Moral Dilemma

[Q.]

I have a moral dilemma and I'm not quite sure how to handle this. Here is the situation:

On Wednesday last week, in our clinic, an elderly man coded. Naturally, the MA ran into the nurse triage room and called for some help. I was the first nurse to arrive to see this man basically aphasic in his wheelchair. The MD and I assisted him to the floor, could not find a pulse and began CPR. Soon the crash cart arrived, and several of our urgent care staff arrived. An IV was started by one of our triage nurses. At this point, I stepped back and allowed the other staff to take over (my background is L&D and have only been at this clinic for a year and have only coded neonates in my career ) I was standing behind the exam table and was basically cornered in there, but took the time to observe. The paramedics arrived and once they assumed care, we left as it was quite crowded in there.

2 days later, on Friday, I was in a supervisor's office about to interview for a new position. Before the interview officially started, the supervisor was talking with another individual (who I do not know) and was mentioning how 2 of the urgent care nurses are filing for workman's comp as they injured their back moving the exam table.

At this point I flipped out because I was there the whole time and no one moved the exam table! I was behind it! Alot of people didn't notice me because I actually was behind one of the urgent care nurses! My dilemma is...do I report this obvious fraud? Or do I not? I have information that I am not privy to (their medical conditions of injury) so there is a confidentiality issue. I am at a loss on what to do.

[hapeewendy]

susy my friend , I suggest you report it

but HUGE DISCLAIMER HERE :

I would do it in the following way

first of all I would approach the supervisor in a manner that is non accusatory of your co workers

sometimes people in positions of "power" or managerial power that is will try to pitt one against another for their greater good, in this case the supervisors greater good would be no injuries sustained to keep a shiny clean record of her workers health etc

I wouldnt approach the nurses right away, because honestly you shouldnt have knowledge of any claims they may or may not be making as far as workmans comp and work related injuries goes, that stuff should be confidential and the supervisor shouldnt have mentioned it with you around in the first place.

but I agree with your dilemma, I would have a hard time not saying something to someone about the fact that you knew they werent injured at that particular code

and thats exactly what you say to your supervisor.

you say that you couldnt help but overhear him/her when they were discussing the fact that 2 nurses got injured at a code and you would just like to let her know that the particular code you were involved in went without sustained injury.

this way he/she can investigate and see if infact it *Was* that code that people are fudging complaints on and if so , act accordingly, and if not, it doesnt look like you are a tattle tale it just looks like you wanted to report that there was a code that no one sustained an injury in

you cant be silent, that will eat away at you, I know, sometimes having morals can be a pain in the *Beep*

but its all in the way you tell what you know....

good luck

keep us posted

[Huganurse]

I have read a few posts about injured nurses who are obligated to provide a specific event in order to get WComp. As a nurse we all know that it is usually not one incident but years of abuse to our backs that cause the injury. The most honest end up out of work without any compensation because they do not want to state that it was a particular incident. Perhaps these 2 have come up with a way to get what they deserve by falsifying the event that the injury took place. It's wrong but so is the way WComp determines if the disability is covered. I doubt that if they are not injured that they will get compensation. Just saying your back is injured these days is not enough and they want diagnostics to back up the claim. If they are not injured they probably wont get very far anyway. Morally you should tell. I have learned over the years that things are not always as they seem. I would also do a little questioning of those nurses to see if they were referring to the event you witnessed or another time. Be very careful, you don't want to point fingers if you really don't know the whole story. I know I couldn't do what it looks like they did but some people certainly can and do. BUT, I have not been seriously injured and if I was I don't know what I would do to self preserve. I have not been in those shoes and would have a hard time passing judgement on anyone until I had. I have a hard time with the fact that they would falsify the occurance when so many witnesses were present. That would seem to defeat the purpose of the two of them going in together as each others witness to the event. That doesn't make sense to me. If they are really being dishonest about the situation I'll bet they get caught by the investigation. I really don't have cut and dry advice for you here. Just wanted to point out some angles that you may not of thought about. I'd go with my instincts and do what I could live with. It's you that you have to live with, not them.

[jstinerich]

If it were me, I would go and tell the supervisor in private (maybe the office) that I did not see the two people lift the table,before I left the code area. Then leave it up to her/him to investigate and draw his/her own conclusions.

[TracyB,RN, RN]

OMG!! I would hate to be you right now, SusyK.

But I think I would say something to the supervisor, but make sure that you are on the same page, talking about the same code.

Maybe they did move a table, maybe not, but from what I have seen of your posts, I don't think you would be happy if you didn't say something. Let the supervisor investigate further. I agree with happywendee about not directly confronting the 2 nurses involved, not only b/c of confidentiality reasons, but also b/c they might be real sh**s to you. Do you now, or will you work with them in the future?? Could make for some mega tension & hostility in the workplace. JMO.

