Should I report this nurse for unprofessionalism?

[crosew]

I've been working as a home health aide for about 2 months, so I'm fairly new to healthcare and dealing with RNs. I have a regular client who can be a bit high-strung, I guess. He likes things done a certain way and can be a bit picky. But there are effective ways of dealing with people when they're difficult/particular, and as healthcare workers I feel that's our job to figure those ways out.

His RN is a really prickly woman to begin with. At first she took it out on me, in a number of passive-aggressive ways, but I just kept doing my job figuring that something must be going on with her if she feels the need to treat an aide this way. But this week she took it out on the patient. To start with, he said something a little annoying, but she totally blew it up, and they got into a full-blown argument (over something relatively minor)--but she took it a step further by raising her voice and then attacking his character, saying he was a bully, no one wanted to work with him, etc. This went on for about 10 minutes and was really uncomfortable.

My friend thinks I should report her behavior to her employer, and I kind of agree. But I'm also afraid that she won't be removed from the case and then I'll have to deal with her when she might figure out I reported her. Since I'm also new to this field, I don't want to overreact and cause drama, either. Anyone been in a similar situation? Am I being over-sensitive? Should I say something to her employer? I just think it was so unprofessional, and my friend pointed out that she probably has similar problems with other clients if she acted this way.

I get that we all get frustrated at times and it can be hard to keep cool. But she always seems to be in a nasty mood and I thought her response was ignorant and unecessary.

[vintagemother, BSN, CNA, LVN, RN]

This is a tough call. I'm curious to see what OPs with more experience have to say. On one hand, I think it is very very inappropriate for the RN to have engaged in an argument with the pt. that's bad pr care period.

But I also think you're right to be concerned with the repercussions of reporting her.

[jaycam, RN]

Please report her. Our clients need our support. The nurse can be prickly with me all they want. I would rather the nurse being nasty to me than let then harass one of my clients like that. With my client base especially, they tend to already be isolated beyond HHAs and NACs that work with them. The whole part about her telling your client that no one wants to work with him just immediately makes me twitch. Power struggles don't help with clients, it just causes resentment towards staff.

[htown]

I have no experience with this but you should definitely talk to her or report her. you shouldn't argue with a patient tow here it turns into a huge argument that will make the patient stressed.

[edmia, BSN, RN]

The person who needs to report the maltreatment is the patient. Talk to him and see how he feels about it. Tell him you felt uncomfortable and validate the experience for him, but encourage him to speak up. Maybe offer to give your account as a witness, but the main complaint will carry more weight if coming from the client.

Sent from my iPhone -- blame all errors on spellcheck

[realnursealso/LPN, LPN]

As an LPN, doing homecare, a certain case manager RN, was a nasty, unmannerly person. She was hated by the moms on every case I was on. The moms would ask me what to do, so I told them that complaints had to come from the parents. Talk it over with your patient and encourage him to report her. It will be better for the patient, tell him you will back him up. That was patient abuse and it's time someone put her and her nasty attitude in her place. Just because she is an RN, she can still be corrected in her dealings with patients.

[Ruas61, BSN, RN]

Mandated reporters. Has this been forgotten?. It sounds like abuse or maltreatment from your description. You are obligated to report if you are in the States.

[suanna]

Without knowing the details it's difficult to respond, but as a general rule: nurses are to accept abusive belittling behavior with a smile and never make a comment back to a patient even if they are completely oriented and are just being a jerk to the nurse because they can. We are, after all, there to take all the abuse a patient wants to throw at us- 'cus they are sick people and we are supposed to be full of compassion. I'm not sure I agree with this policy but it is the way most people see our jobs.

If the patient isn't playing with a full deck, I can see being a bit upset that the nurse got into a sparring match with an unarmed opponent. Me, just because someone is old, and has some health problems that require assistance in the home, dosen't give him the right to treat a care provider with anything but respect and courtesy. If it happened to me, I would have been tempted to tell him he was being innapropriate and I wasn't going to tollerate it. Sometimes a nurse just gets tired of being the doormat.

[Ruas61, BSN, RN]

Calling someone out on their behavior and setting boundaries is one thing. I am all for that course of action.

However, engaging in verbal arguments with patients particularly as described by the OP is likely going to buy you trouble.

Explaining that to the Board is not going to be easy.

Patients can be horrible, I have seen and experienced it.

There's a list that I have that would be fed to the zombies when the ZA happens.

Some parts of the job blow, this can be one of them.

[crosew]

I talked to the client again today to see how he felt about reporting the incident. Apparently he had reported her for something else to her employer and she got in trouble. But he seemed more upset about the thing that they were arguing about than what I was concerned about, which was her maltreatment of him. I understand, as someone said, that we need to set boundaries and with alert and oriented pts (as he is) she could have definitely responded in a way that was firm, respectful, and appropriate. I think I am going to talk to the managers at my org since they have more experience and can steer me in the right direction. I also definitely want to report it if this does indeed constitute abuse...I hate to think she is doing this to other, possibly more vulnerable, patients.

[caliotter3]

Allow the two to work it out this first time. But if it happens again, definitely report her.

[MLSTTS2015]

I would report her.