focusing on the PATIENT
it was a few days overdue, but i did it. a few hours ago, i set up an appointment to talk to our nurse manager about the incident that happened last week, and we had a short but serious chat.
i spent the past days mulling over my feelings, my thoughts, and my fears, that i had to delay the actual reporting. i totally understand how some commenters felt that the relief charge RN involved should be fired. i honestly get that, but i don’t share that opinion.
some might find this attitude disgusting about me, but i am all for second chances and keeping family peace. if i may elaborate on that, i would like to say that although D (the relief charge RN) definitely crossed the line with the hateful joke he did, it was the very first time, at least in my knowledge, that he did cross the line. i don’t know, he may be homophobic, and not conscious about it, or he maybe a total jerk just waiting for his time. whatever he is, in my opinion, he deserves at least a second chance.
i want him to be reprimanded and be enlightened, that he did something wrong, and that it is not acceptable. if he does it again and i find out? you can bet all your inheritance money that i will do everything within my little power, for him to be fired, and that he will be fired with the worst record ever, he will regret ever messing with me. or, if it doesn’t happen, because let’s face it, i have very little power, you can bet your remaining inheritance money, that i will be out of our unit as fast as i can, and will warn every breathing person to avoid him like a plague.
secondly, and this might be more disgusting to some, i personally know it will greatly affect his family if he gets fired like that without warning. he has a preteen daughter from a previous relationship that he supports, and a new baby with his new wife. despite the fact that there is a nursing shortage, it is not like you can get fired today and start on a new job tomorrow. in as much as i want him to learn a lesson, i don’t want to teach him that lesson in such a jolting way that it will create a major havoc to his family.
those are the two other reasons why i kept quiet for a while. the first one was of course figuring out if i just needed to lighten up and get myself some sense of humor. i discussed it with fellow nurses, who all agreed, in an instant, that what D did was indeed very unprofessional, inappropriate, and definitely not funny.
then of course, there was the majority of YOU…who commented and shared your thoughts with all honesty. that made me realize i am not alone in being an “uptight” person or nurse, who believed helping the sick should go beyond the boundaries of how we feel towards people who are different from us. thank you guys!
that doesn’t mean i am not grateful to those who disagreed with me, because i respect your opinions too. i would like to thank you for your thoughts too. it’s just that after thinking about it, i don’t agree with you. i’m sure we are all adults to agree to disagree.
anyway, as i was saying, after all the internal debates i went through, i made my decision. i sat in that office and honestly expressed how the whole situation shocked, angered, and disgusted me. i emphasized that i was reporting it not for him to be fired, but for it to be addressed, so he will not do it again. ever. i trust that the nurse manager will be true to her words when she said she will “address it accordingly”.
one thing that is worth mentioning here, is the lesson i learned from our nurse manager. she said she totally agreed with my conclusion that it was inappropriate. however, she was much more concerned with the possibility that if i didn’t have the insight to question the said order, and did it without asking, i would have done what could have been very inappropriate as a nurse.
a good number of people who knew about the incident shared the same view. they were not so concerned that it was a hateful attitude towards gay people, but they are focused on the patient, simply as the patient. to quote the nurse manager, summing up our talk… “anything that involves patient care should always be appropriate. period.” unlike me, she was very objective, and sort of disregarded my all emotional line…”i just can’t believe how some people in our unit can be so hateful”. she acknowledged the fact that there are a lot of phobias/prejudices about race, sexual orientation, or religion, and that fact didn’t shock and bother her. she was all for patient safety. all in the name of PATIENT safety. period.
what can i say? i maybe a bit naive but i shouldn’t be that hypocritical. our nurse manager was right and i think she has the right attitude. there are certain generalizations about certain groups of people that all of us form or embrace over the years. i have seen these everywhere, and i have seen that it defies social status, education, or background. it doesn’t matter who or where people are. everybody carries a sense of prejudice about other people at a certain, although varying degrees. i do acknowledge and accept that now.
