Guest1201992

I will try to make this brief. I work on a psych unit in a not so good hospital in a not so safe city I have seen a lot of abuse since I started working here 10 months ago, but yesterday takes the cake. We have a young pregnant patient with bipolar disorder with psychotic features. She was put on a 1:1 for impulsive violent behavior. Despite her aggression, she is for the most part fairly easy to manage as long as you treat her with kindness an respect. One of the verbally abusive MHAs, lets call her Caroline, called her stupid. She is always insulting patients and has been to HR multiple times. I don't know why she still works there. As expected, the patient didn't take this well. She threw a cup of water at her. And who can blame her? This is where is goes from bad to worse. Another MHA, let's call him Landon, puts his arm around the patient's throat from behind. She is taken to the quiet room, where she hysterically cries and hits her head against the door. I had to give her an injection. I was mad, because it was the MHAs fault, but the PT was hurting herself so I had too. PT throws herself on ground and resists the injection while sobbing. My view was blocked for this next part, but I believe he pushed her back hard. Remember she is 36 weeks pregnant, and he is much bigger than her. One of the good MHAs "Sally" protects the patient from Landon. The patient has marks on her neck I go home and call the police and tell them what happened. I walk into work the next day, and who do I see, still working on the unit as though nothing happened? Landon. I ask Sally (because I trust her) if the police came. She said she was with the patient on the labor and delivery unit for 4 hours, so she isn't sure. But I don't believe the police did much if they came because Landon was still there. I have worked here for 10 months and everytime I report abusive behavior nothing happens. I have talked to my nursing manager and the director of the unit I have talked to an attending. I tried the recipient rights guy I called the police I even made a report to the Department of Health months ago. And still nothing changes I tried to do things the right way. The wrong way felt like my only other option. I ended up rolling back security footage of Landon assaulting the patient. I recorded it with my phone, violating HIPAA. Another nurse saw what I was doing and told my manager. I clocked out and left immediately after taking the video. My plan was to send the video to Office of Inspector General. My hope was actual proof instead of a complaint would lead to justice. How much trouble can I get in for deliberately violating HIPAA? Honestly, I'm afraid of going to jail. Does anyone think that will happen?

So my boss wants me to come back. I feel like they kinda guilt-tripped me by saying the patients need me. They said I can call out abuse and refuse to let other RNs from scanning meds into my MAR. I have considered going back, but it feels like a stupid idea; I already "tattled" on a lot of my coworkers and made a report to the dph. If the investigation goes anywhere (I hope it does) I am sure they will know it is me. Truth is I do wanna go back because I love the job itself (talking to patients, charting, giving meds) but I do not want to deal with staff gossip or patient abuse. To top it off, I do not trust a lot of my coworkers, and it is hard to function as a team because of this. Should I leave or stay?

UPDATE I put in my resignation and listed all the patient maltreatment I have seen. I also left an anonymous complaint to the DPH. To top it off I also left my contact info for the Recipient Rights advocate. My supervisors asked me to come in and talk. They want me to reconsider, and stay on the unit. While walking into the building, I bumped into my coworker, who told me there had been another incident the day prior. The same charge nurse who threatened the elderly schizophrenic man, actually did assault another patient. Apparently, this patient didn't want to take his meds from a mental health associate (apparently the charge nurse let her do this because she was graduating nursing school??), and I think the charge nurse actually hurt the patient. This patient was also an elderly schizophrenic man (I'm noticing a pattern). I brought up this new incident today and apparently my boss knows he has a history of doing this. He said he has talked to this nurse before. It then felt like my boss was trying to make excuses for this RN. He said the RN had been in the army, that he was getting burnt out from working there so long, and that apparently he gets very angry when he sees patients threatening female staff members because he has daughters. It alarmed me that my boss knew that this was a reoccurring issue and did not terminate this guy. And I don't think anything going on in this charge nurse's life excuses this behavior. It disgusts me that his actions are being portrayed as some noble deed, sticking up for us women in the office. None of us ladies have asked him to threaten/ assault patients on our behalf. The good news though is that my coworker told me the Recipient Rights Advocate was pissed. I have talked to him before, I hope he can do something. Anyway, my boss said that he is working on a culture change on the unit, that he has already fired people who were not a positive influence. Now on one hand I feel for my boss, we are extremely short staffed, and this hospital is not in the safest neighborhood, he probably cannot afford to fire some people. I feel so gross about the whole thing. I want to be there for my patients, but the abuse is not OK. Also, a handful of my coworkers and I are not on good terms because I don't like a lot of the behavior I have seen, how am I supposed to work with staff that are pissed with me? And assuming the DPH does their job, I'm sure most people will guess that I was the one to make a report. A part of me feels guilty for reporting, because I don't want the place shut down. This place may be terrible, but it is still better than being homeless (a lot of patients are) or someone getting hurt because there was no hospital to go to (quite a few patients have threatened their family with knives). My hope is the DPH will get this unit to run better, make positive changes instead of closing it down. What the heck is the right thing to do here?

