Should I report this CRNA?

[RNPamP]

Hi everyone, sorry for the length of this post. I had a situation happen to me at work on Friday that I would like to get some feedback on. I am a PACU RN with 5 yrs of experience, and I consider myself to be extremely competent at what I do. Here is the situation: a male CRNA brought a lap chole patient out to PACU still intubated with an oral airway in place. Almost immediately upon arrival, the patient began to wake up, gagging on ETT, sitting up in bed, etc. At this point, the patient wasn't even on a monitor yet, and the CRNA extubated the patient. After the extubation, he turned away from bedside to throw away the tube and the patient contined to gag and cough quite severely on the oral airway. Thinking of risk of aspiration, I quickly removed the airway (which is something nurses on our unit do all the time). Also, there were 2 other nurses at the bedside with me who were both saying we needed to take the airway out. Anyway, the CRNA became very angry, saying "Don't you ever remove MY airway!". I tried to explain that she was gagging and seemed to be at risk for vomiting and aspiration, but he was too worked up. The next thing that happened is the part that I am thinking of reporting him for--he grabbed my arm and tried to pull me away from the bedside. I pulled away from him and said, loudly, "Don't you ever put your hands on me again; that's completely inappropriate for you to touch me!" :angryfire After that I think he realized what he was doing and he apologized, and we went back to business as usual. (In case you're wondering, the patient did fine). The more I think about it , the angrier I become, and I really want him to be reprimanded for his inappropriate and intimidating behavior. If you were in my situation, what would you do? I am thinking of putting the incident in writing and giving a copy to his supervisor and my manager. I just don't think I should let this go away. After all, how many other times has he probably done this (or worse) to someone else? Thanks for any help you all can give me.

[Marie_LPN, RN, LPN, RN]

The grabbing was uncalled for. Write him up.

[meandragonbrett]

Is he a hospital employee? Most anesthesia folks are employed by the hospital. You might not get very far if not. I'd still report it.

[Laurel RN]

He definitely should not have grabbed you. It depends on how you want to handle it. If you don't want to write him up, you could talk to your manager and ask her to handle it. But if you are really upset and want to make sure it gets addressed, then write him up. Yelling at you is bad enough, but grabbing you is uncalled for. You should definitely do something so that he starts to understand that this kind of behavior is unacceptable.

Who knows, maybe he'll think twice before acting like this again!

[DoubleblessedRN, ADN, RN, EMT-B, EMT-P]

He assaulted you and had no right to make any physical contact. Write him up and you'll be glad you did. Just wondering: isn't the oral airway supposed to be removed before the pt is extubated?

[bethin]

Without a doubt, write him up. He layed his hands on you in a hostile manner. Please, please write this up. If not, he may continue to do it. Evil prevails because good men (and women) stand by and do nothing.

[morte, LPN, LVN]

i would write him up, and asap, just in case he attempts to write you up for interferring with his patient care....good luck

[noggin_wise]

I think a write up is appropriate but don't be surprised if he does the same to you for the airway incident.

[traumaRUs, MSN, APRN]

I think a write-up is appropriate and feel you did nothing wrong at all. No one should lay hands on you, be it a housekeeper, CNA, another nurse, MD or APN.

[RNPamP]

Thanks to everyone for the advice. I have written up the incident and reported it to my acting nurse manager, her supervisor, and the CRNA's supervisor (figured I'd cover all my bases). I'm glad to hear that others would also report the incident; I was trying to convince myself that it wasn't a big deal but of course it was. BTW, I think if he decides to write me up he doesn't have a leg to stand on, the patient met all criteria for the removal of the airway. Also, there is nowhere that it says "only CRNA's can remove airways" and he's only going to make himself look bad by saying he was going to leave in an airway on an awake patient. I stand by my decisions, and I managed to keep my cool!

[Charity, RN, APRN]

Keep us informed if anything else comes of this!

[camoflage]

Just a teaching point here (from a CRNA) ..... If a patient is actively gagging then the patient is actively protecting his/her airway from aspiration.

I personally would not have had an issue with you removing the oral airway (I probably would have beat you to it if the patient didn't beat us both to it)

camo