Shocked At Nurses Actions Tonight

[PMFB-RN]

I work part time at a local SNF / rehab faciliety. On PM and NOC shift it is staffed with 3 or 4 LPNs and one RN charge nurse (tonight it was me). One of our LPNs is a sweet young girl from a very small town near by. She is in a BSN program to become an RN as well. She was late to work and I assinged her to care for a new admit who is recovering from a serious MVA. She took report and went to meet her patient. She came back out of the room about 5 min later very upset. She demanded to know why I hadn't told her the patient was a muslim in report. I asked her why it mattered. She said that "those people are all trying to kill us!" and she couldn't understand why the patient was even admited or even given medical care in America! She flatly refused to provide care for this person. Nothing I said to her had any affect on her. She actually got angry at me for trying to explain why this person needs and deserves nurses care.

I ended up sending her home without pay and doing to work myself. I am only part time at this place and while I supervise LPNs and CNAs I am not their boss with the power to hire and fire. I did write a letter to the DON explaining the stuation and recomending that the LPN be fired. I also intend to inform our state board of nursing of her actions. I had another LPN who heard the whole thing write down what she had heard and submit it to the DON as well.

I consider her to have abandoned a patient that she had taken report and accepted responsibiliety for.

I understand that she is from a small, all white town and know from previous conversations with her that she has never so much as had a conversation with an african america person or any other minority except the Amish (many in this area). She aslo claims to be a very devout christian and is very involved in her church but I think her attitude is not compatable with nursing.

[kukukajoo, LPN]

I haven't read most of the responses but did want to comment on the situation.

It sounds to me this young nurse is just plain ignorant and needs to be educated. Will firing help? I am not sure. I most certainly think that some education and more training would be in order. When one has seen how the media portrays certain groups of people we tend to believe to a certain extent and some are more naive than others. Think about how we as amercians view the Chinese or the remote tribes in Africa. Why do we see them that way?

Did you tell her if she does not care for the pt she will be considered to have abandoned him or did you just in frustration tell her to go home, therefore excusing her from her duties?

[PMFB-RN, RN]

OK couple things. I called DON's house today. SHe is visiting relations out of state but I got the number. Called her today before work and while she didn't say so she seemed anoyed that I had bothered her about it. Her attitude is that it seems like this can all wait until Monday to sort out. I did get an OK to not use the LPN for the rest of the weekend if, in my judgement, I can do without her.

To answer a couple people's question, no the patient had no idea any of this happend. I have (and am currently) personally taking care of him. No problem.

I want to respond to some of the comments made about muslims by certain posters. My regular job is in the ICU at ****** Hospital in Marshfield Wisconsin (not the faciliety we have been discussing). A many of our doctors are muslims. Most of the hospitalists seem to be muslims. I work closely with these people and as a group they are good and skilled doctors who daily display great compassion to our patients. I would be happy if my child was under their care. I also want to point out that many muslims are currently serving bravely and honorably in the US armed forces as you read this. When I was in the army I served with many muslims. Almost all of them were native born Americans and good citizens. There are still lots of African Americans who have converted to islam serving in the military.

Just some things to consider. My lunch is almost over and I have to go now. More later.

[Daytonite, BSN, RN]

I called DON's house today. She is visiting relations out of state but I got the number. Called her today before work and while she didn't say so she seemed annoyed that I had bothered her about it. Her attitude is that it seems like this can all wait until Monday to sort out.

If I were the DON I'd be more than annoyed at someone who got my relatives telephone number and called me over a holiday about a disciplinary problem. She's right! This could have waited until Monday morning. There is supposed to be someone assigned to take administrative calls for problems with the facility during non-business hours and that chain of command is supposed to be followed to the letter. As a hospital supervisor we knew exactly who to place phone calls to when there were emergent situations that required a decision by an administrator above our level of authority. And, it had better be serious enough for them to put their clothes on and high tail it to the hospital. I agree that the LPN who refused to provide care to the patient was wrong, but to disturb the DON about it during her time off? Very bad judgment call in my opinion and experience. It's very possible that you may be in trouble now as well.

[Spidey's mom, ADN, BSN, RN]

Poor original poster . . . first we all implore you to contact a higher up and then you get a post that you may be in trouble. I almost always agree with Daytonite too but in this case I think it was the right thing to do to call. Maybe I'm just spoiled - our DON was always open to having us call her with problems.

steph

[pagandeva2000, LPN]

I think that you did the right thing...this woman is very small minded. I would have said trade, but as you stated, she was late. Why should someone else have to alter their assignment if they came on time. I have had issues with quite a few patients I have dealt with, but I try and keep in mind that they have to be safe under my care. I would certainly question how she would conduct herself as an RN with a higher degree, and the example she would be setting for other people.

