Unfair suspension

[ILoveRatties]

I took care of a pt who had a daughter who truely was borderline personality disorder. DeLing w/ her was crazy, as those familiar w/ bpd know. The pt was end-stage and the daughter's vehement; furious demands were contrary to the patient's best interests. Anyway, I advocated for the pt and her needs. The daughter was furious. I only cared for the pt once, as the daughter asked that I not care for her mother. The pt's other daughter was very apologetic about her sisters behavior, and begged that her mother not suffer, which I totally agreed with. One day later, the MDs forced the issue and the family made her comfort measures only. She died peacefully shortly thereafter. The crazy daughter saw me as the family wad leaving the hospital and yelled awful things at me. Well, it turns put that she called the DOH, and the hospital is frantic to satisfy the DOH, and I was suspended for 2 days via a phone call from my boss. I was not obnoxious at all, just tried to sort out the truely wrong demands of this woman. The other sister was completely fine with me and appreciated my efforts to help this family understand end-of-life options. I've been through it personally more than once, and have always been thanked by families whom I have helped through that experience. I am angry that I am the hospital's sacrificial lamb to satisfy the DOH complaint. What, if amything, should I do?

[orange_dolphin]

I'd hire a lawyer and fight it. You should get paid leave of absence while there's an investigation.

[mmm333, LVN]

unpaid suspension implies wrongdoing. paid suspension means external investigation which may or may not be unrelated to you, and could result in a determination of wrongdoing on your part.

It is murky whether "suspension" is always a bad thing. In my opinion, it means "time to get another job soon" because I consider suspension to be something that "sounds bad" and can thus be turned against you later - "she is a bad nurse! see?, look, she was suspended once already!" Think of the impression it makes on a jury, a judge, or anyone hearing the story.

Nursing suspension is not the same as police suspension. cops get suspended all the time, for days and weeks. Nursing suspension is bad news. It means that your administrator or DON are trying to wrap you up in something and deface your license or employment record in order to discredit you. This happens when you know too much or are perceived as a threat, or simply work too much overtime. They are trying to make you look bad and ruin your credibility. Time to find another job or get ready for a legal battle. If you have a union, that makes a legal battle much easier in most cases. If you work in a SNF, just find another job because they make the rules unfortunately.

[jadelpn, LPN, EMT-B]

People can act very strange to say the least coming to terms with someone's impending death. Just because someone acts like they don't have sense, doesn't label them a borderline. And more so, if the daughter is clinically a borderline, that comes from trauma, and who the heck knows what kind of family dynamics were going on there. In any event, seems to me that you were the one who had the very first "real" conversations with the family, and they were unable or unwilling to hear or cope with what you had to say. Any introduction to "guess what, your mother is dying" talk needs to come from the doctor, needs to be dealt with by the social worker, and not left up to the nurse to be the first one to set everyone straight. Prior to that conversation, I would definetely defer to the charge nurse to speak with the family about a conference with the MD. Instinct kicks in and we want families to be prepared, we want to be clear on the plan of care, we want everyone to be on the same page--but as a back up when the doctor tells them about the terminal nature of the patient's condition, and a social worker can prepare the family for the events to come. Therefore, yes, they are angry at you--to be the first one to say it out loud, it seemingly makes it so (and could even be construed by some as your "fault" for labeling their mother, therefore, every nurse is going to treat their mother as a dying patient). They may not have had any earthly idea that their mother's condition was terminal, impending terminal, and were very shocked to hear it from you. It is all crazy, and a bad spot to put yourself in, but even worse for the patient, who needs peace, comfort, and pain free as opposed to the sh** storm that you unknowingly started. It could be considered beyond your scope. It could be considered a number of things. However, you do have the right to know what the complaint says, and I would not get into calling the person at the DOH that the daughter called and the like, as then it makes you look like you are attempting to get into unethical territory. I would, however, ask for a copy of the complaint. Ask what your rights are as far as answering to the complaint. Ask if the complaint goes away if unfounded. Does it get reported elsewhere? Speak with HR about same.

From here on out, document carefully, don't give medical information if the doctor has not had the opportunity to review and speak with the patient and family first, defer to adminstration if you find yourself in a sticky situation with a difficult family. That is why they get paid the big bucks.

[Harmony2]

Tough day! My best advice is when you have a difficult person such as the daughter. Politely leave and call your supervisor to assist. Taking it up the chain is often better than trying to handle it yourself. Family members are not always as they appear.