Manipulative facility practices

  1. I've really been getting a snootful of how facilities operate today.

    Downright untruthful and unethical in their dealings with agency. and of course they're running off their own staff left and right.

    Anyone else here ever been trapped into doing supervisor or charge? I told the facility I would do it 'this time' (what a sucker, I know, I'm sure this is how they traped the others too) but NEVER again....also put it in writing I will GO HOME if I come in and find myself supervisor for the whole facility again...grrr.

    This is one of those places where most nurses would be comfortable with her/his 'own litle group' but the staff competence is too iffy to risk being in charge of everyone else.....

    All I can say is agency sure has gone downhill in my parts in the last 5 years....but I guess the hospitals all have too (and shyt rolls downhill, eh?) :roll
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  2. 14 Comments

  3. by   BadBird
    I was scheduled to work In a ICU unit and I was the only RN with ICU experience, they had to float a med surg nurse in to take patients. That hosp. has serious staffing issues, so unsafe. I protected my license with my feet, I now schedule elsewhere.
  4. by   mattsmom81
    That is a bad situation too, Badbird, as we know who they will blame if something goes wrong.

    I don't understand the management teams in these places who turf so much responsibility to agency who are not familiar with their policies, etc.

    It's like the opposite administrative shift washes their hands of the next one, turns a blind eye, and doesn't care what may occur. This has always been true to SOME extent, I know, but I've never run into it so strongly as recently. It's like zero common sense, zero common decency, CYA and run.

    Is this a trend the rest of you are seeing in other parts of the country? Or am I in an unusual area?

    License protection is the name of the game for sure. We have to protect ourselves against unscrupulous facilities who would abuse us.
  5. by   eddy
    I would say that MOST facilities are fair and honest in their dealings with agency staff in my neck of the woods. However, there is always someone who pops up and makes me doubt that every once in a while.

    Actually, my biggest fear here is being accused of diverting drugs. It is a rampant "disease" here for staff nurses and agency nurses alike. I'm always watching my counts closely, just to make sure no one tries to divert using my pts, hall, etc. Smart staff nurses that divert are quite good at pinning missing meds on an agency nurse. You've got to watch out... the problem is their is no fool proof way to 100% protect yourself IMO.
  6. by   mattsmom81
    I hear ya Eddy...agency nurses make great scapegoats...and I am also SUPER careful with narcs. I love the new PYXIS that uses fingerprints too...harder for someone to cop my password anywho. And I try not to carry the keys as agency.

    I've had staff try the 'can you get something out for me while you're in there' deal...that's a no no for me too...

    I insist staff directly and immediately watch me waste meds and vice versa....prevents potential problems as agency. I have refused to witness an after the fact waste... I let the regulars take THAT risk.
  7. by   eddy
    All good advice mattsmom. I just wish more of the rural facilities had "modern day equipment". Unfortunately, a lot of the places out here are still in the dark ages for this kinda stuff. PYXIS is a rare but welcome thing... provided they give you direct access to it.
  8. by   mattsmom81
    Had a supervisor ask me for they keys once. 2 hours later I found them on the counter. And lo and behold 20 Demerol were missing.

    I wrote this up left and right, offered to be searched, pee in a cup, etc. Her story? "I never asked her for the keys...she must have left them on the counter...I didn't go into the narc cupboard." My word against hers.

    Now that supervisor is still there (have heard through the grapevine narcs still come up missing). No surprise there. Guess good supervisors are hard to find, eh?

    Nothing ever came of this thank goodness, but I refused to go back as I saw the writing on the wall...this was NOT a good place for an agency nurse.
  9. by   eddy
    Grrrrr.... been there done that. My policy these days is TRUST NO ONE. Not even a good friend I'm on shift with. Some people may not like my policy, but if everyone went with my policy there would be far fewer false diversion suspensions and wrongly revoked licenses. I simply explain that "hey I wouldn't ask YOU to do this, so please don't ask ME."