[pagandeva2000, LPN]

Poor original poster . . . first we all implore you to contact a higher up and then you get a post that you may be in trouble. I almost always agree with Daytonite too but in this case I think it was the right thing to do to call. Maybe I'm just spoiled - our DON was always open to having us call her with problems.

steph

Personally, I can't see why the original poster would be in trouble for calling the DON during off hours. I can see the DON being annoyed, yes...this wasn't a sentinel event...and personally, I would have waited until Monday, however, I think that at the most, she may be chewed out for calling for a non-critical issue. This should be at her desk first thing next week, but, again, I don't think she has to worry about her personal job.

[Daytonite, BSN, RN]

Subordinate help get ticked off for one reason or another in LTC facilities all the time and act up. It happens a lot on the off shifts. When you are a supervisor in one of these facilities you have to learn how to handle these situations smoothly. 99.9% of the time it sure doesn't require a phone call to the DON at home. As a supervisor I learned a long time ago how to handle these fools and the scenes they want to subject everyone to. It is what it is--attention-getting behavior. A supervisor can't be intimidated by those they supervise. I have no argument with anyone's personal views about nurses being non-judgmental, but it applies to all nurses, those in leadership positions as well. One's job responsibilities or actions should not be driven by their emotional feelings toward another employee, but by the breaking of rules and the application of discipline.

Try calling your nurse managers at their homes to tell them about someone you sent home because they refused to take care of a patient for any reason and see what kind of reaction YOU get from your boss. When I was a nurse manager, I would have torn your head off and put it where the sun don't shine if you'd done something like that with me. Work issues need to stay at work. My time at home is my time unless I instruct you otherwise.

[ZASHAGALKA, RN]

I would have rather risked the minor annoyance of a 2 minute phone call than the major annoyance of the chain of command being out of the loop on such a major event.

Sending someone home for a whole weekend is not a minor disciplinary action.

You did the right thing calling. If anything, you greatly tempered her being even MORE annoyed come Monday morning. At least, she cannot complain that you left her out of the loop.

It's a good call. If you don't CYA yourself on stuff like this, it's amazing how discussions can turn towards YOUR actions instead of addressing the issue at hand.

I stand by my previous advice. It didn't hurt her vacation greatly to discuss this with you for 2 minutes.

~faith,

Timothy.

[Lacie, BSN, RN]

Subordinate help get ticked off for one reason or another in LTC facilities all the time and act up. It happens a lot on the off shifts. When you are a supervisor in one of these facilities you have to learn how to handle these situations smoothly. 99.9% of the time it sure doesn't require a phone call to the DON at home. As a supervisor I learned a long time ago how to handle these fools and the scenes they want to subject everyone to. It is what it is--attention-getting behavior. A supervisor can't be intimidated by those they supervise. I have no argument with anyone's personal views about nurses being non-judgmental, but it applies to all nurses, those in leadership positions as well. One's job responsibilities or actions should not be driven by their emotional feelings toward another employee, but by the breaking of rules and the application of discipline.

Try calling your nurse managers at their homes to tell them about someone you sent home because they refused to take care of a patient for any reason and see what kind of reaction YOU get from your boss. When I was a nurse manager, I would have torn your head off and put it where the sun don't shine if you'd done something like that with me. Work issues need to stay at work. My time at home is my time unless I instruct you otherwise.

My time as a Nurse Manager I got called frequently at home. Whether it be couldnt find coverage for a call in or someone refusing to care for a patient, doesnt really matter. Yes it would be nice to wait till Monday but I agree that sending someone home and preferring they not come back.....Call!! Not just covering yourself on the patient care aspect but it can also lead to legal issues if the employee wants to do so if fired down the road for this action. So in the long run your covering the DON's rear also that she is up to date on what's happening in her house so to speak. I've learned a long time ago alittle orifice chewing is much better than ending up in a legal battle or dealing with other consequences that can arise if you didnt call.

[DutchgirlRN, ASN, RN]

IN my entry interview for my new job, I had to answer and list patient sceneros where I would switch care and not accept a patient! That way a charge nurse knows what type of patients I am uncomfortable giving care for. That can be changed upon getting report

I thought that was a good idea...let it be known straight off the bat before being hired, and have it documented right of the bat too!

Wow, that surprises me. As a former charge nurse I cannot imagine making out the assignment having to be concerned that a nurse felt uncomfortable with a certain type of patient. That seems so bizarre to me.

I think the LPN was definately wrong to demand to know why a Muslin was admitted, making a scene and refusing to care for the patient. For that I would have sent her home also. If she had quietly asked to switch patients I would have seen if that was possible. I wouldn't want a nurse taking care of me who disliked me simply because of my nationality or for whatever bigoted reason.

I would not demand she get fired. I think that's a decision for administration to make as well as informing the BON. I think she definately needs counseling regarding her extreme predjuice.

