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Discussion

Rn in charge who has a temper?

Hi, Nursing student / Nurses aid,

I have recently encountered a situation which I have to admit I suspected was going to happen eventually.

I work night shift with a very smart and very good RN who has over time been a caring friend as well, a few weeks ago she had told me of a situation where she had been having a tough time with a male resident in the care home who was calling her names and trying to hit her.

She admitted she clipped in behind the ears in frustration, but she said that the minute she did it she knew it was wrong an felt bad, so I didnt say much as I didnt witness it.

Okay so you all know what is coming now dont you, yup, I was working with her and we have a lady who has dementia and has a pretty good right hook, which caught this RN by surprise to which she retaliated by grabbing this ladies arm and forcefully pulled it towards pretty much making her hit her self.

This RN has a reputation where if you cross her path she can and has managed to use the system to her advantage in order to get rid of people. Since this I have been seething inside as I know that I should be reporting it, but I admit there is the element of fear as I will be graduating in 4 months and dont want it all to be in jeopardy, I know that is selfish......

Can anyone offer some ways to deal with this in a tactful manner, so I can stop beating myself up over it.

Milenko

Featured Replies

Report her anonymously

  • Experts

You have a duty of care to act as an advocate for your patients/residents.

You have a duty of care to yourself.

When good people stand by and do nothing, 'evil' prospers.

The only difference between those patients/residents, and the rest of us; they got there before us! Our turn will come, eventually. If it was yourself or your loved one, would you want the caregiver treating you this way?

And, while she's doing it to them, she's also covertly, doing it to you!

There is NO place in the healthcare profession for bullies, abusers, assailants.

Challenge your feelings of fear. Fear is an emotion which can be converted into strength. Strength to conquer the feeling of fear and do what you know is right and responsible.

Always remember, at the end of the day, we all have to live with ourselves and we cannot do that in freedom, peace and joyfulness if we carry guilt or regret.

I wish you courage and send my best wishes to you.

The above poster already touched on this but just think of that patient as your parent. Would you want that going on? If not then you need to report it. It is just the right thing to do.

However if you do not report it and this gets out somehow along with the information that you know then you may be looked at as just as responsible as the RN abusing the patient. These issues can be extremely serious. This can cause a suspension or termination of license for both of you (in your case can stop you from being eligible for a license). It is of the upmost importance that you tell someone.

There is no way to make this situation pretty but you are not the one to blame for this AND REMEMBER THAT! I wish I could tell you that policies and actions were always just but they arent. You may get fired, they may believe the RN in charge, you may get harassed but in my experience when you do the right thing, it does always work out in the end.

She may try to make you feel guilty however she is the one who is being inconsiderate of the patient and you. She has the problem not you. I would go to the DON and tell her about the situation.

You will be required to write the situation up and perhaps talk to the appropriate investigators. Stay strong!

As a person who "retaliated" when a patient hit me (I was trying to put in a feeding tube, she slapped me and then tried to pull it out and I slapped her hand), I realized after it happened that I needed help with my anger management issues. The hospital hotlined me to elder services, the hospital put me on unpaid leave while they investigated and had me jump through several hoops to come back to work (which I did gladly). I got counseling, took anger management, got on antidepressants. To be honest, I'm glad it happened the way it did because it forced me to get help for my depression and anger, and I re-evaluated my job as a float and whether I wanted to continue with it. It was a one time thing and I got help immediately. You may be doing your co-worker a favor by reporting her, and you should be able to do it anonymously if you are afraid of repercussions. As others have said, think about if it was your mother that was hit by this nurse. The fact that I slapped a patient's hand still mortifies me (although I would be upset with my mother if she was in the hospital and hitting the staff).

This RN has a reputation where if you cross her path she can and has managed to use the system to her advantage in order to get rid of people. Since this I have been seething inside as I know that I should be reporting it, but I admit there is the element of fear as I will be graduating in 4 months and dont want it all to be in jeopardy, I know that is selfish......

