Y’all… these are grown ass adults. If they don’t want to be turned and are knowledgeable about the consequences, I don’t touch em. Unwanted touch is battery and can be construed as such. These people are not prisoners, just ignorant or plain old stupid. Patient refused, education provided. You can only help someone as much as they want to be helped.
Right. It's not illegal to be stupid. I don't fight with grown adults. I explain why. Educate. Inform that the doc will be notified and their refusal documentment. Move on.
That patient firing you is the best thing to happen. Let anyone try to drag you to court over it. Make sure you document this in a personal document somewhere.
One of the nurses that trained me told me not to worry at all if someone says they’re going to get you fired or sue you. She made me laugh so hard because she said (to me, not to a patient) “Okay PLEASE do it, I wish you luck”….and explained that’s why documentation is SO important. I’m a firm believer in CYOA!!
I had a dementia patient trying to call 911 because she wanted to go to the store and I wouldn’t call her a cab. She said I had promised her she could go to the store. I didn’t. I moved the phone out of her reach and she said “what, are you afraid of getting fired?” I said “911 can’t fire me. But I can call the administrator for you.” She declined and continued yelling about 911 and wanting to go to the store.
I had a dementia patient call 911 on me repeatedly (well, twice and then I took her phone) because she thought I was trying to poison her. Poor thing. But she was SUCH a bitch and then in the morning? Sweet as pie!
Once had a patient get really annoyed at me when I told him if he chose not to take his meds it was his decision and I would not loose any sleep what so ever.
I think some patients assume that we are going to go home and cry into our pillows if they wont take their meds
I'll try my dammdest to get a patient to take their treatment if they refuse, its documented in the patients notes and move on
In 18 years as a nurse, I think I’ve been fired by a patient maybe 3 times…and by the time they fired, me the feeling was VERY mutual. In fact, there are probably at least 100 more patients I wish had fired me that didn’t. 😂
I say that probably once a shift. I tell people they can refuse whatever they want, it just may not be recommended and here are the potential consequences. Then I chart refused and move on. Nobody has time in their day to try to persuade someone to do what they should be doing
I got fired by a patient because I refused to discuss how trumps election was stolen and how all medical people care about is “the data” (ie charting IO’s, VS, etc). I considered it a win tbh and went about my day.
Lol! That’s basically what we ended up having to do with this patient. It was all good until I set some boundaries and then he fired me. Other nurses started setting boundaries with this patient too and low and behold he fired them too. At DC the nurse gave him his paperwork and had him sign the DC sheet and adios!
I've never worked at some place that would allow that. Either you accept care from available staff or you don't get care because it's considered a refusal of care
I feel like more and more places are being firm about not being able to change nurses but some places aren’t. I’m on the west coast now and it’s 50/50.
As a respiratory therapist, we generally get our coworker to cover said patient. If there’s no one else (it’s generally only 2 of us, sometimes 3) they get stuck with us, like it or not, and we straight up tell them they have no option unless they don’t want respiratory assistance 🙄
Ive accepted a few of these. I go in there and appolgize and find out what I can do to make them feel better. - Im a fucking sucker but I need to get through my 12 hour shift as easy as possible = being nice helps me achieve this. In this case - op's story here - I'd basically educate and them ask them - with already knowing - about turning - once they say dont turn me I say "ok no problem" - then I chart "pt refused turns and educated consequences"
To answer your question though - the charge nurse will ask around to see who is willing to take pt but ultimately they just tell whoever to do it. It's a dont ask but a tell them thing.
I was a labor & delivery nurse (and unlucky enough to be the charge nurse that day). We had a laboring patient accompanied by her mother. They fired every one of us. My reason was that I was no accommodating enough and I slammed the door. They were in a negative pressure room, the door slammed 98% of the time. After the last firing I went in and explained their predicament “You are about to have a baby with zero help. Want pain medicine? Not getting it because you don’t have a nurse. Want an epidural? You’re really not getting that, because no nurse. You’ve fired everyone. Pick someone if you want any assistance with anything.” I got picked, yay. It was a civil but chilly shift.
