How would you handle this?

[MedFlightDreams]

I'm a traveler and am a little out of my element dealing with a situation like this since it's not my own home ER where I'm comfortable. There is a tech in my ER who has been there for 20 years. He is a bit too comfortable in his role and it's getting on my nerves, but he's the type who you have to watch your back with so I have been hesitant to deal with this period...however, the other night he ordered a urine for my patient under my name without asking, then sent it and after getting the result told the patient they may have a UTI. He also advised the doctor of the results in front of the patient before going to me. I have also caught this tech looking up results on other patients who aren't mine under my login and now I have been logging out every time I turn around. He was even doing it when I was right there. I have also seen other things like him advising a nurse on where a patient's STEMI was when medication was dependent on it, but I wasn't involved and wasn't interested in getting involved. This tech wants to do everything BUT tech things, and I respect the longevity but I have no relationship and it's my ass and license. Do I pull the tech aside or do I go to the manager? Either way I'm setting myself up for a long assignment of backstabbing and being under a microscope, but I HAVE to say something because I'm not a pushover and I won't be treated as one by someone working under my license.

[One1, BSN, RN]

I have seen ER techs hang around a department way too long, and way past the point where "respected experience" turned into "acting outside the scope of practice". I would not expect much success from talking to management, but I would tell the tech very clearly that he cannot enter orders under your login. Change your password immediately, like others suggested, and log yourself out all the time, no matter how painful. Document in your charting if the tech discusses preemptive dx with the patient - patients often forget who exactly upset them when they fill out complaint cards.. Beyond that, I would not rock the boat too much. This btw is coming from a former ER tech. The tech works under the medical director's license - as an EMT he is certified, not licensed.

[studentnursemon86]

As an ER tech myself; I feel this tech is overstepping their bounds. Techs there probably don't have the ability to put orders in and they shouldn't.

I work with many techs who have been there for 20-30 years. They would never do such a thing. They have more respect for their nurses like that.

I agree with everyone about changing your password and locking your computer. Where I work we usually forget to do this, but we also have more respect for each other's privacy and don't go into each other's computer and mess with things.

I've gotten into the habit of locking my computer because sometimes a transport tech or another tech will look at my computer to see where a patient is: I am ok if they ask to see where a patient is, but I don't appreciate people going on my computer without me there because other things are on there like my personal information (insurance and payroll for instance) not to mention information about other patients.

[paramedic-RN]

I don't think urine thing is a big deal, almost every ER has a protocol for ordering urine anyway. Females with abd pain for instance, immediate UA, MD shouldn't even have to order it.

The whole STEMI thing I"m assuming this is about an inferior MI and NTG, in which case he has a point-maybe he's a medic idk.

But he SHOULD NOT be ordering stuff under your name, totally wrong, just say something to him even jokingly is fine or just log out.

[caliotter3]

Agree with what Stargazer said. Just watch out for yourself. There are many permanent employees in many situations that are similar that can not make it to first base, because such a gem is the twinkle in the eye(s) of the manager(s). It is not worth the aggravation trying to fight a losing battle. Better to use the energy to keep your back to the wall when he is near you.