What everyone else said, and this, too: if she's done it to other people, don't think that she won't do it to you, too. It's just a matter of time. I'm not saying don't report her, just that she would be willing to turn her back on you, as well.

You have a duty of care to act as an advocate for your patients/residents.

You have a duty of care to yourself.

When good people stand by and do nothing, 'evil' prospers.

The only difference between those patients/residents, and the rest of us; they got there before us! Our turn will come, eventually. If it was yourself or your loved one, would you want the caregiver treating you this way?

And, while she's doing it to them, she's also covertly, doing it to you!

There is NO place in the healthcare profession for bullies, abusers, assailants.

Challenge your feelings of fear. Fear is an emotion which can be converted into strength. Strength to conquer the feeling of fear and do what you know is right and responsible.

Always remember, at the end of the day, we all have to live with ourselves and we cannot do that in freedom, peace and joyfulness if we carry guilt or regret.

I wish you courage and send my best wishes to you.

I could not say it any better!!

Mary Ann

It is your duty to report her. What if you didn't and next time she gets "mad" she seriously injures a resident. OMG. You can't worry about you right now as bad as it sounds. You have to fight for the patient, who else will?

What everyone else said, and this, too: if she's done it to other people, don't think that she won't do it to you, too. It's just a matter of time. I'm not saying don't report her, just that she would be willing to turn her back on you, as well.

Cute CNA has a point also, If this nurse does in fact have this 'reputation' then that will work to your advantage. think about it; if 'everyone' knows that she can be malicious, then why would they doubt what you are saying? Who would they believe-you, with no agenda, or her, with a history of vindictiveness? You have an obligation to help these people, as I often tell my kids, 'Sometimes doing the right thing s**ks, but good karma will come back to you'-or something like that! Best of luck, and let us know what happens...

I'd tell if I were you. If the DON is any kind of a DON she'll want to get rid of this RN.

  • Experts

no matter how much power and knowledge of the system you think this rn has, she can't get rid of you unless you've done something wrong and it can be proven. your defense to any false allegation she might make against you in the future is to adamantly deny what she is accusing you of and demand the don do nothing without further proof as it is your word against the rns. also, once she's reported, she is going to have to answer for what she's done. do you think you can trust the don? if so, i would have a closed door talk with the don and start out by telling her that you are very fearful of retaliation by this rn, that you have something to report about her, but you want the don's reassurance that she will protect you from the wrath of this nurse. if you get that reassurance then i would tell her what this rn had said to you and what you observed. i would follow it up with a memo addressed to the don that you write detailing the talk you had with the don and signed by you to get it memorialized in case something comes up in the future where you need proof of your actions. the don is going to need some kind of write up on this anyway for the rns personnel file.

i have been an aide, staff rn, supervisor and nurse manager over the years and here is what i know that perhaps you do not yet know. when a don in a ltc facility is told about an incidence of physical patient abuse they have a legal duty to report it to elder services of the state so it can be investigated. the don knows that if she fails to do that, she and the facility can get into big, big trouble with the state. now, think about it. if you know and the don now knows about this rn, don't you think the don has no choice but to do something about this nurse? if you want to assume the worst (that the don does nothing and tells the rn what you said), this don still has to consider that you can always report to the state agency yourself and that you can, on your own, contact the patient's doctor and family, as well, which would make the don and the facility look pretty stupid. i doubt very much that the don is going to be willing to put her own employment at risk to protect this rn of yours. the don also has a responsibility to respect your confidentiality in this once you have requested it. however, it's possible that the rn is going to figure out who told on her unless your don is very clever and finds a way to approach this so the rn never has a clue as to who said something. also, you don't know that the rn hasn't made similar confessions to other people on the nursing staff or that others have also seen her doing this and have not reported her for the same reasons as you.