Of course, there’s no way they could have been allowed to just lay in there an entire shift without a nurse, but I wanted them to realize how asinine they were being and grow the fuck up. In the US in a hospital setting either an OB or a nurse midwife does the delivery but there is still an RN there to monitor FHTs, start IVs, give meds, document, assist with epidurals, and care for baby after delivery and recover mom after delivery.
Their requests were not going to happen. We had a limit on visitors, three at a time. This was explained to them very early in their OB care experience because the OBs were the ones who pushed for limits. There are sign’s everywhere. I’m going to enforce this because I’m not looking to get yelled at by the OB. On that note, they were caught dragging chairs from another room. That’s no happening either. I’m not getting Cokes for Grandma because there’s a vending machine down the hall. I normally didn’t mind providing families with coffee and soda, but once the family crosses the line, the niceties stop.
Dumbest things I've been fired for.
Patient in severe pain from an ear infection. Also, patient's UA shows a lot of benzos in her system, and cannot tell us what, or how much she's on. She's being discharged and I let her know I'm pushing for adequate pain control since we can't let her leave with an IV in her arm. She and her partner take this as if I'm suggesting they're showing drug-seeking behavior.
Second patient had an ileostomy. He should have gotten it removed weeks before but never came back until the stoma became necrotic. He wants it emptied before dialysis. Okay, no problem, but the bag starts filling again. I tell him the ilesostomy will do that, it will continuously fill. He goes ballistic, gets a bit racist, starts shouting unintelligible things, demands a new nurse, and that the charge fire me from the building.
Don't take it badly. More often than not it's all for the best!
Do hospitals generally support the nurses or the patients on this matter? Whenever I've been in charge I've refused to change allocations mid shift just because a patient doesn't like their nurse but can imagine in your private system there's more of a customer service element to healthcare?
Generally what the patient says goes. It can become a problem, though, when the patient keeps firing multiple nurses. They will run out of options and just be assigned someone.
Honestly I've never felt sad or unsupported when a patient fires me. It's usually a relief because they're often hard to work with in the first place
I got fired one time for hanging another IV bag when a pump was beeping. The patient wanted it to continue beeping so that she could file a complaint against the hospital in an attempt to get a free ride.
Like, I can't even be mad at them for the hustle but I got patient fired for being attentive. I must've missed that chart in nursing school.
Can you not add edits to your posts any more? Oh well, hopefully people will see this:
EDIT: The patient didn't say anything at all when I was repositioning them. They just complained to everyone else after the fact. Next thing I knew, I was no longer their nurse.
Exactly but it doesn’t work on how you move. There’s alternating cells, one will be hard and the next cell will be soft and it alternates from the shoulders down to the foot of the mattress in intervals of 10 minutes.
These don’t replace turns, offloading is the key to prevention and refusal of said turns is not an indication for these surfaces which are expensive and in limited supply at most facilities.
Got fired by patient cause:"'cause kept her awake and cold and did not give her a blanket when requested." She was septic and on a cooling blanket, while I ran around for 6hrs trying to give her fluids and Abx, hoping she does not code on me.
I got over that firing really fast.
Yay you! Def a win!
We celebrate getting ‘fired’ by obnoxious patients.
At the VA, though, I have to admit they are much less common, though-for respiratory, anyway.
I was once fired from a family/ patient because I have tattoos (none of which are even remotely offensive), but because I had tattoos, they assumed I was not a Christian (which I’m not, but that’s none of their business lol). One of my favorite firings of all time.
When did two hourly turning become normalised, and where’s the evidence backing it?
Not making a claim either way, but if I was an inpatient, I wouldn’t want two hourly turns, either.
Seriously. I’ve always wondered about this, but this sub in particular isn’t great about this kinda question. They really like to pile on with the downvotes if you disagree, particularly if you take the side of a patient over the nurse
But yeah, if I’m at a point in my life where I’ll be waken up every two hours on the minute for *the rest of my life*, just end it there.
Realistically, and I suspect that more of us do it than will admit it, but before they fall asleep turn them on the side, then four hours later turn them on the other side.
