April 20, 2013 at 6:13 AM #6547
I am looking for AUTHORITATIVE LITERATURE [such as text books or journal articles] that discusses whether it is “incompetent” or “negligent” for a nurse to have inadequate interpersonal skills or poor bedside manner.
My client has been an RN for nearly 30 years. During that time she has had 1 complaint due a medication recording error – but was discharged because there were also prior complaints, all of which were NOT CLINICAL but interpersonal in nature.
In 1 incident a patient said they were afraid of the nurse because she had been their nurse on a previous admission. She says she never saw the patient before and was nothing identifies anything she actually did that made the patient fearful. In another, a para-profesional accused her of “bulling.” Again, no actual behavior was identified.
My client is an assertive professional and she is not too timid to say-so if feels a Nurse’s Aide or LPN has done something incorrectly. She “stands up for herself” but she does not come across as a warm, empathetic counselor in a busy hospital environment. No patient was ever injured in anyway.
I have seen journal articles that discuss how important it is to establish a caring environment – but I have not found anything that says a personality clash or interpersonal issue with a patient or another nurse is not incompetence or negligence. Can anyone suggest any PUBLISHED LITERATURE on the tropicApril 20, 2013 at 3:05 PM #6555
Jason Hautala RNMember
Good luck on finding something authoritative on whether or not bedside manner is negligent, I doubt you will find anything, but you can look or maybe someone here will know of something. That said, I don’t think it matters what you find. It sounds like your client was laid off due to patient complaints and conflict with staff and not because of negligence. Even though no patient was harmed, those are valid reasons for a nurse to lose her job. If there is a union, then you might have a case since it doesn’t sound like the hospital did a very good job on documenting which behaviors and rules she was breaking, and you might have a wrongful termination that way, but if it is from a right to work state, the nurse can be fired for the above reasons even without any negligence.
Good luck. I would Google this up for you, but I really don’t think it matters what the literature shows from what you said above.April 21, 2013 at 12:12 PM #6562
Here’s a brief interesting article that might be helpful for you: http://ccn.aacnjournals.org/content/23/5/72.full
I’m not sure how a poor bedside manner can be considered negligence (M.D.s, anyone?), especially since it didn’t cause any harm to the patient. Unless the patient argued emotional/mental harm, perhaps they have a (albeit weak) case? And if the prosecutor can claim and prove that therapeutic communication, as all nurses learn about in school, is a “standard of care.” It can get very tricky and I think it all depends on the circumstances, the nurse’s interpersonal history, etc. I think it would be very possible to prove incompetence on the nurse’s part for her lack of creating an emotionally therapeutic environment for the patient, however, I’m not sure how easy it would be to prove actual negligence.
Here is another interesting article from the same journal about incompetence and yes, creating a therapeutic environment is discussed: http://ccn.aacnjournals.org/content/29/1/12.full
Either way, it’s an interesting debate!April 21, 2013 at 12:19 PM #6563
A few more thoughts:
Ultimately, whether we agree or not, healthcare is moving to a “customer service based” model. We, as nurses, doctors, assistants, etc, SERVE a population of people. We are public servants. Obviously I don’t know all the in’s and out’s of the case, but sometimes nurses need to remember that “standing up for yourself” is not always needed or useful when interacting with patients. Sometimes it’s best to let whatever is being thrown at you by the patients to roll off your back and not “tell how it how it is.” It’s a far cry between assertive and aggressive and whenever we’re called bullies, we need to stop our defensiveness for a moment and see if that title was warranted. If this nurse is having several negative interactions with different people, maybe there is a little burn-out going on? Maybe the accusers have a point? The fact that she has been a nurse for 30 years does not give her license or an excuse to behave without regard to anyone else. She has not earned the right to be “a bully” as one person accused her of.
Just some thoughts. Again, I know nothing about the case. I’m just kind of throwing ideas out there.
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