needless to say, i have been at the receiving end of discriminating racial remarks and insinuations a number of times in my life, and it isn’t such a nice place to be. but the truth is, despite that fact, there were many times when i have tolerated and participated in the same generalizations myself, even if it was only in my head. i may have gone through the process of learning to respect every person’s choice, and am very comfortable in accepting and facing all sorts of different people for a long time now, but that doesn’t give me the right to be mean to other people who are still going through their own struggles, at their own pace.
if i may be bold enough to ask, assuming everyone can be brave enough to admit, who can say they’ve never been down that road? who can say they just woke up one morning and realized we all belong to one earth, and we are all the same, therefore they just accept everyone without any amount of reservation? who can say that they have never looked at a person differently because of his/her unpopular traits, choices, or orientation?
so now, it doesn’t upset me that people can be so hateful sometimes. more than anything, the thing that upsets me is the fact that people take their fears, hatred and prejudices to work. especially in the medical field, where we deal with live, feeling human beings just like us.
in nursing school, we have been taught countless of times that when we face our patients, we have to make sure we take with us our heads to know, our hands to do, and our hearts to care. nothing else. not our hatred, not our fears, especially not our prejudices. i believe it is but natural for human beings to feel afraid, or feel ambiguous about other races, or sexual orientation, or beliefs, but it is also possible to leave all those ideas at home and go beyond all those things once we step into the patient’s room.
i am not saying this is not difficult, because it is. the thing is, it does not matter that it is difficult, it only matters that we are aware we owe it to our patients. it is unprofessional and inhuman not to do it. at the end of the day, all patients are human beings, and they deserve to be treated with respect and care regardless of anything that they are, or that they are not.
i understand there may be people who will be disappointed with the course of action i have chosen. whether you think i have made a mistake by taking this all so seriously when all it is is a freaky joke, or you think i was not brave enough to rally for the charge nurse being fired, i won’t question any of that.
i will still welcome your thoughts, and will respect them. it is in hearing other people’s voice that we learn to listen to ours and keep or change them. it is in hearing your voices that i learn to listen to mine, and keep or change it.

Thanks for sharing your decision with us, May. It doesn’t really matter what we think about your decision, what matters is that you carefully considered things and did what you think is right.
That said, I am pleased that you brought this issue to your nurse manager. In my opinion, it needed to be done.
She is correct that patient safety is key. And she ought to be thankful that YOU were astute enough to question the bogus order. The charge nurse jeopardized patient safety and I hope your unit addresses is inappropriate actions accordingly.
Comment by Kelly — May 29, 2007 @ 7:36 pm
I also applaud your decision to go to the nurse manager. What the charge nurse did was really not okay. And I respect the way you approached it, by saying that you felt it was inappropriate and not okay, but not pushing for him to be fired or whatever. You did your part, and if the manager thinks the offense is worthy of termination, then so be it. You don’t have to make that decision. Thanks for being a thoughtful nurse.
Comment by girl in greenwood — May 29, 2007 @ 7:59 pm
I am in complete agreement that the charge nurse gets a second chance. Very glad you went to the nurse manager!
Comment by pam — May 29, 2007 @ 9:01 pm
This story has sickened me and my wife. We’ve talked alot
about it. If my MELD score goes up one point, I’ll be requesting a liver transplant evaluation. But What if someone like
that charge nurse works at my hospital? Or my ammonia
goes up and I rant or talk hateful like my best friend
did when she was in LIVERLAND, and then all the nurses
write in thier blogs like the story about the aids patient?Or someone like shrimplate decides that I’m a selfish asshole because I drank too much beer and decides
“fuck um” “he deserves to suffer… did it to himself.
See, Beth, you have a lot more power than you will ever know. When we are at your mercy, or the charge nurses’
mercy. I’m glad to hear that you will do the right thing.
