What to do when a patient alleges staff abuse?

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Non-nurse seeks wisdom/advice on this scenario:

A patient tells an employee that they do not want a certain staff member (who I'll call "X") to care for them again, because X has been rude and "abusive" to them, both in attitude and care. The patient says that they did tell their nurse about X's actions, and they requested that X doesn't care for them again (but they are worried that this request may not be honored), and the patient doesn't want further advocacy. The employee feels torn - they know and are friendly with X, and wonder if X's no-nonsense manner may come across as rude, or if in the course of no-nonsense physical care, the patient may have interpretted it as abusive.  So, the employee relays this conversation to their own boss, without giving any names or identifying info (since the patient didn't want the employee's advocacy and asked that they not speak out about it). The employee isn't sure of what to do beyond this, since the patient said that they told their nurse. The employee wants to ensure the patient's safety and wellbeing, but doesn't want to betray the patient's request not to say anything more, nor do they want to put X through the process of allegation/etc., but they DO want to make sure that they do the right thing, whatever that is. And then they also wonder: if they do something more, should they tell X, and the patient, that they did? 

IreneTouTheou said:

Thank you, The  snag here is that I won't be able to speak to the patient for a while because of circumstances, so I can't follow up right now.

I realized my wording was ambiguous. I meant now as in "these days;" this is how I would now handle a situation like this after years of patient interactions and observations. Sorry about that. I don't actually think you should go back to this patient for further clarification about this.

A case could be made that you have met your duty by relaying this to your supervisor. If anything, you could touch base with your supervisor again to check if there is something more you are supposed to do.

This is probably super bad advice to give on the internet (I wasn't there and know nothing other than what you have told us), but I get bad vibes about someone who doesn't want serious attention brought to the matter but is okay with spreading the accusations among the coworkers of the accused. Speaking of Karens, everybody knows how to demand a manager if they think they have been wronged. ? There's something that really doesn't sit well with me about an allegation where the person decidedly doesn't want the manager (or anyone that can do anything about the situation), they just want to tell 2 or 20 of the person's peer-level coworkers. 

I think you're done here.

IreneTouTheou said:

I feel so in the middle and haunted by this. I feel bound by the patient's request not to say anything, 

This is the answer right here. There are processes in place to protect patients from abuse but they also serve to protect staff from unfounded allegations that can be very damaging to their reputation and career. 

If the patient wishes to make a complaint anonymous or otherwise it is absolutely your responsibility to give them information on how to make a report. If they don't want to make a report leave it at that. We are all well aware of our duty to protect and advocate for our patients but I think in this case you also need to be a little concerned about your co-worker. You specifically mention rudeness and abuse. Rudeness is a perception and varies a lot in how it is perceived but it hardly abuse. Are you really going to wade into this mess over "rudeness".

Specializes in I am not a nurse.

I really appreciate the time, thought, and wisdom you've shared with me about this. One thing I should have mentioned in greater clarity (in my effort to be brief and vague for anonymity's sake, I didn't go into detail about this) is that the patient said that they asked that the employee not care for them again, but there was a pretty solid evidence that the employee had again been assigned to the patient. So, I saw my role as twofold here: to ask the patient if they had told someone about the employee's attitude/roughness/"abuse" (and the patient said they had already done this and spoken to staff), and 2)my offer to advocate for them, to speak to someone higher up and re-state that the patient does not want that employee caring for them again (and the patient declined my offer for this, said that if they decided to have me speak to someone, they would let me know). While because of circumstances I'm not able to speak to the patient now, someone else in my identical role is also available (and familiar) to them, and they could share the concern with them. I did ask my boss about doing anything more, and may do that again. 

Specializes in I am not a nurse.
kp2016 said:

This is the answer right here. There are processes in place to protect patients from abuse but they also serve to protect staff from unfounded allegations that can be very damaging to their reputation and career. 

If the patient wishes to make a complaint anonymous or otherwise it is absolutely your responsibility to give them information on how to make a report. If they don't want to make a report leave it at that. We are all well aware of our duty to protect and advocate for our patients but I think in this case you also need to be a little concerned about your co-worker. You specifically mention rudeness and abuse. Rudeness is a perception and varies a lot in how it is perceived but it hardly abuse. Are you really going to wade into this mess over "rudeness".

Thank you - the patient said that the employee's attitude was rude, and they cited an incident of the employee's physical care that they felt was physically abusive and rough, and I asked if the patient had told someone about these incidents, and they said that they had. It sounded like the big thing at the moment was for the patient to have some peace of mind that the employee would not be caring for them again (they had requested it, but apparently, that request may not have been honored), and that's why I  offered to speak to someone about that (and the patient declined my offer). I did tell the patient that if they changed their mind, I would be available to be their advocate. Unfortunately -- and unexpectedly -- I'm not able to be in the facility for a time to follow up about this, so without mentioning anything the patient told me, I asked my coworker (who is also in my role) to visit the patient in my absence (and to let the patient know that I won't be there for a while). I'm hoping that the patient will be comfortable enough to share any concerns with the coworker. 

Specializes in ER.

Id inform the patient that unless they give permission for you to inform your supervisor, no one will know who they don't want caring for them. You don't have the power to rearrange staffing without a reason. You can let your boss know the patient has issues, and encourage the patient to talk to them, but after that, bow out. Not worth the stress or bad feelings on all sides.

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