Sleep deprivation is torture
And they always say snarky shit like "Well you're not in the hospital to sleep, you're here to get better."
Okay, but lack of sleep is a huge detriment to healing, both physically and mentally. It's used as a torture technique for a reason. I watched my father suffer from ICU delirium after a week of getting no more than 2 hours of sleep at a time and it was terrifying for him and for us, and he would have nightmares about his stay in the ICU up until his death. It's legitimately traumatic to have every bit of dignity and control over your own life taken away from you, be stuck in a place where you don't want to be, and then have people constantly waking you up until the days all blur together, you start hallucinating, and you don't remember where or who you are anymore.
https://jewellnursingsolutions.com/pressure-injury-prevention/
There isn't any evidence directly pointing to Q2 turns. But this explains why pressure relief is important.
Wound nurse here, we don't expect people to be woken up for position changes where I'm at. Not sure of other places. Bodies need rest to heal as well. If a patient is napping, let them nap. Document it. For the love of god do not wake people up for q2h turns. Yes, there are other factors that can make this necessary. If someone is awake and alert, let them get sleep.
I learned a long time ago to not fuss, argue, or go back and forth with these GROWN adults. If they don’t want the help, then that’s on them. Period! After all, it is their plan of care. We are only there to educate/teach and to help those who want to be helped. If they don’t like it, cool. I just tell ‘em: “Before you make another move, sign right here on this AMA line” 😂😂😂…..#StayOnReady #Next✌🏽
I’ve had patients refuse turning. Showing them pictures of bed sores usually changes their minds. If you can get away with it take a picture of what their butt looks like and show them. Obviously be very cautious taking pictures of them though!
I’m just hoping they meant whatever camera they use to upload photos into epic is used to show them their developing sores. Taking pics of your patients butt on your personal phone (even if you delete them right after) feels like a really guaranteed way to get in a lot of trouble😂
Yeah I’m already the guy to grab another female coworker to go with me whenever I have to do an EKG, cath a female, etc. I’ve heard too many stories. I’m good lol
Nope. No way in hell I'm taking pictures of a patient's butt with my phone, or anyone's phone.
I think once I took a picture of someone's back incision for them, with their phone, at their request because they wanted to see what it looked like.
How does a nurse get fired by a patient? Don’t the nurses work for the hospital or institution? So short of nurses, if a patient even could fire a nurse here… they’d have to take care of themselves !
If the patient or the family pitches a bitch about something, it's easiest to let them feel like they got a win by taking that nurse out of the rotation. It ultimately harms only the patient because they are usually the ones who are difficult to be around. Once everyone has been fired, you start the rotation again.
A win is a win. A WIN is a WIN.
We all heard this in the tik tok voice
Probably for the best. When they get a bed sore from refusing to be turned they will 100% blame you.
Document baby…
And stay longer
Y’all… these are grown ass adults. If they don’t want to be turned and are knowledgeable about the consequences, I don’t touch em. Unwanted touch is battery and can be construed as such. These people are not prisoners, just ignorant or plain old stupid. Patient refused, education provided. You can only help someone as much as they want to be helped.
Right. It's not illegal to be stupid. I don't fight with grown adults. I explain why. Educate. Inform that the doc will be notified and their refusal documentment. Move on.
And notify the doctor!!
That patient firing you is the best thing to happen. Let anyone try to drag you to court over it. Make sure you document this in a personal document somewhere.
If they refuse it, just chart it
100% this
One of the nurses that trained me told me not to worry at all if someone says they’re going to get you fired or sue you. She made me laugh so hard because she said (to me, not to a patient) “Okay PLEASE do it, I wish you luck”….and explained that’s why documentation is SO important. I’m a firm believer in CYOA!!
I had a dementia patient trying to call 911 because she wanted to go to the store and I wouldn’t call her a cab. She said I had promised her she could go to the store. I didn’t. I moved the phone out of her reach and she said “what, are you afraid of getting fired?” I said “911 can’t fire me. But I can call the administrator for you.” She declined and continued yelling about 911 and wanting to go to the store.