[DutchgirlRN, ASN, RN]

I am Jewish. I have cared for many a pt with shaven blonde head and swastika tattoos all over the place. I make absolutely certain to give them the absolutely best possible care. At some point during my interactions with them, I have made it known that I know they apparently admire Hitler and his teachings and I make it known that I am Jewish.

Whoa! I can't believe you would make a comment like that to a patient. Outside of work, hey you've got your rights, but at work, wow, that's out of bounds no matter how good the outcome was.

I am Jewish by heritage, my father was in a concentration work camp in Germany he was very emiciated, had TB and would have died had the US soldiers not liberated the camp when they did.

My mother was in hiding during the war. She had been in a jewish orphanage when the war broke out and her older sister arranged for her to hide amongst a family with 14 kids. Don't ask why her own sister did care for her. It's obvious she was jewish also. The natzi's did not pay much attention to the number of children. If you think these people were kind for hiding my mother think again. They had purely selfish motives. She was 13 years old. They made her sleep in their attic where there was no heat and no windows due to the fact that the bombs had shattered them and there wasn't money to replace windows in an attic. She did housework all day, was not allowed to play with any of the other children and ate when everyone else was done if there was anything left. She had lice so bad they kept her head shaved. When she started her period for the first time she thought she was dying and the mother had no sympathy for her whatever. Basically shut up and deal with it. No explanation as to what was going on with her body.

My relatives were among those who were burned alive, experimented on and left crippled, sterilized without anesthesia, worked in labor camps until they died of starvation or illness. My mother's 5 year old twin cousins were in an experiment camp. One survived one didn't. The one who survived 5 years in that hell, told how when children would cry the soldiers would take a hammer and hit their little hands so hard their fingers broke and she was left with crippled hands.

I would never assume that a person with swastika tattoos admired Hitler and his teachings.

It's easier to assess that they are ignorant, caught up in a way of thinking, and forming opinions about something they know absolutely squat about. I feel sorry for these people in their ignorance.

I know you're aware that their are people who don't even believe the holocaust ever happened. Can't phatom killing 6 million people, I repeat 6 million people simply because of their religious beliefs. Exterminated people just because they were handicapped or retarded regardless of their religious beliefs. It is hard to phatom.

I have never had any negative repercussions and I'd like to think that they have gone away just a little more informed, a little less angry at Jews, and a little more open to the suggestion that we all try to live in peace.

These people with swastikas are ignorant. They are to be pitied. You can't honestly believe that a few minutes with them would really change their minds. If you run into a patient with swastikas who is really extreme (ignorant) you may find yourself in trouble on your way out to your car after work. It's just not worth it.

BTW I would not refuse to care for a person with swastikas. They did not kill my relatives, they weren't even alive during that time in history and as I said they truely do not know squat about what really happened in Europe during WWII.

[Megsd, BSN, RN]

BTW I would not refuse to care for a person with swastikas. They did not kill my relatives, they weren't even alive during that time in history and as I said they truely do not know squat about what really happened in Europe during WWII.

Exactly. Despite what "those people" may have done, your particular patient didn't do it, and he/she should not be neglected or receive subpar or no care simply because people of the same background did something bad.

I am disheartened when I hear people talk so poorly about American muslims for the same reason. When the Sept. 11th attacks took place, I was a freshman in college, in the midwest, where we had a large population of international students (and teaching assistants), including many from Saudi Arabia, Iraq, UAE, Afganistan... you name it. That day and the days after, I saw how they were looked at by other students. I heard conversations in the halls about not wanting to go to class because a muslim was teaching it, or because muslims were enrolled in the class.

It was truly awful, because although yes, bad things happened, these college kids didn't do it, and yet they received the wrath of the whole nation because they looked like those who did it. It's not fair, and it's not right. All patients, regardless of their background, deserve the same quality of care.

I have met several muslims over the years, including friends, students, and instructors (my linguistics prof. in Fall 2001 had the first name of "Osama", in fact. Imagine how uncomfortable HE felt). We have a muslim man in my nursing class, in fact, who even brings his prayer mat to campus so he can pray at the designated times between our lectures. He is an enjoyable person and we all get along. In fact I didn't even know his religion until I saw and recognized the prayer mat, because A) I never asked and he never mentioned it in conversation and B) IT DOESN'T MATTER. A person's religion, yes, is a part of who they are, but it honestly should not change how you look at them, just as the color of their skin shouldn't change how you look at them, let alone how you treat them in the hospital.

I can't comment on the action taken against the LPN because I am not far along enough in school to know the proper procedures for these things, but I am personally appalled and disappointed at her behavior, as well as the behavior of some of the posters who have replied. Oh, there is a lady in my nursing class also who recently got out of the army after serving two stays in Iraq and one in Afganistan. (And she rode convoys weekly, so yeah, she got shot at too.) She treats our muslim classmate with as much respect as she treats any of us. So at least not all veterans come home with such a negative mindset.

Please excuse the long reply, but I couldn't sit by silently any more.