my feelings because i truly try to look at a situation from that person's shoes, and in no way mean to belittle them. My whole attitude in this world is to try to "help" people, because I know that is the only way to be. I'm not perfect, I don't know everything, and I welcome opposing opinions. Realizing that all we are giving is our "opinion."
Document what is said verbatim and then talk to your assigned faculty at the school. The faculty should be able to assist you in taking this information to the appropriate person at the hospital. This issue may even need to be resported to the State Board of Nursing - again, consult your faculty at school. Don't let it drop. Be prepared to go forward and quote chapter and verse of what was said and when. If your faculty is hesitant (sometimes they hate to make waves as clinical slots for students can be hard to obtain) go above his/her head to the director of your program. In our state (AZ) we can also make a confidential report to the Board of Nursing, all done 'online'.
I commend your professional attitude and your ethics. Keep pursuing this as this is a person who may need help but in the meantime shouldn't be spreading these thoughts in a nursing area.
I bet she has the most gold stars attached to her badge as well. How can management not know certain things about certain people? I've heard nurses actually swear on the floor, and then laugh with each other, and get another pin in their badge. It's beyond me. Certain people get treated a certain way from management and others would be fired. I have no idea how to change it. If I were you, I wouldn't say anything - it is being allowed to go on.... I don't think you need to tell anyone it is happening when they already know. A tiger doesn't get it's stripes overnight.
What a HUGE HIPAA violation. She should (really must) be reported to the Corporate Compliance hotline of that institution. These are anonymous reports and your name will not be mentioned.
How sad that this is your preceptor! I have been a nurse for 27 years (APN for 23) and have heard most any and everything from all kinds of staff. Remember, it is sometimes hard for people not to fall into that kind of talk when it is going on. That doesn't excuse the behavior nor really explain it - just a simple statement of fact. What has your response been? Have you reported this to your "supervisors" (i.e., your instructor, dean of your school, the unit director, etc.)?
Remember, we are here to protect patients from harm. I guess the bigger question is, would you want this person caring for you or someone you loved? Would you want her to continue to be a "role model" for the nurses coming up behind you?
You will become no more ethical as a nurse than you are right now as a student. The right thing to do is report it up the chain of command, starting with your nurse instructor. I am so sorry you are going through this distress, but you will be able to sleep with a clear conscience, no matter what happens. And as this is whistle blowing you have protection under the law if anyone chooses to retaliate. Document clearly, concisely and objectively. I admire you for speaking up and for being willing to bring something that is so clearly wrong into the light of day. I would be proud to work with you.
OP, I understand why you're upset. This nurse's behavior is reprehensible. Unfortunately, you'll find that nursing has its share of creeps like any other profession.
I agree that you should report it to your clinical instructor. Some hospitals also have a number you can call to anonymously report issues that affect patient care and/or ethical concerns.
I don't think you need to lighten up at all- what this nurse is doing is flat out wrong.
You will become no more ethical as a nurse than you are right now as a student. The right thing to do is report it up the chain of command, starting with your nurse instructor. I am so sorry you are going through this distress, but you will be able to sleep with a clear conscience, no matter what happens. And as this is whistle blowing you have protection under the law if anyone chooses to retaliate. Document clearly, concisely and objectively. I admire you for speaking up and for being willing to bring something that is so clearly wrong into the light of day. I would be proud to work with you.
This is nice. If only it were that simple. Unfortunately, the nursing floors are politically driven. It is who you know and who you are connected with. If this nurse, who has "proven" herself to be such an asset that she is mentoring new nurses, has connections - then going up against her is a risk. This has nothing to do with right and wrong and what you should do on your part - it is about how will you survive and get a job. You will be filing a complaint against someone who you know nothing about with respect to who her friends are.... There will be responses on this board that this does not matter. I've seen it first hand. It matters, believe me.
Agree 100% with above post by cosmicsun. I am not saying the nurse's behavior is acceptable, it's actually horrible. However, if she has been a nurse there for 10+ years I guarantee her superiors are aware of the situation and for some reason condone it. Definitely discuss this with your instructor first, as making a wrong move could negatively impact both your schooling and your future employment options. I am not encouraging you to ignore the situation, just encouraging you to talk to your instructor first and to get a better idea of the "office politics" that may be involved before proceeding with a formal complaint. Kudo's to you for standing up for the patient's and good luck!
Spidey's mom, ADN, BSN, RN
11,305 Posts
either we read two different posts or we just don't see things the same way because i do not agree with your comment above. there is a lot in the original post that actually points to neglectful care on nurse r's part. the op goes on in later posts to clear up misunderstandings that this thread was started due to a preceptor giving substandard care based on her bias against certain types of patients.
and the op makes an impassioned plea for help in understanding this.
from the original post:
"she is projecting an attitude of that care (or lack of) is based on if she thinks the patient is deserving. poor patients that make bad choices in life, lower class people, needy elderly, obese, minorities, certain ethnic groups are put into her category of "bad" patients. bad patients don't deserve the same level of care as good patients. she even goes so far as to look up history (including social work reports, financial information, etc.) on patients she is not assigned to take care of "just in case." she gossips in a way that is mind boggling. i've actually had to just get up and leave the area. i feel sick to my stomach sometimes when she starts a rant about a patient.
am i naive? is this normal? i heard the other nurses doing it to a minor degree, but nothing anything near this level. maybe the everyone does it, maybe i just don't hear them. this nurse talks badly about patients in front of other nurses in the med room, the break room, at the desk -- everywhere!!! i am mortified. i want to crawl under a rock."