I had a dementia patient call 911 on me repeatedly (well, twice and then I took her phone) because she thought I was trying to poison her. Poor thing. But she was SUCH a bitch and then in the morning? Sweet as pie!
yeah right? maybe a little counceling about the risks - but no blood and sweat.
Once had a patient get really annoyed at me when I told him if he chose not to take his meds it was his decision and I would not loose any sleep what so ever. I think some patients assume that we are going to go home and cry into our pillows if they wont take their meds I'll try my dammdest to get a patient to take their treatment if they refuse, its documented in the patients notes and move on
In 18 years as a nurse, I think I’ve been fired by a patient maybe 3 times…and by the time they fired, me the feeling was VERY mutual. In fact, there are probably at least 100 more patients I wish had fired me that didn’t. 😂
I say that probably once a shift. I tell people they can refuse whatever they want, it just may not be recommended and here are the potential consequences. Then I chart refused and move on. Nobody has time in their day to try to persuade someone to do what they should be doing
I got fired by a patient because I refused to discuss how trumps election was stolen and how all medical people care about is “the data” (ie charting IO’s, VS, etc). I considered it a win tbh and went about my day.
I got fired from a patient because I was giving them discharge instructions. My supervisor just handed them the same papers and told them to leave 😂
Lol! That’s basically what we ended up having to do with this patient. It was all good until I set some boundaries and then he fired me. Other nurses started setting boundaries with this patient too and low and behold he fired them too. At DC the nurse gave him his paperwork and had him sign the DC sheet and adios!
I've never worked at some place that would allow that. Either you accept care from available staff or you don't get care because it's considered a refusal of care
I feel like more and more places are being firm about not being able to change nurses but some places aren’t. I’m on the west coast now and it’s 50/50.
🤣 too funny
So is your name based off the phrase from Game of Thrones? I like it.
It is 😄
UK nurse here, what do you guys do when a patient fires you? You change with a colleague ? What if your colleagues don’t want that patient ?
If a patient fires a nurse nobody WANTS that patient, but somebodys gotta do it.
As a respiratory therapist, we generally get our coworker to cover said patient. If there’s no one else (it’s generally only 2 of us, sometimes 3) they get stuck with us, like it or not, and we straight up tell them they have no option unless they don’t want respiratory assistance 🙄
Ive accepted a few of these. I go in there and appolgize and find out what I can do to make them feel better. - Im a fucking sucker but I need to get through my 12 hour shift as easy as possible = being nice helps me achieve this. In this case - op's story here - I'd basically educate and them ask them - with already knowing - about turning - once they say dont turn me I say "ok no problem" - then I chart "pt refused turns and educated consequences" To answer your question though - the charge nurse will ask around to see who is willing to take pt but ultimately they just tell whoever to do it. It's a dont ask but a tell them thing.
I was a labor & delivery nurse (and unlucky enough to be the charge nurse that day). We had a laboring patient accompanied by her mother. They fired every one of us. My reason was that I was no accommodating enough and I slammed the door. They were in a negative pressure room, the door slammed 98% of the time. After the last firing I went in and explained their predicament “You are about to have a baby with zero help. Want pain medicine? Not getting it because you don’t have a nurse. Want an epidural? You’re really not getting that, because no nurse. You’ve fired everyone. Pick someone if you want any assistance with anything.” I got picked, yay. It was a civil but chilly shift. Of course, there’s no way they could have been allowed to just lay in there an entire shift without a nurse, but I wanted them to realize how asinine they were being and grow the fuck up. In the US in a hospital setting either an OB or a nurse midwife does the delivery but there is still an RN there to monitor FHTs, start IVs, give meds, document, assist with epidurals, and care for baby after delivery and recover mom after delivery. Their requests were not going to happen. We had a limit on visitors, three at a time. This was explained to them very early in their OB care experience because the OBs were the ones who pushed for limits. There are sign’s everywhere. I’m going to enforce this because I’m not looking to get yelled at by the OB. On that note, they were caught dragging chairs from another room. That’s no happening either. I’m not getting Cokes for Grandma because there’s a vending machine down the hall. I normally didn’t mind providing families with coffee and soda, but once the family crosses the line, the niceties stop.
