I recently read about the Honest Abe Award honoring nurses for being the most honest profession. Where I work I do find many honest nurses however I see an equal number of dishonest nurses. Nurses that chart they flushed IV's when there were none to flush, nurses who chart LS exactly as the previous nurse charted in spite of improvement or deterioration , competent and lucid patients who report that their nurses didn't assess areas that the nurse charts that she assessed, medication errors that go unreported. I could go on. These things bother me tremendously as I believe that nurses should be completely trustworthy and honest. Does anybody else experience this? What do I do? Do I follow my personal ethics and report these events and risk the wrath of fellow nurses? Do I ignore them as long as the patient experiences no harm? Help!

I recently read about the Honest Abe Award honoring nurses for being the most honest profession. Where I work I do find many honest nurses however I see an equal number of dishonest nurses. Nurses that chart they flushed IV's when there were none to flush, nurses who chart LS exactly as the previous nurse charted in spite of improvement or deterioration , competent and lucid patients who report that their nurses didn't assess areas that the nurse charts that she assessed, medication errors that go unreported. I could go on. These things bother me tremendously as I believe that nurses should be completely trustworthy and honest. Does anybody else experience this? What do I do? Do I follow my personal ethics and report these events and risk the wrath of fellow nurses? Do I ignore them as long as the patient experiences no harm? Help!

Hello,

As a soon to be nurse I think you should choose your battles wisely as long as you can sleep at night knowing that your choices of "battle-dismisals" are ethically sound. Meaning that if someone "absentmindedly" or complacently charted a flush where there was no IV or Heplock that you likely could ethically dismiss that as a battle.

However there may be other things going on that your nurse manager may need to know about this. It may not be, as I hope it is, mere complacency or absent-mindedness but outright "false-charting" and unethical blatant dishonesty.

All for integrity,

Gen

However there may be other things going on that your nurse manager may need to know about this. It may not be, as I hope it is, mere complacency or absent-mindedness but outright "false-charting" and unethical blatant dishonesty.

Complacency: total lack of concern. I am bothered by any nurse that exhibits complacency. It is both unprofessional and unethical. A patient chart is a legal document meant to accurately reflect all assessments and interventions provided. Not just a piece of paper that gets filed away.

Have you never made an honest mistake?

It is always possible that an IV was flushed prior to being dc'd later in the shift, or sometimes pt. will pull them out and the md doesn't give order to restart. As for charting the same as the the nurse before even though there is no improvement, can you prove it? I have had competent and lucid pt. say that things ween't done that I knew without a doubt I had done. As for med errors, if I make a med error I usually only notify the people that need to know. I don't mean to come across as crude or rude, but you really do have to be careful about what you actually know for a fact and what you might assume. I'm not trying to imply that there aren't nurses that probably do some of these things, but, as the above poster stated, you have to learn how to choose your battles when you go to war. There are human beings in nursing as in any other profession that are not always on the up and up, just be vigilant and choose your battles wisely. Bless you for caring.

Complacency: total lack of concern. I am bothered by any nurse that exhibits complacency. It is both unprofessional and unethical. A patient chart is a legal document meant to accurately reflect all assessments and interventions provided. Not just a piece of paper that gets filed away.

Hello,

No where in the post did I say that a total lack of concern was a dismissable battle but put complacency next to absent mindedness.

If you care to be Super Nurse then all the best to you.

Gen

I think that as long as you approach the nurse first and tell her/him that what they are doing is wrong and that you are being a patient advocate and that if they don't stop or if they don't straighten up their act that you are going to upper management then its fine. Don't say something behind someone's back that you wouldn't say to their face.

Hello,

No where in the post did I say that a total lack of concern was a dismissable battle but put complacency next to absent mindedness.

I hate to be the one to inform you but the definition of complacence is "total lack of concern", a far cry from absent-minded. I'm not so sure you would want an absent-minded surgeon working on you. Nor is it right to expect that your patients would want an absent-minded health care professional taking care of them. I think it is a far reach to suggest that accurate charting requires a "super nurse". Heaven help your patients if that is the approach you will be bringing to your new profession.

complacent (when used as an adjective)

1. Contented to a fault; self-satisfied and unconcerned

2. Eager to please (never heard it used this way...) complaisant

Love words, don't you?

I don't think any one here is suggesting they are unconcerned, but just that wisdom would teach that you can't spend your time swatting at flies when a grizzly is coming through the window. Pick your battles.

I I don't mean to come across as crude or rude, but you really do have to be careful about what you actually know for a fact and what you might assume. I'm not trying to imply that there aren't nurses that probably do some of these things, but, as the above poster stated, you have to learn how to choose your battles when you go to war.

You're right that one has to be careful and not assume that just because something looks one way to you that's the way it is. And certainly, there many little things that just aren't worth the effort to pursue. If someone is new to a facility, they usually should wait awhile before tackling anything beyond their own responsibilities as they might realize their first impression was incorrect. However, if something that looks amiss, it's not a good idea to always just assume everything's okay since no one else seems to be bothered by it.

If, over time, certain problems seem to continue, then it's right to address them. In most cases, addressing the person in question is the best place to start. Simply ask them what happened or if you (the person asking) missed something. Now is a good time to assume the best - that it's either on honest mistake on their part or a misunderstanding on your part.

If this doesn't work, then get some documentation together (evidence of the questionable documentation/actions) and bring your concern up to management. Again, approach it as an issue you're concerned about and not as if you're "turning someone in" or "tattling." Perhaps in collecting the info, you might realize that these are just honest mistakes that aren't worth making a big deal over. Or you might find a bad trend that should be addressed.

I think worrying over things like this is majoring in the minors. Most nurses I know are too busy with their own work to go back and check to see if so-and-so listened to each abdominal quadrant for the same length of time or flushed a heplock at exactly 18:00...

Complacency: total lack of concern. I am bothered by any nurse that exhibits complacency. It is both unprofessional and unethical. A patient chart is a legal document meant to accurately reflect all assessments and interventions provided. Not just a piece of paper that gets filed away.

I certainly hope you judge yourself as harshly as you judge your co-workers.

I'm usually too busy with my own work to know that much about what everyone else is/isn't doing. I'm also a firm believer in staff nurses doing their jobs and unit managers doing theirs. In other words, it's not my job to be minding how everyone else does their job; that's my manager's job.

I hate to be the one to inform you but the definition of complacence is "total lack of concern", a far cry from absent-minded. I'm not so sure you would want an absent-minded surgeon working on you. Nor is it right to expect that your patients would want an absent-minded health care professional taking care of them. I think it is a far reach to suggest that accurate charting requires a "super nurse". Heaven help your patients if that is the approach you will be bringing to your new profession.

I think it is absolutely disgusting when a nurse is being meddlesome, and continually checking the work of her coworkers. This might sound rather harsh, but it is time to mind your own business.

Other so-called 'professionals' do not openly snoop into the affairs of their coworkers to the degree that nurses do. You do not really hear about accountants reporting other accountants, doctors reporting other doctors, occupational therapists reporting other occupational therapists, social workers reporting other social workers, chemists reporting other chemists, and engineers reporting on other engineers.