Manager wrote defaming remark on IR that also goes to county

  1. The NOC nurse told me of unusual bumps on patient's genital area and we were to put a certain PRN ointment on it but she hadn't written an IR so I offered to do it. The IR came back with the manager's remark that she was curious why I was giving such close attention to the patient's genital area. I took offense to that statement because it implied an inappropriate sexual interest in the patient and the IR clearly stated why this was being done. A copy with her comments goes to the county. I have NEVER done anything inappropriate or been disciplined for anything at this company. I think this could cast a negative light on my nursing license and me personally. I think this was done in retaliation for me exposing falsification of documents by administration for government funding. What should I do?
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    About soregonnurse

    Joined: Feb '13; Posts: 2; Likes: 1


  3. by   netglow
    Eeeek! Consult a lawyer ASAP for advice.
  4. by   Altra
    I'm surmising a number of things, from the OP.

    1. The OP works at a county-run facility.
    2. Facility policy requires "IRs" -- incident reports -- for patients who present with pre-existing alterations to skin integrity.
    3. Incident reports also make their way to at least one person in county government responsible for some oversight of this facility.
    4. The OP followed policy by completing the IR on the patient's skin condition, although the state of the patient's skin had clearly also been assessed by the previous nurse and the patient's physician, thus generating the order for the cream.
    5. The OP has previously been involved in some sort of disagreement with her manager regarding documentation, possibly resulting in some governmental/regulatory/legal action.
    6. The OP now feels that the manager's snarky comments on the IR are retaliation for that previous disagreement.

    Of course ... any/all of the above may be incorrect.

    I don't think you should do anything, OP, except alter the wording of all future IRs you write on skin integrity to conclude with a phrase such as: "Incident report completed per policy". And that is also your defense *if* there is any accusation of impropriety on your part. For now, all that has been done is that your manager has succeeded in making you feel very uncomfortable.
  5. by   Irish RN
    May I ask how old the patient is? Mental status? Not that it should matter, but I'm curious....and the latter may work in your defense if it comes down to that.

    I think this is ridiculous and it's sad this happens in our profession. Why didn't the previous RN document the pt's skin condition if she notified the MD AND got a new order? Your manager is SO in the wrong. You did your job....which includes a skin assessment on every pt. I ask every patient about their skin and if they meet a certain critera (elderly, confused, frequent stool, etc), I ask to specifically assess their bottoms/coccyx/groin/abdominal folds/breast folds.

    If I were you, my next step would depend on my relationship with this manager. If you feel comfortable and have a good working relationship, I'd ask to discuss the IR. But by your post, it sounds like you already have a target on your back. If that's the case, I'd keep quiet and look for a new job ASAP.
  6. by   HouTx
    Hmm - Federal laws protected whistle blowers from retaliation. If the OP feels that this issue is a 'soft' form of retaliation, it could be actionable, thereby exposing the organization to even more unwanted consequences.
  7. by   nurseprnRN
    Quote from netglow
    Eeeek! Consult a lawyer ASAP for advice.
    Yet another example of why every working nurse in any setting should have his/her own malpractice insurance. Your carrier will provide you a lawyer with experience in cases like yours for no extra charge. Even if all you do is call the carrier to ask about it, you'll have someone on your side.
  8. by   chrisrn24
    I guess in the comments section of the IR, I would've written "Nurse on previous shift reported seeing ------- to --------- periArea that has previously not been seen. Writer examined the area, found -------. ------ not painful."

    And then follow up/delegate someone to follow up. Get a cream scheduled, get an OBGYN appt etc.
  9. by   Ruas61
    Off the cuff, what the lady wrote makes her look a little pervy. That was inappropriately worded in my opinion. If I read that I would raise an eyebrow at the author more than the subject.
  10. by   RainMom
    Quote from soregonnurse
    The IR came back with the manager's remark that she was curious why I was giving such close attention to the patient's genital area.
    Wait... you haven't mastered the art of pericare or inserting a Foley without looking? lol Sorry, I can't help but laugh at that; as if we are never expected to view/assess a pt's genitals!
  11. by   nurseprnRN
    Oh, and it's not defamation if it's true. If it's not true, you could call it libel (written) or slander (verbal), though.
  12. by   leslie :-D
    is there any way that you can add a comment/response to the mgr's remark?
    for example, "i don't understand what you are asking, since i have already stated that i am following up on noc nurse's concern."
    (hopefully you're ir will indicate the aforementioned. ;p)
    otherwise and if able, try to let it go.
    i agree with the poster who believes it makes the mgr's comment questionable, not yours.

    from hereonin, be even more articulate and detailed in your reports/notes, so that any questions will look silly and/or antagonistic.
    in the meantime, offer your mgr a big, cold drink so that she can swallow her zillion suck pills.

  13. by   netglow
    Quote from leslie :-D
    in the meantime, offer your mgr a big, cold drink so that she can swallow her zillion suck pills.

    Ah, the clarity of a leslie :-D post. Refreshing.
  14. by   sharpeimom
    Whenever I made a meds error, I had to sign the IR at some point. (Not the same issue, but the same principle applies) My lawyer mom's suggestion was to add any pertinent comments just below my signature, but running into the signature, so they couldn't white it out later on -- thus making me seem guilty as opposed to simply careless and/or negligent.