Voice recordings

[ssgmedic]

I have been having issues w/ a new manager and patient complaints. When she first took over the position, I had a very difficult night w/ a patient (4 new IVs to start on patient and 2 foleys w/ the family sitting right next to patient doing absolutely nothing to help). I made was really frustrated by the morning and I made two mistakes (threw my arms up when pt family could see and didn't go talk to the family when they asked (bc we had just discussed what he said he wanted to talk about less than 10 min prior)) leading to a complaint and meeting w/ the manager. I realize I was wrong and have done much better at hiding emotions and maintaining composure.

Then a few weeks later, I picked up on another unit and had a 54 y/o female admitted for N/V/D. I did my normal assessment (including "Can you tell me where we are right now?" & "What year is it?"). I explained to the patient what meds I was giving her and what they were for. I told her about the prn meds (lomotil) and when she could get it next and side effects. At approx 0400 the aide informs me that the patient is upset because I didn't bring jet lomotil to her when it was due. I went and explained to the patient & husband that the lomotil was for each loose stool (again) and if she didn't have any diarrhea that she probably shouldn't take it because it could make her constipated. Patient said "That's fine. I don't want anything until I speak to the doctor." I asked her if she wanted her Bentyl & IVP protonix to which she said she did. I grabbed the meds and the patient took the Bentyl and refused the protonix. I exited the room w/ my standard statement of "Is there anything else I can do for you?" She said no. Then I said "Ok ma'am. Call if you need anything".

The husband then complains to the manager that I had horrible bedside manner, didn't scan anything (I scanned everything except the AM Bentyl) or tell the patient anything about the medications I was giving her. The best part of the complaint is that I "thought I (the pt) was crazy because I asked her the time & place questions. My manager proceeded to give me a verbal on that one. (Those two were last year around September time frame)

Last week, I had a patient who was Renal Insufficiency w/ a UTI. She had a HD graft to her right arm and was a hard stick (I am pretty good when it comes to starting IVs and will at least look on anyone). One the second night w/ her, I noticed her 22g hand IV was leaking a little blood. I told her that we may have to start a new one and gave her the choice of waiting until it went bad or starting another. She said that she'd like to go w/ starting a new one before it blew. I told her I would see the rest of my patients and then come see about a new IV. I returned about 2200 and quietly entered and asked the patient if she was ok w/ doing the new IV or if she wanted to wait. Patient said she was ok w/ new one. I turned on lights to see and attempted twice w/ 22ga IV catheters (even checked w/ the patient between attempts to ensure she was ok w/ another attempt). I got a flash on the second attempt but was unable to thread the catheter. While attempting to thread the catheter the patient said to stop so I immediately complied. The patient later asked for the charge (spoke w/ the CNA) and said she didn't want me back in the room. When the manager arrived Tuesday and said she needed to speak w/ me, I knew it had to be about that patient. The patient said that I told her to "lay down and take it" when she told me to stop. There were other things like I left a mess in the room (was all clean unused IV starting supplies in a nice neat organized spot). This time the manager gave me a write up.

All of this has me looking for ways beyond charting in the actual chart to cover my ass since the manager obviously doesn't believe that I am not being a complete dick who commits assault and battery on his patients. Today I thought about keeping a digital recorder on me like the cops do to have evidence that I'm not being an ass or rude or saying inappropriate things to patients or family. Does anyone know if this is legal? I live in Louisiana and I know that I don't have to notify the person they are being recorded but what about from a HIPPA stand point? If that's not a good idea, what could I do to protect myself? Obviously I can't have a second person follow me around forever but I'm at a loss for actions to take.

I apologize for the length of the post but I felt that the background was important part of this question.

[sirI, MSN, APRN, NP]

Hello,

We moved your thread to another forum from the Legal Nurisng forum. The Legal NUrsing forum is a forum for RNs seeking to become educated as LNCs. Your thread is about patient care, nursing collegues and patient relationships, so we moved it there.

Members will come along and offer helpful information here.

I suggest that you check with the LA NPA about this issue and you might need to seek an attorney to advise you in this situation. We wish well .

[Here.I.Stand, BSN, RN]

Sounds like your manager has adopted the "customer is always right" mentality of Superior Customer Service, to the exclusion of finding out what happened. Based on your account, I'm not sure what you could have done other than scanning everything and being very specific about what "prn" means. FWIW I've had pts get mad at me for not bringing thier q 4 hr prn meds exactly on the 4 hrs without them asking first.

That said, I doubt recording them would go over well. They haven't consented to having their conversations taped, and besides we're not even supposed to keep brain sheets w/ PHI on them after we're done caring for them.

[TheCommuter, BSN, RN]

Today I thought about keeping a digital recorder on me like the cops do to have evidence that I'm not being an ass or rude or saying inappropriate things to patients or family. Does anyone know if this is legal?

If I am not mistaken, I think HIPAA rules forbid the use of voice recordings in areas where direct patient care takes place because protected health information is being exchanged, and therefore, could get into the wrong hands if recorded.

[Been there,done that, ASN, RN]

Your manager is expecting you to placate all of the off the wall/ demanding patients all of the time.

That's not possible.

Manager has you on her radar and will not lose sight.

Time to leave.