Comment by bobby — May 29, 2007 @ 11:01 pm
may,
i am all about second chances. and i think it is fair, that this nurse get a second chance. i am also all about calling a spade and spade, and being held accountable for acting highly inappropriate and inconsiderately. he deserves for this to be addressed in a Very Appropriate manner, and documented, and a good firm warning. i hope he takes it as the wake-up call it should be. humor is all well and good in the workplace, but not when it has potential to hurt a patient.
i’m grateful you are reporting it :}
gypsy
Comment by gypsygrrl — May 29, 2007 @ 11:38 pm
hello may. thank you for this very insightful entry. i was a victim of bureaucracy in the hospital numerous times, but i never questioned my decisions. salute to you.
Comment by lei — May 30, 2007 @ 12:18 am
You’ve done the right thing, I think. And I hope the charge nurse learns his lesson — for the sake of future patients and for his family’s sake as well.
Comment by The Curmudgeon — May 30, 2007 @ 8:33 am
May, I too am glad you talked w/your manager. It was the right thing to do.
As for your reflections about tolerating other people’s hateful behavior, and letting people evolve at their own pace: I think we all have the responsibility to speak up when we see someone, or a particular group being targeted for hateful speech, behavior, or anything else. The “It was only a joke” response is the refuge of bigots. I’m not saying that any of us are perfect at coming to the defense of the oppressed, but the more of us who more often call people all their inappropriate behavior, the less of it will be tolerated by the rest of the community.
I don’t care what anyone says, it is ALWAYS appropriate to tell people when you think their behavior falls in that realm. Not always easy to do, but right.
There’s that wonderful poem, usually attributed to Martin Niemöller and with many variations:
First they came for the Communists, and I didn’t speak up,
because I wasn’t a Communist.
Then they came for the Jews, and I didn’t speak up,
because I wasn’t a Jew.
Then they came for the Catholics, and I didn’t speak up,
because I was a Protestant.
Then they came for me, and by that time there was no one left
to speak up for me.
Comment by marachne — May 30, 2007 @ 12:34 pm
My first reaction was ‘fire him’. This second post on the matter enlightens things and broadens my mercy, but the guy should still be suspended, officially reprimanded, and allowed to return to work on probation.
Comment by beajerry — May 30, 2007 @ 12:35 pm
I think you did the right thing, May. It was a joke in terrible taste but what is more frightening is that he wrote an order that, if taken seriously, could have really put the patient in jeopardy.
Now, I cannot say that I’m not biased. But in a hospital situation, whether a person of a different heritage, culture, color, belief, or lifestyle than my own, I am very aware of my duty and that they are counting on me to do it.
I have worked in a mental hospital on the forensic (or criminal) unit and it was a little work to overcome the stigma most people have for mental illness but in the end, I knew that these people were still people with problems and needed someone to care for them.
Comment by Kit — May 30, 2007 @ 3:04 pm
You did the right thing.
That’s what counts. Good work, May. I am proud of you. Sometimes all you have to do is act naturally.
Comment by shrimplate — May 30, 2007 @ 3:54 pm
That’s a very thoughtful post. Glad that you’ve weighed on everything.
Comment by ipanema — May 30, 2007 @ 7:18 pm
You did the right thing, to think it over and not act hastily, then go to the nurse manager. You are right about not wanting the person who did this or his family to suffer. I am currently trying to figure out how to deal with a similar dilemma. Like you, I don’t want the person who has made a mistake to suffer, esp. if they have learned from these mistakes and are moving on past them (I’m hoping this is the case and that they are not currently still making the same mistakes, which are felonies).
Comment by Lisa — May 31, 2007 @ 6:46 pm
You totally did the right thing. What’s even better is that you first gave the entire issue rational thought and evaluation about your decision-making— and then you even had the decency to think about the consequences to his family if he got fired! I think you are being very professional and understanding about the whole thing. Bravo! But I do think the guy should get some rather severe consequences, whatever the manager decides, because he is an adult and should have known that this was not a funny “joke”—it was actually something that could have seriously compromised the patient’s care, physically and emotionally. If he would do this, I wonder what else he would be capable of….