Good luck

[Q.]

Yeah...it sucks.

I actually posed this same question to one of the docs that works there (who is actually the primary of the patient who coded) who is a trusted friend and father-figure to me, who has been at the clinic for 30+ years and whom I've know for about 7.

He questioned as well as whether or not the nurses moved the table at a different time, while I was gone: perhaps moving it back into place for some reason. He asked if I had reasonable doubt, and I sorta did. He then stated that since I had some doubt about whether or not they did so while I wasn't there, that I shouldn't say anything.

HE was also present at the code and said he couldn't recall or not if ANYONE moved the table, but he did note that the gurney could not fit in the room with the exam table where it was. He didn't see anyone move the table per se, but wondered why 4 200lb firemen would ask 2 female nurses to move such a laborious object. He also noted the confidentiality issue that is at hand, and seemed to be like me: puzzled as what to do here.

He seemed to want to take the owness off me by saying that he was going to casually mention to the supervisor to investigate further - as a doc he wouldn't be questioned, but if I said so, as a lowly RN, I sure as heck would be. At this point, I think he is going to mention it for me. I don't want to cause trouble, but I am so sick of unfairness.

[SKM-NURSIEPOOH, BSN, RN]

originally posted by hapeewendy

...you say that you couldn't help but overhear him/her when they were discussing the fact that 2 nurses got injured at a code and you would just like to let her know that the particular code you were involved in went without sustained injury. this way he/she can investigate and see if infect it *was* that code that people are fudging complaints on and if so , act accordingly, and if not, it doesn't look like you are a tattle tale it just looks like you wanted to report that there was a code that no one sustained an injury in...

originally posted by susy k....2 days later, on friday, i was in a supervisor's office about to interview for a new position. before the interview officially started, the supervisor was talking with another individual (who i do not know) and was mentioning how 2 of the urgent care nurses are filing for workman's comp as they injured their back moving the exam table.

at this point i flipped out because i was there the whole time and no one moved the exam table! i was behind it! a lot of people didn't notice me because i actually was behind one of the urgent care nurses! my dilemma is...do i report this obvious fraud? or do i not? i have information that i am not privy to (their medical conditions of injury) so there is a confidentiality issue. i am at a loss on what to do.

hapeewendy's correct in clearing-up the particular code with the supervisor in which the interview occurred with. perhaps the injuries occurred on a separate day/code or during a routine shift. the suggestion of telling him/her that you'd overheard :imbar ...not intentionally of course...& that you needed clarification as to the date/& or code these two individuals claim to be injured on is good advice.

in re-reading the first post, i realize that it would be inappropriate to confront the employees due to the patient confidentially issue, unless one or both have since made public knowledge of their injuries at which time...you could talk to them directly. if it isn't public knowledge, then just speak with your supervisor...perhaps, off the record at first...until the needed clarification is done.

[Jenny P]

Susy, it could possibly be a different code, couldn't it? Hapeewendy has some good advice; go to the supervisor you heard talking and tell her that no one was injured at the code you were at. That supervsor should never have spoken about this in front of you or anyone else. And Tracy is right; knowing you from this site (reading your posts here), you need to speak out about it. You aren't the type of person who could live with yourself and keep quiet about someone cheating like this.

[Q.]

Jenny and Moe-

Since our clinic is just that, a clinic, when there is a code (which is about one q YEAR) usually everyone knows about it. So..if there was another code, I would've known about that too. The clinic is staffed with all MAs with the exception of 2 urgent care RNs and my group, the triage nurses. So yes, it was THIS code they were referring to.

And I agree - I'm actually kinda irritated that the supervisor unwittingly put me in the position by yammering about this in front of me.

[SKM-NURSIEPOOH, BSN, RN]

originally posted by susy k

...he seemed to want to take the owness off me by saying that he was going to casually mention to the supervisor to investigate further - as a doc he wouldn't be questioned, but if i said so, as a lowly rn, i sure as heck would be. at this point, i think he is going to mention it for me. i don't want to cause trouble, but i am so sick of unfairness.

:chair:

[Q.]

HEY - that guy under the chair is CUTE!

[SKM-NURSIEPOOH, BSN, RN]

originally posted by susy k

hey - that guy under the chair is cute!

...yea, check-out all of the new smilies...some of them are a scream!!!:balloons:

[Jenny P]

"And I agree - I'm actually kinda irritated that the supervisor unwittingly put me in the position by yammering about this in front of me."

And I don't blame you one bit, either!