Is this legal??

  1. 0 Because there have been so many "holes" (missing initials on MARs), our DON has established a new policy that if a nurse forgets to initial a med or treatment given,
    that nurse AND the nurse who worked right after her
    would both be written up! The outgoing and oncoming nurses are supposed to stand there together and look through the whole MAR while the outgoing nurse checks for holes, then both nurses have to sign this daily. The main trouble I'm having with it is ----how can I be responsible (& written up) if another nurse won't initial her work ?? This just doesn't seem legal. Are they just trying to scare us and don't actually intend for the oncoming nurse to be written up along with the outgoing nurse? Crazy!!!!
    Ruby
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  3. Visit  nurseruby} profile page

    About nurseruby

    53 Years Old; Joined Apr '06; Posts: 2.

    33 Comments so far...

  4. Visit  lifeisgood2012} profile page
    0
    I didn't know being written up had something to do with the legal system - I guess someone else can chime in on that one.

    In the limited amount of time I have worked in LTC I have come to find that being written up,, at least at my facility,, does not carry a lot of weight. Maybe ask the DON, especially if it is bothering you or if you do get written up, the same question you are asking us - about how is it that you should be held responsible for another nurses behavior.

    See what she/he says.
    Last edit by Esme12 on Aug 3, '12 : Reason: formatting
  5. Visit  Sparrowhawk} profile page
    0
    I don't understand why they would the nurse right after her, possibly because she didnt catch the whole and flag it?? Or they could just be threatening *shrug*
  6. Visit  NurseCard} profile page
    1
    I'm sure it's legal.

    I also think it's completely ridiculous.

    That's all I'm going to say right now.
    I'm tired.
    BrandonLPN likes this.
  7. Visit  adriane192} profile page
    0
    I agree with Sparrowhawk- it sounds like the write up is for not catching the mistake and getting it corrected before the prior nurse leaves.
  8. Visit  BrandonLPN} profile page
    2
    Legal? Yes. Stupid? Yes.

    I would laugh my butt of if my management came up with a gem like this. I wish they *would* try to make both nurses go over the whole effing MAR looking for holes. The fireworks would be amusing.
    NamasteNurse and DSkelton711 like this.
  9. Visit  SP1CEGRL} profile page
    0
    this policy doesn't seem like it will last too long.......i wouldn't worry about it too much.
  10. Visit  Asystole RN} profile page
    0
    I would imagine that the nurse following would only be written up if that nurse did not catch, and bring to attention, the missing documentation for the patients that the nurse takes responsibility for. If the following nurse brings the missing documentation to the attention of the previous nurse and that previous nurse does not correct this then it would be the responsibility of the oncoming nurse to either take corrective action and/or report this to someone of authority.

    When I receive patients from the ED or other units I do not get a free pass if I do not receive the patients chart, labs, or consent. I must personally take action to correct the missing documentation.
  11. Visit  LindaB73} profile page
    0
    Quote from BrandonLPN
    Legal? Yes. Stupid? Yes.

    I would laugh my butt of if my management came up with a gem like this. I wish they *would* try to make both nurses go over the whole effing MAR looking for holes. The fireworks would be amusing.
    Exactly!!!
  12. Visit  CapeCodMermaid} profile page
    1
    When I worked for the big K, we were supposed to go through the other nurses' MAR before end of shift to make sure all the meds were signed off. It lasted less than 2 weeks. And, to top it off, the DON and ADON would call all the managers to the conference room for "signing parties" where they expected us to sign someone's initials in every blank spot. I was one who wouldn't even sign off an A&D on the treatment sheet if I hadn't personally applied it, so you can imagine how eager I was to falsify medical records to make them look good.
    I have never asked any nurse working for me to sign her/his initials to something they haven't done.
    LTCangel likes this.
  13. Visit  blessedmomma247} profile page
    0
    I was always taught that if it is not documented, then it did not occur. At patient is c/o pain and you check to see when he/she can have a PRN or scheduled pain med. You notice that the previous nurse did not sign out the scheduled med. Do you assume the patient was given the med and not give the patient any thing for pain or do you give the med? Its med error because there was documentation that the med was given. Sounds like what the DON is trying to do is to cut down the med errors that are occuring. If you see a med error, its your job to report it and that includes the lack of documention that a med was given. You will be written up if you notice the error but dont do anything about it. That is how I am taking it.
  14. Visit  BrandonLPN} profile page
    1
    Quote from blessedmomma247
    I was always taught that if it is not documented, then it did not occur. At patient is c/o pain and you check to see when he/she can have a PRN or scheduled pain med. You notice that the previous nurse did not sign out the scheduled med. Do you assume the patient was given the med and not give the patient any thing for pain or do you give the med? Its med error because there was documentation that the med was given. Sounds like what the DON is trying to do is to cut down the med errors that are occuring. If you see a med error, its your job to report it and that includes the lack of documention that a med was given. You will be written up if you notice the error but dont do anything about it. That is how I am takingit.
    I wonder if you're thinking of the computerized MARs usually found in acute settings. LTC med documentation exists in an entirely different universe. In EMARs you have a computer system that warns and alerts you if you forget to sign off on a med. In most LTC facilities we're stuck in the 1970s and can't get out. No computers. It's all giant books full of thousands of itty bitty little boxes where you initial tiny little initials for each pill or glucoscan or eye drop or HS snack, etc. I don't care how good you are, the law of averages states you will miss one of those boxes every now and then. And when you pass meds the next day you'll see it and say oops and initial it then. No big deal. To make both shifts "check" the entire MAR and sign off that there's no holes at shift change is absurd. Anyone who would come up with that is so out of touch with reality it isn't funny. Well, actually it IS pretty funny....

    As for reporting holes in the MAR as "med errors" to the manager, come on. Doing that has nothing to do with patient concern and everything to do with being mean spirited and spiteful.
    LTCangel likes this.
  15. Visit  Asystole RN} profile page
    1
    Quote from blessedmomma247
    I was always taught that if it is not documented, then it did not occur. At patient is c/o pain and you check to see when he/she can have a PRN or scheduled pain med. You notice that the previous nurse did not sign out the scheduled med. Do you assume the patient was given the med and not give the patient any thing for pain or do you give the med? Its med error because there was documentation that the med was given. Sounds like what the DON is trying to do is to cut down the med errors that are occuring. If you see a med error, its your job to report it and that includes the lack of documention that a med was given. You will be written up if you notice the error but dont do anything about it. That is how I am taking it.
    You are correct, missing documentation is 100% a patient safety issue. Other posters are correct too in that mistakes do happen but we always strive to perfect our practice and should never become complacent to make mistakes.

    Poor MAR documentation is a very serious and very real risk to patient safety.
    noahsmama likes this.


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