Not doing vitals on a sleeping patient is one thing, not giving psychotropic medication because you can't be bothered to wake the patient up, which results in a prolonged stay at the hospital and major miscommunication b/w staff is a different matter entirely.

Update Probably quitting this job this week. Got into a fight with two other nurses. I had a patient who would take his risperdal every night that I was passing out meds. This guy falls asleep early, so I make sure to get him his meds before he falls asleep, and if he does fall asleep, I wake him up and he calmly and politely takes them. Another nurse however, did not give him the meds, she would chart "patient refused" because she wouldn't wake him up when he fell asleep. So this patient comes up to me one day, and is confused because the doctors told him he had been "refusing" his meds. I walk into report and there is a note about how this patient has "sporadic compliance with meds" and as a result was more than likely going to court. When I tried to talk to the nurse about this (I was calm, not accusing) she closed the door in my face. We got into another disagreement regarding meds later, because of the "nursing dose" she was doing. She went into an office and screamed (yes screamed) about me to another nurse. Next day, a different nurse (the one who my coworker complained to about me) yelled at me in front of staff and a patient, about how I was "telling other nurses how to do their jobs" and needed to "stay my own lane" I tried to talk it out, it didn't work, I am done. Thank you guys so much for responding, my coworkers made me feel like I was overreacting or being too sensitive. It meant a lot to see the support. Last question, does anyone have experience in reporting a facility to the DPH for misconduct?

klone, Thank you for responding. I feel like I'm going crazy because that behavior is so common on the unit. One woman's clothes were lost/stolen in the ER, and she was crying and yelling loudly on the phone about it. A doctor took one look at her and said they had to give her a shot. He didn't even ask if she wanted to talk about what happened to help her calm down. I am so fed up with my coworkers. Thank you again for responding

I started at a psych unit a couple months ago and this is my first job as a nurse. I don't like the way I hear staff talking to/about the patients. Examples: One patient had a history of domestic abuse, and a coworker told me "her boyfriend probably hit her because of her mouth". Another nurse joked about how fat a patient was and that she was an "***" then this nurse proceeded to be nice to her face. An 18 year old was put in 4 point restraints and one guy "joked" they would let her *** the bed and they could just change the sheets when she started yelling she had to go to the bathroom. Same guy talked about how "dumb" all the patients are Worst coworker called a developmentally delayed patient "***" and a "***" in the break room. One schizophrenic patient, old skinny guy, threatened to beat up a female staff member. The charge nurse, very tall heavyset man, got in this patient's face and started yelling at him and threatening to hurt the patient, then when he was done yelling he turned to me and told me to give him a shot. I felt like this charge nurse just wanted to feel tough so he started threatening him. When a tall heavyset woman was combative, this nurse put in a mouth guard and let me give the shot, like he was afraid to do it or something. All of these people are my fellow nurses. I have seen coworkers give the "nursing dose" where they give extra ativan and haldol. Or sometimes they give an injection, then leave the med vials out and tell me to scan and chart it in the computer for them, which terrifies me because I was taught "don't chart it if you didn't give it" in nursing school. Got into a fight with a coworker today about that. I love my patients, but I hate my coworkers. What do you guys think?