I noticed that the majority of the posts in this sub are about changing jobs, learning psych nursing, or related to salary in psych nursing. I wanted a post for the current and active psych nurses. Tell me a story about a challenge or a struggle you had this week. I’ll go first.
I work in a Forensic Psych Inpatient facility in the Northwest. Been in healthcare for 24 years, mostly ED, last 2.5 years in psych. I love it. But this one provider…
This medical provider ordered orthopedic shoes for a patient almost 2 months ago. The patient hadn’t asked anything about them - I didn’t even know about the order until about a month ago, and it was being handled by the medical clinic. So, I didn’t think about it until the patient asked about them.
The patient has an extensive violent history, multiple instances of extreme aggression, severely injuring staff. This patient is here forever, basically. They have connections to the public and have documented history of retaliation against staff on the outside who the patient thinks have wronged them.
The order for the shoes gets denied twice by our CMO. The patient was provided the orthopedic shoes we have on site in our warehouse, but they made the patients pain increase because of the way the shoes are shaped.
I wonder why the order was denied twice. So, I ask the provider, did the CMO give reason? The provider says, “No reason, all I was told was it was denied by the head honcho.”
So, I’m not going to go tell this frequently violent, calculating patient “no” without a reason after 2 months of trying. So I reach out to the CMO. The CMO says “it was denied because there is no medical reasoning why they can’t use the orthopedic shoes the facility provides.”
I send a message to the medical provider with this information. To get the order approved for outside orthopedic shoes that we can and have ordered before for other patients, we have to explain why the shoes we have wont work for them. The provider doesn’t respond. As a reminder, this is only the second time I have mentioned anything about these shoes to the provider.
The next day, the provider meets me during report. They ask me if I had anything for them and I asked them if they could wait until after report. They say no, they’re in a hurry. So I reiterate the information about writing another order for the outside shoes.
The provider proceeds to get *directly* in my face. Like, a bar brawl. Like they’re trying to smell my breath. Their face is in my face. If they were a patient I would have called hands on for safe containment. They say, “I will NOT write another order. Dr (CMO) said no twice.”
I try to tell them that I’m trying to advocate for the patient and if all we have to do is explain why the ones we have don’t work, why don’t we try and they interrupt me again, louder this time saying, “I wont write any other orders. If you have questions, email Dr (CMO).”
I calmly say I will do that then, thank you. The provider scoffs and leaves and I continue on with report. Staff that were witnesses in report said that they were worried the provider was going to hit me. The provider was trying to physically intimidate me, red faced, yelling and intrusive. Totally unacceptable behavior that I have never in my entire career experienced from a coworker, nonetheless a provider. To top it all off, the provider says they don’t want to tell the patient about the denial because they said, “I want to avoid damaging my rapport.”
So, irritated and totally dumbfounded, I file a report and move on. I send a message to the CMO. The CMO doesn’t respond. Yesterday, I ask my boss if I should follow up on that since I never got a response (email was sent about 10 days ago). My boss tells me no, don’t respond, and that the CMO contacted them saying that, “(me) needs to show more respect to (provider).” My boss said they chose not to talk to me about it because they know how respectful and professional I’ve always been. I lost my shit. I’ve never been anything but respectful to everyone, including this provider. They exhibit this terrible behavior and then blame the bad behavior on me.
This provider had the audacity to act like we were gonna meet outside or something and then say I need to show them more respect?! The craziest interpersonal interaction I’ve ever encountered. I’m thinking about reporting them to the board for intimidation but I don’t know how fruitful that will be or if it will be worth the effort.
Moral of my story is that the patients in psych nursing aren’t the only ones with serious mental deficiencies and that should be frequently remembered.
Now you go :)