Comment by The Bohemian Road Nurse — May 31, 2007 @ 7:20 pm
Your professionalism is to be admired. It is important to coach employees so they can succeed, if after coaching the behavior continues…that’s a different story. You are so right that all of us participate in some form of discriminatory ideas if only in our heads and that is why our professional codes of ethics caution us about valuing all human beings equally…because unless we are advised to do so, we are tempted to put people in the boxes we’ve created for human beings. Looks and acts like me. Perfect! Doesn’t look an act like me. What’s wrong with them?!
Onehealthpro
Comment by Onehealthpro — June 1, 2007 @ 1:55 pm
Now that you have added more background to the story, I cannot believe how much this incident reminds me of a personal situation I was in a few years ago.
I was just in a car accident, had a crack in my neck and didn’t know it. Was in a lot of pain, on pain pills and very irritible. I came back to work about 3 days after the accident (stupid!) and when a manager barked an unreasonable order at me, I snarled a very insubordinate comment back at her, something our office has zero tolerance for. This was totally out of character for me, and was the pain talking. I was written up, kicked off the team, was made to stuff envelopes for 6 months, and was avoided like the plague, but wasn’t fired thankfully.
Had I been fired, I definately wouldn’t be where I am today. I guess my point is, although I by NO MEANS am justifying what he did, we all make stupid mistakes and say stupid inappropriate things - yes he crossed the line, but perhaps he does deserve a second chance. If not, that one “joke” he made really could have steered his whole life (and his families) spiraling down.
Comment by Jen — June 2, 2007 @ 11:28 am
OK - one more thought re ethics/prejudice etc. A very close friend of mine has been battling brain tumours off and on her whole life. The stress of this caused her to start smoking occasionally. Her cancer Dr left town, and she ended up with a new one. When her tumour came back and she went to him for a consult, he found out she was a smoker and refused to treat her stating, “obviously you don’t care whether you live or die, so why are you bothering even coming to me” and then he walked out of the office. She was so upset she started smoking regularly, thinking she was going to die and there was nothing she could do about it. So she went almost 2 months without treatment and finally went out of town to another cancer clinic and by then had 2 tumours and lost vision in one eye. She successfully went through treatments out of town, is cancer free again, and has stopped smoking, on her own, and hasn’t smoked for over a year now. Her situation really opened my eyes to how so many Dr’s/nurses can still get away with not only judging people, but acting on it too…. As stated by a previous commenter, I do believe that all of us have something we judge others on, but the important thing is not to act on it.
(Sorry May, I just seem to ramble on!)
Comment by Jen — June 2, 2007 @ 11:36 am
You don’t play with lives. You don’t put jokes in patient charts. Gay or straight, black or white, male or female, christian or muslim you don’t lie. Fire him? Hell NO, pull his liscence. Where was he the day they talked about medical records and respecting patients.
How about a joke about pedulous breasts? How about one on small penises?
You know what it going to happen. Every doctor in your facility is going to hear about this and every nurse in your unit is going to wear this. Years from now someone will pull this out as an example of nursing professionalism.
I might save the second chance for the relief nurse who told you to wait until the charge nurse came back. That one should be on leave until he figures out that standing silent is being an accomplice.
Being hated and vilified by people who do such things or condone such things is a mark of honor.
Comment by JaneMc — June 4, 2007 @ 12:35 pm
i hope your reflection will help insure that you all continue to bond with eachother which will only be beneficial for your patients….nurses telling on eachother and alienating eachother will only affect the patients negatively.
dealing with issues between yourselves can be a way to resolve them too
Comment by arlene — June 6, 2007 @ 4:13 pm
Young Underage Pussy
Sorry, it just sounds like a crazy idea for me
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