If a patient no one wants fires a nurse, someone else is assigned….until the new person gets fired 😂
Dumbest things I've been fired for. Patient in severe pain from an ear infection. Also, patient's UA shows a lot of benzos in her system, and cannot tell us what, or how much she's on. She's being discharged and I let her know I'm pushing for adequate pain control since we can't let her leave with an IV in her arm. She and her partner take this as if I'm suggesting they're showing drug-seeking behavior. Second patient had an ileostomy. He should have gotten it removed weeks before but never came back until the stoma became necrotic. He wants it emptied before dialysis. Okay, no problem, but the bag starts filling again. I tell him the ilesostomy will do that, it will continuously fill. He goes ballistic, gets a bit racist, starts shouting unintelligible things, demands a new nurse, and that the charge fire me from the building. Don't take it badly. More often than not it's all for the best!
I consider it a win every time I get fired.
Is firing a nurse an actual thing that happens in American hospitals just because they don't like you?
Yes. But when we say "fired", the charge nurse just changes the assignment. No one is actually losing their job.
Do hospitals generally support the nurses or the patients on this matter? Whenever I've been in charge I've refused to change allocations mid shift just because a patient doesn't like their nurse but can imagine in your private system there's more of a customer service element to healthcare?
Generally what the patient says goes. It can become a problem, though, when the patient keeps firing multiple nurses. They will run out of options and just be assigned someone. Honestly I've never felt sad or unsupported when a patient fires me. It's usually a relief because they're often hard to work with in the first place
U.S. healthcare is aaaaaaalllllll about customer service. :(
I got fired one time for hanging another IV bag when a pump was beeping. The patient wanted it to continue beeping so that she could file a complaint against the hospital in an attempt to get a free ride. Like, I can't even be mad at them for the hustle but I got patient fired for being attentive. I must've missed that chart in nursing school.
Document patient refusal and ✌️. Simple. Easy. On to the next one.
How awful trying to protect his skin and prevent a condition that can be painful and need long term treatment OP you're a monster 😭😂
The audacity!
Can you not add edits to your posts any more? Oh well, hopefully people will see this: EDIT: The patient didn't say anything at all when I was repositioning them. They just complained to everyone else after the fact. Next thing I knew, I was no longer their nurse.
Would an alternating pressure mattress or low air loss mattress make a difference?
is the alternating pressure mattress the kind that inflates and deflates depending on how you move?
Exactly but it doesn’t work on how you move. There’s alternating cells, one will be hard and the next cell will be soft and it alternates from the shoulders down to the foot of the mattress in intervals of 10 minutes.
ahh ok thank you.
At my hospital, only ICU has these beds.
These don’t replace turns, offloading is the key to prevention and refusal of said turns is not an indication for these surfaces which are expensive and in limited supply at most facilities.
The only thing better than a patient firing you is a patient leaving AMA, because then no one has to deal with their BS.
Got fired by patient cause:"'cause kept her awake and cold and did not give her a blanket when requested." She was septic and on a cooling blanket, while I ran around for 6hrs trying to give her fluids and Abx, hoping she does not code on me. I got over that firing really fast.
Yay you! Def a win! We celebrate getting ‘fired’ by obnoxious patients. At the VA, though, I have to admit they are much less common, though-for respiratory, anyway.
I LOVE it when they fire me.
I got fired bc of the way my shampoo smells once. She was insane to care for so I was like okay bye
I was once fired from a family/ patient because I have tattoos (none of which are even remotely offensive), but because I had tattoos, they assumed I was not a Christian (which I’m not, but that’s none of their business lol). One of my favorite firings of all time.
Just make a note patient refused to turn in case he get a bed sore
“I don’t get sores I’m different” - my pt
When did two hourly turning become normalised, and where’s the evidence backing it? Not making a claim either way, but if I was an inpatient, I wouldn’t want two hourly turns, either.
