The "risk my license" game

Nurses General Nursing

Published

You are reading page 2 of The "risk my license" game

Orca, ADN, ASN, RN

2,066 Posts

Specializes in Hospice, corrections, psychiatry, rehab, LTC.

It's not a frequent occurrence. It's just something that has come up from time to time.

kanzi monkey

618 Posts

Orca, I'm wondering if these instances you are describing may be "teachable moments". That is, maybe the LPN is refusing to pass a particular med that she believes she cannot give (ie, an IV push med or something). Maybe a conversation and a peek at the policy together would help clear things up. And for the dressing change-maybe the nurse was concerned about the clarity of the order, whether she had the right supplies, etc.

I am in a position now where I write orders. Once, a pt had delay in her beta blocker treatment because there WAS historically a policy that mandated certain monitoring parameters for new IV beta blocker therapy. Having been a nurse when that policy existed (and when it was changed), I understood where the confusion was--but an order I had written to be given NOW wasn't actually given for over an hour, which was ridiculous. It really wasn't the nurse's fault, but it was aggravating and potentially dangerous for the patient. As far as dressing changes go--many of my patients have dressings that only docs or NPs change, and I've had conversations with many very good nurses about letting a dressing remain as is. We'll usually document this as such--and when we want nursing to change dressings, we give specific directions. As a nurse, I would feel very uncomfortable changing a dressing on a wound that I wasn't familiar with (ie, open abdominal wounds, skin grafts, flaps, etc) without specific instruction.

So, when you encounter these "risk my license" scenarios--maybe there are good questions lying beneath the surface. If NOT, then a few short and to the point conversations with the offending party ought to set them straight.:yeah:

Orca, ADN, ASN, RN

2,066 Posts

Specializes in Hospice, corrections, psychiatry, rehab, LTC.

With the LPN, it was just the latest in a long string of attempts to get out of doing pill pass. To put it bluntly this was a lazy employee who had been at several stops within my division - and failed at all of them. I gave her twice as much orientation as I usually give new hires (she has three years of experience with us) and she still didn't get it (in my opinion, deliberately).

The RN takes a similar tack, trying to pawn her work off on other people.

f NOT, then a few short and to the point conversations with the offending party ought to set them straight.

That was done. There have been no recurrences that I know of (the LPN has since become someone else's problem).

Specializes in LTC.

Is the OP even telling the whole story ? I m that lpn that won't pass meds at my job... due to fear of losing my license. Now ask me why. I don't do the assignment because I Refuse to pass meds for 64 residents ! To me its outrageous and I have seen nurses written up for so many med errors and I have seen the residents suffer. I did contact the bon about this and got no where. However my facility is considering changing the med assigment due to these saftey issues.

I just can't imagine nurses refusing routine tasks, there have to be more to the story.

tencat

1,350 Posts

There are some lazy employees out there for sure......but if you've sat them down, written out a plan of improvement, given them the proper training and guidance, then why can't you send their sorry behinds out the door?

nicurn001

805 Posts

Specializes in Psych , Peds ,Nicu.

There are also some slipshop managers out there , if they don't document their actions , follow applicable law and facility procedures , they then wonder why they cannot get employees to either improve their work or be terminated .

On a related subject , I often see on this forum , laments from those who feel , all unions do is stop the incompetent / lazy / stupid from being fired . They don't , they simply make managers comply with applicable laws and procedures . My attitudes is if its good enough for the indians to be tied up with all the laws , policies etc , they have to put up with while trying to care for patients , then its good enough for chiefs (management ) to have to put up with the same BS. to do their jobs .

brownbook

3,413 Posts

Orca, I understand exactly what you mean. It is much more polite and professional for a nurse to say no to an assignment followed my her reasons. I won't take that assignment because (fill in the blank) gives a manager something to work with. It may very well be appropriate and reasonable for a nurse to say no to any assignment, but give your reasons, don't give the almost childish 'nah nah I won't put my license as risk" reason for saying no!

elkpark

14,633 Posts

The only time(s) I've ever refused to do something I was assigned at work was because I was being asked to do something that was legitimately illegal/unethical or outside the scope of my practice (and I'm amazed at how often that's happened over the years ... :rolleyes:). And, in each case, I've always been happy to explain why I'm not able to perform that particular action.

island40

328 Posts

Specializes in ICU, School Nurse, Med/Surg, Psych.

I believe that the root of the problem is in our educational system. We do not provide class time to review the state statues that govern nursing practice and students hear a lot of inaccurate (okay - down right false) information from their clinical instructors and other nurses. Nurses are told that unfavorable lawsuits are common and that it is relatively easy to have a nursing license suspended or revoked. Another thread that is helpful is the one discussing how many - if any - nurses you know personally who have lost their license. New nurses just don't understand that most nursing license disciplinary action is due to drug use on the part of the nurse and not anything to do with daily practice.

eriksoln, BSN, RN

2,636 Posts

Specializes in M/S, Travel Nursing, Pulmonary.

I actually understand where the OP is coming from.

We have a charge nurse who will refuse admits, claim she can't take one, it "puts her license at risk". If she does take one, there must be, minimum, three hours between that one and the next. She'll outright refuse to admit people to the unit at all if there are no other open beds to pawn the admits off to.

Same charge nurse thinks nothing of giving other people three admits within the same hour. Laughs about it. I asked her once "If something happened to one of those pt's, would your license be at risk since you placed them as charge nurse?" :p I've never gotten back to back admits. :smokin:

Jules A, MSN

8,864 Posts

Specializes in Family Nurse Practitioner.
I actually understand where the OP is coming from.

We have a charge nurse who will refuse admits, claim she can't take one, it "puts her license at risk". If she does take one, there must be, minimum, three hours between that one and the next. She'll outright refuse to admit people to the unit at all if there are no other open beds to pawn the admits off to.

Same charge nurse thinks nothing of giving other people three admits within the same hour. Laughs about it. I asked her once "If something happened to one of those pt's, would your license be at risk since you placed them as charge nurse?" :p I've never gotten back to back admits. :smokin:

OMG I'd love to get away with this although even just two hours between admits would be heaven for me. FWIW in all seriousness I do believe that stacking admits one after the other is a serious safety risk for the patients and in psych even one admit can really disrupt the tone of the entire unit in a dangerous manner.

+ Add a Comment