Q: Dear Nancy,
I am an RN working at an outpatient and residential psychiatric facility. I was told one of the clients wrote a letter saying she does not want me to have access to her records or speak to her psychiatrist. She said my conduct has been unacceptable and that I "have been warned several times." She also supposedly stated that my contact with her has caused her stress at school.
I do not work with this woman one-on-one at all, and deal with her only superficially when she sees her case manager at a group home where I have an office. Our conversation is very cordial and casual. I have very little knowledge of her health needs and all of this comes out of left field. I am not clear about her mental health diagnosis. She does have a personality disorder.
This appears to be malicous and vindictive since I work with another client with whom she is friends. This other client feels that I purposely am trying to get one of his medications discontinued, and on his part this is delusional. My nursing reputation is excellent, I have been employee of the month and have wonderful evaluations. My supervisor stands by me, but this is causing me so much anxiety and stress. Do I have any recourse?
Joan
A:Dear Joan,
Your being upset with the two clients and their conduct you describe is understandable. However, there is probably little that can be done about the letter she wrote. Although it would be natural to want to "clear this up" in some way, getting involved in such a process will only lead to further problems. You know you are a good nurse, a good employee, and your supervisor stands behind you. You are the professional in this situation. Continue to interact with her as you have in the past: Be cordial and casual.
It probably would be a good idea not to be assigned to any part of her care, especially since she has asked that you not have access to her records or speak to her psychiatrist. It might also be a good idea not to provide care to the patient's friend who is falsely accusing you of trying to decrease his medications. If they pair up against you, things could get out of control. Talk with your supervisor about that.
Unfortunately, false accusations often occur against psychiatric nursing staff. If you feel you want to explore whether or not you have any legal recourse against this resident, a consultation with a nurse attorney or attorney in your state who knows about psychiatric nursing is certainly an option for you.
Regards, Nancy