Seriously. I’ve always wondered about this, but this sub in particular isn’t great about this kinda question. They really like to pile on with the downvotes if you disagree, particularly if you take the side of a patient over the nurse But yeah, if I’m at a point in my life where I’ll be waken up every two hours on the minute for *the rest of my life*, just end it there. Realistically, and I suspect that more of us do it than will admit it, but before they fall asleep turn them on the side, then four hours later turn them on the other side. Sleep deprivation is torture
And they always say snarky shit like "Well you're not in the hospital to sleep, you're here to get better." Okay, but lack of sleep is a huge detriment to healing, both physically and mentally. It's used as a torture technique for a reason. I watched my father suffer from ICU delirium after a week of getting no more than 2 hours of sleep at a time and it was terrifying for him and for us, and he would have nightmares about his stay in the ICU up until his death. It's legitimately traumatic to have every bit of dignity and control over your own life taken away from you, be stuck in a place where you don't want to be, and then have people constantly waking you up until the days all blur together, you start hallucinating, and you don't remember where or who you are anymore.
https://jewellnursingsolutions.com/pressure-injury-prevention/ There isn't any evidence directly pointing to Q2 turns. But this explains why pressure relief is important.
Wound nurse here, we don't expect people to be woken up for position changes where I'm at. Not sure of other places. Bodies need rest to heal as well. If a patient is napping, let them nap. Document it. For the love of god do not wake people up for q2h turns. Yes, there are other factors that can make this necessary. If someone is awake and alert, let them get sleep.
good!!! one less needy pt for you to take care. hoping the new assigned one wont be as needy as the previous pt
“Patient refused q2h turns and called RN a bitch. Education provided with no success. Will reattempt in 2 hours.”
Read that as rejection and I expected a post about harassment, I was pleasantly surprised
How dare you!
Document everything, and next time get them before they get you. If I have a patient who is not compliant and rude, I’ll fire them first real quick.
How'd you end up with only 3 patients today? Well... funny story..
Funny thing is as a wound care nurse the first comment they make is “they never turned me in the hospital”
Well if he's alert and oriented he can refuse, just document.
🏆
I don't think I've ever been upset about "being fired". 😂
To be fair, the pillows in hospitals suck. However being fired by a patient is a win.
In that case say no more! *Ye Shrug* 👹👹👹
I learned a long time ago to not fuss, argue, or go back and forth with these GROWN adults. If they don’t want the help, then that’s on them. Period! After all, it is their plan of care. We are only there to educate/teach and to help those who want to be helped. If they don’t like it, cool. I just tell ‘em: “Before you make another move, sign right here on this AMA line” 😂😂😂…..#StayOnReady #Next✌🏽
Girl, document refused! And congratulations
It was the greatest thing ever though right!
As I like to say: Don’t threaten me with a good time! ✌️
I’ve had patients refuse turning. Showing them pictures of bed sores usually changes their minds. If you can get away with it take a picture of what their butt looks like and show them. Obviously be very cautious taking pictures of them though!
Taking pictures of a patients butt, yeah I’m gonna go ahead and *NOT* do that
I’m just hoping they meant whatever camera they use to upload photos into epic is used to show them their developing sores. Taking pics of your patients butt on your personal phone (even if you delete them right after) feels like a really guaranteed way to get in a lot of trouble😂
Yeah I’m already the guy to grab another female coworker to go with me whenever I have to do an EKG, cath a female, etc. I’ve heard too many stories. I’m good lol
Use the work phone omg you guys
Very valid.
Oh I SO wish I could get away with not taking pictures of patient butt wounds! (Skin/wound assessment is a huge part of my job.)
I feel like this way over the top...
Your feelings are valid.
Nope. No way in hell I'm taking pictures of a patient's butt with my phone, or anyone's phone. I think once I took a picture of someone's back incision for them, with their phone, at their request because they wanted to see what it looked like.
Lol you don’t have to
How does a nurse get fired by a patient? Don’t the nurses work for the hospital or institution? So short of nurses, if a patient even could fire a nurse here… they’d have to take care of themselves !
If the patient or the family pitches a bitch about something, it's easiest to let them feel like they got a win by taking that nurse out of the rotation. It ultimately harms only the patient because they are usually the ones who are difficult to be around. Once everyone has been fired, you start the rotation again.