[NytimeRN]

I'm going thru this same thing now. I blew the whistle on a Thrusday, and by Monday morning I was discharged because of a "patient complaint." It makes me absolutely sick to think they-nursing administration-can do this without consequence...I'm not the first this has happened to.

[TNNURSE]

I complety agree. It is horrible to think that nsg administration would just kinda " throw away" a dedicated valuable employee who is simply trying to do the right thing and ensure patient safety.There is NO valid reason for my termination.I was terminated within hours of notifying my HCF of the situation. It turns your life upside down.What makes it even worse is when they try to attach the stigma of me being "terminated". I mean...for a nurse she had called "dedicated" and a "role model" only hours earlier....I am going to be interested to hear the hospitals defense. I brought this forward to this HCF in the spirit of mainatining a safe environment for my patient...bc....thats my job.Thats who I am.I am a patient advocate.....and unfortunately right now.....thats not a "popular" thing to be.

[TNNURSE]

Corvette Guy,
Thanks so much.I knew it was covered under the nurse pratice act ,..but I hadnt actually archived the actual nurse pratice act.Is this the same Nurse Pratice Act that Texas and all states acknowledge or are the individulaized?Is it universal for all RN's ,..or just for Texas? Thank you...I am just devastated.

[Corvette Guy]

Originally Posted by TNNURSE

Corvette Guy,
Thanks so much.I knew it was covered under the nurse pratice act ,..but I hadnt actually archived the actual nurse pratice act.Is this the same Nurse Pratice Act that Tennessee acknowledges?Is it universal for all RN's ,..or just for Texas? Thank you...I am just devastated.

Silly me... I thought you lived/worked in Katy, TX. I don't know if TN has a similar NPA as Texas.

[NRSKarenRN]

May I make a suggestion here? Management folks tend to get very defensive when the work "incompetence" is thrown at them as SUBJECTIVE term. Much better to use phrase "nursing practice issues" as that can be described in concrete objective terms using state board of nursing standards, department policies and procedures, nursing textbooks, ANA Standards of Practice and Code for nurses, specialty organization standards: AACN standards apply here

I'd recommend printing out those emails with glowing praise and having copy of last evaluation. HR required to allow you access to employee files and for employee make any corrections, add explanatory note-since you've left, lawyer might need to help you gain access.

I'd write down time line of all issues you brought to Managers attention, note any documentation supporting your concern, etc and your managers response or lack thereof to each issue.

Each state has its own practice act with interpretations by each state board of nursing(SBON). Link to all SBON here:
http://allnurses.com/nursingboards-a-k.shtml

Google search "Determining competent practice + nursing" came up with these interesting articles



The ANA supports the professional obligations of the nurse to safeguard patients.
It is the nurse's responsibility to:

• Provide competent nursing care to the patient.
• Safeguard patients and avoid actions that place the interests of the patient(s) in jeopardy. The right to refuse an assignment should be narrowly construed and the nurse must balance such a refusal against the obligation to provide for patient safety and to avoid abandonment. A refusal of an assignment may be justified when the risk of harm to the patient(s) is greater by accepting the assignment than by rejecting it.
• Exercise informed judgment and use individual competence and qualifications as criteria in giving, accepting or rejecting an assignment. Nurses are individually accountable for the care of each patient.
• Clarify assignments, assess personal capabilities, jointly identify options for patient care assignments when the nurse does not feel personally competent or adequately prepared to carry out a specific function.
• Determine what will put a patient in immediate, serious danger. The nurse may be held legally responsible for judgments exercised and actions taken in the course of nursing practice. ...

Nurses are accountable for judgments made and actions taken in the course of nursing practice. Neither physicians' orders nor the employing agency's policies relieve the nurse of accountability for actions taken and judgments made.
http://www.nursingworld.org/readroom/position/workplac/wkassign.htm


Nursing Management - Fulltext: Volume 36(5) May 2005 p 14-16 What ...
Nurses have the legal obligation to report conduct that's incompetent, ...
safety are affected by incompetent, unethical, or illegal practice by any person. ...
www.nursingmanagement.com/pt/re/ nursemgmt/fulltext.00006247-200505000-00006.htm


Assuring Competence
A Regulatory Responsibility
Figure 1: Standards for Competence
www.ncsbn.org/resources/complimentary_ncsbn_competence.asp


North Carolina Board of Nursing
Section: § 90-171.37. Revocation, suspension, or denial of licensure.
(5) Is unfit or incompetent to practice nursing by reason of deliberate or negligent acts or omissions regardless of whether actual injury to the patient is established;
www.ncbon.com/NPA.asp


Nursing Practice Act
Administrative Code (Rules)
Learn About North Carolina’s Nurse Practice Act-and Earn CE Credit!

Kansas Nurse: Kansas guidelines for the registered nurse in ...

Connecticut Nursing News: Continuing education: Scope of practice ...

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Depending on facility, review boards may be helpful. Ones I've been involved in as part of Grievance Task Force about 60% sided with management, 40% sided with employee and able to overturn termination decisions. Take a look at your facility's process. Often employee is able to bring colleague to provide support to you along with lawyer. Some allow you to choose members of pannel from those on a list so cross section of departments represented. Look carefully at this option, and don"t choose only those in nursing-- maintenance and radiology staff often look at issue as department outside and are able to look objectively at situation, instead of having "department blinders" on.

Good luck in taking this stand.

Edited for clarity, spelling and links!

[TNNURSE]

It is...kinda hard to not call it what it is.It is incompetence. We are not just talking about giving a wrong dose/ route kinda error.these are serious...serious deviations from the Gold Standard ANA guideleines.

[SEOBowhntr]

TNNurse,
I applaud you for taking stand in efforts to ensure safe patient care. But often times, we need to make sure that our message delivery is not overly harsh. Either way though, if you were acting as a patient advocate, they are crazy to fire you. I've been through a similar situation in which our "uppers," when I made an issue of incompetent staff. Sometimes you just have to take the high road though, and that was one of those times. They didn't fire me, but did threaten my license over an unrelated event, in which I was keeping one of their other fav's from having to code a patient. Probably irregardless though, you will have to move on, unless they are going to remove the management staff who've done this to you. And now you probably don't feel you can trust your HR dept, so it certainly is time to move on, but I'd at least want to be reinstated until I could make the decison on where to go next. Good Luck!!!

[hrtprncss]

Just adding here...Since you think that they have tampered with your charting...And I assume that it's computerized charting...If it's ''edited'' by either you or someone else, then you should be able to know who edited it. From the IT department. Though I wouldn't mention that over the phone, it's better if you can print out the info right before the grievance process and you're in front of the board, just to avoid additional tampering from their part. I'm glad you want to clear your name, but for me personally I would not return. But your reputation is what you're basically after.

[gauge14iv]

Arent you obligated to report these two to the board? One for chart tampering and one for practice issues?

[ocankhe]

This just shows how a lose lose situation develops. Even if you win a legal battle the settlement would probably be cash and not reinstatement.
Another point is even if the nurse manager and hospital acted wrongly and possibley illegally, what is there punishment? Not much I bet. Because there is no real legal punishment this type of behavior will continue.
My advice is to get a cash settlement have your records purged of this incident and move to another organization.