    It may make me unpopular at times, but it helps me keep my career intact.
  10. by   JoyfulNurse
    At one facility I was a there as agency, there was a 'paperwork' or MDS nurse who would come around right at shift change and ask for your keys, saying she only needs to get a tylenol.

    Two months later she was lead out in handcuffs. She was taking out Percocet from the bubble pack, and replacing them with Tylenol. Taping them in. How dare her. The potential to blame am agency nurse is huge in cases like this, as we seem to get pinned for everything.

    Eddy, I've never heard of a Pyxis with a fingerprint. That is great! Any advice for those of us new nurses out there to protect us?

    Also, to everyone...What is the most outrageous thing youve seen pegged on, or attempted to peg on, an agency nurse?

    Dara
    Last edit by JoyfulNurse on Mar 4, '03
  11. by   debRNo1
    Originally posted by JoyfulNurse
    Two months later she was lead out in handcuffs.
    My neighbor worked BUSY tele unit with the same nurse for many YEARS. They became good friends, babysat for each other and been to each others houses. My poor clueless neighbor was in a complete state of SHOCK when they came and took her partner/friend/coworker out in handcuffs for narcotic
    diversion.........

    At my hospital AGENCY nurses DO NOT use the keys. A staff nurse must sign out any and all meds for them.

    A brand new nurse asked me to "co-sign his waste" that he had already wasted without a witness. SORRY but NO. Someone else signed it for him-bad practice

    ya never know...........

    deb
  12. by   debRNo1
    Originally posted by JoyfulNurse
    Two months later she was lead out in handcuffs.
    My neighbor worked BUSY tele unit with the same nurse for many YEARS. They became good friends, babysat for each other and been to each others houses. My poor clueless neighbor was in a complete state of SHOCK when they came and took her partner/friend/coworker out in handcuffs for narcotic
    diversion.........

    At my hospital AGENCY nurses DO NOT use the keys. A staff nurse must sign out any and all meds for them.

    A brand new nurse asked me to "co-sign his waste" that he had already wasted without a witness. SORRY but NO. Someone else signed it for him-bad practice

    ya never know...........

    deb
  13. by   jude11142
    This is real scary for me. As a fairly new LPN(RN student), I am a charge nurse in a LTCF and have been working for an agency part-time. I have only been to a couple facilities so far and don't know if I want to continue. I'm saddened to say that even at my full-time job, when pool comes in, they are almost always assigned to the most difficult unit. Seems that the feeling is, "they are getting paid alot more, so let them work for it"........ARGGGGGGGG!!

    One of our units has been having a problem with narcs missing. Who is getting blamed??? Pool, that's who. I have heard, "we have so many coming in from pool"........like big deal! Does that mean it must be one of them? Talk about denial or is it a cover-up. I hope that I am never in a position where I would be blamed for something just because I am working pool.

    As a very trusting person, I had a hard time not trusting people. Like when another nurse needed something from med cart and asked for my keys. Atfirst, I gave them to her. Nothing was taken, but another nurse who I knew for yrs called me aside and told me, "don't trust anyone with your keys".........."not even me,, you don't know if I had a drug problem" etc.........And if my narcs were short/missing, it would be my you know what on the line, plus my license on the line. Now, I don't give up my keys for anyone, period. Just not good practice.

    It just makes me so angry to see pool getting blamed.

    JUDE
  14. by   mattsmom81
    It's a scary thought that the lead person in the facility...the one who is 'administration'..would be the one to set another nurse up. They have the ability to do so fairly easily, unfortunately as they have the right to ask for the keys.

    My situation I described could recur easily...in this facility I was the only nurse on the unit and the supervisor came from another unit and asked me for my narc keys...no witnesses. Luckily I had nothing to hide but sometimes just a rumor is enough to get a nurse in trouble, so I was fortunate my reputation preceded me.

    I like the fingerprint PYXIS best as it protects us....but many facilities cannot afford this newfangled PYXIS. Wastes can still get us in trouble and I'm like Eddy with wastes.

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