as a manager i would take into account your previous record. if after reporting someone for misbehavior, that person suddenly starts telling me about all kinds of wrong doing on your part, red flags are going to go up all around me. this is where the manager has to use her common sense and wonder why a good employee is suddenly "gone bad". it doesn't make sense. upon hearing what you had to report i would start interviewing all the other staff working with this rn to get statements from them before saying anything to the rn. that way, if word gets around that the don is asking questions of all the staff about this rn, the rn in question is only going to wonder just what the heck is going on. and, if the rn asks you if the don questioned you, you just say yes, but you said nothing. if the rn accuses you of being the one who said something to the don, for your own preservation you just lie and deny, deny, deny. let her be mystified as to how she got found out. i'd suggest to her that maybe someone else saw her do something to a patient and tattled on her. i'd go further to make her feel comfortable and say something like, "isn't that just like a coward." let her think you're her buddy although you and the don know the real truth. also, don't talk about this to anyone else on the staff. you'll be safer that way.

my experience has been that people who physically abuse patients do it again and again. it's sad, but eventually they get caught because they pick on the wrong patient, leave physical evidence on the patient, or someone else sees them.

here is an interesting case of physical abuse that happened when i was a night supervisor in a ltc. i got a call around 10am in the morning just as i was settling in at home to go to sleep. i was asked by the don if i knew anything about a patient, mr. x, being roughed up by two of the night shift nursing assistants. no, i didn't know or hear anything about it. turned out the patient who was a little demented went up to his day shift charge nurse, rolled up the sleeves of his long sleeve shirt and asked her if there was something that could be done about the nurses who did that to him. he had bruises going completely around both wrists. csi couldn't have done a better job since you could see that some of the bruises were in the shape of finger marks on his skin where he had been held in restraint. it was always amazing to me that he didn't get any skin tears from it. he insisted that it was two nurses on the night shift, but couldn't tell them names or describe them. it wasn't hard to figure out. there were only two nursing assistants assigned to the unit he was on that particular night. when confronted with the evidence the don had collected, the aides admitted what had happened. they were trying to dress the man for breakfast, he got belligerent and started slapping at them. they grabbed both his wrists and forcefully dressed him. the incident was reported to the state, the family and the doctor. it became one of the many reasons i ended up leaving this facility because the don did nothing to punish these aides. but you can be sure i watched them like a hawk. i never let the two of them work together ever again while i worked there as their supervisor.

whatever you decide to do, i would watch this rn like a hawk and i would at least stop her from hitting a patient while i was at her side. think about how you would handle this if you are ever in the position of being the supervisor of aides or the don over a nursing staff. this is a real world problem and there are answers.

Report her. I had the same problem when I worked in LTC, except it was a fellow aide. Not only would she hit patients she was verbally abusive. I felt like crying everytime I worked with her. I reported her anonymously and she was promptly fired. If you don't report her and they find out that you saw this, I think you'd be in trouble also. Like someone else said, if she does this with one patient, she will do it to others.

  • Author

Hi, everyone

I have just read all of the supportive posts and you may have a good idea of how heavy my chest is, I have almost been in tears because I know deep down that you are right I need to report this. One problem, I trust the DON however her sidekicks all have big mouths and no concept as to confidentiality.

In turn I have had time to think and act and here is what I have done, I know I may be criticised for this but after much consideration and self beating I thought this would be the best conclusion. Ready

Basically I wrote down what she had told me, and I also wrote down the details of the incident I witnessed and of course dated it and made 2 copies one I mailed to myself so it has the actual postage stamp on it, and I kept one on a floppy.

I called this RN and invited myself over for coffee, we sat and chatted and I very casually broached this subject, basically I explained how hurt I was that she would even consider putting me in this position, and I aslo acknowledged her positive points as well.

To make a long story short, she now knows that I have this safely documented, I have assured her that just because I am a student and a friend that I am a co-worker first and my duty of care is to the patients and in no un-certain terms if this type of thing happened again on my watch I would not hesitate to report her and submit the preserved documentation from previous.

She was very shocked to say the least but I suspect she will be watching her own moves as well as mine so as precaution I have made up a good excuse as to why I need to have my shifts changed to suit my studies.

This has been a very hard lesson to learn, I am an ex-office manager it was my job to keep people happy but to be honest as well, trust me I have become stronger for it.

Thanks again everyone for your support.

Milenko

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