Dishonest Nurses - page 3
I recently read about the Honest Abe Award honoring nurses for being the most honest profession. Where I work I do find many honest nurses however I see an equal number of dishonest nurses. Nurses... Read More
May 18, '07Hi everyone. Just a reminder here:
In the spirit of lively debate and fair play, please refrain from personalizing your posts. In other words, debate the issue, not the other posters.
May 19, '07I checked off things I was supposed to have done when I hadn't when I was in the hospital. This bothered me at first but became easier after a while. It was a matter of professional survival. You really don't want a chart going to court that has lots of stuff uncharted---like q 15 minute limb checks for restraints, or a q 2hour neuro check that you missed because you were too busy running up and down the halls like a maniac trying to take care of 12 or more patients. Lawyers just love it when you don't chart crap like that.
I worked in a nursing home for about 2 months---the worst job ever. False charting---- often including charting meds you didn't give--- was rampant. When you're passing meds for 30 to 50 geriatric patients all of whom take a slew of meds, it's just a way of life and a means of surviving the shift without loosing your mind. You just skip the patients that you know are going to fight you about taking their pills anyway and sign off their meds. This was just too dishonest for even jaded old me and so I left.
Thank God for home health nursing.
And to whoever started this thread---you just go ahead and report your fellow nurses. Guaranteed when you make a little screw up, they'll pounce on it. Best to mind your own business and do your own job as best you can.
May 19, '07QUOTE:I was floated at 11:00 pm after the first four hours of a 7P-7A night shift. The registry nurse who was being sent home early gave me report. Charting was done for the entire night until 6:00 am the next morning!
I did ask how this could be and was told, "I have a pretty good idea what the urine output will be based on the NG feeds and piggybacks."
Then tore the chart in half, threw it in the trash, and copied the 7-11 part on a new flowsheet. I asked this RN to wait while I called the supervisor but was refused.
The supervisor made the RN as "do not send" but said it would be too much work to report the incident.
I filled out an incident report. The next day I wrote the registry with facts of the incident.
The wrote the Board of Registered Nursing the facts as I knew them along with the torn chart.
I have no idea what became of that nurse.
Would you want a nurse so dishonest caring for your loved one?"
You know---eventually karma will come back to you, my dear.
May 20, '07We all must remember WE are human. We have to care for ourself as we do others, honest is a personal value each individual is accounted for. My believe is "what comes around goes around" and eventually this will catch up to that person. It is our responsibility--as a patient advocate to protect our patients..there should be an anonomous ethical committee or such in place in your work setting, If this is realy bothering you and pt.'s are at stake it is our responsibility to address the issue, whether directly or via supervisor explaining to not disclose your identity to protect yourself understanding you don't want to be "tatle tale"...and have to work with that person. We must remember our profession is admired however we all are human and addiction for example is very high just as abuse for law inforcement, alcoholism for bartenders etc...You have to answer to yourself listen to your gut feeling, one little "lie" may accually many more compromising pt. care in the future. This CAN be addressed without anyone knowing you reported what you saw.Last edit by shellek on May 20, '07 : Reason: the smallest of dishonesty can grow into more compromising pt safety
May 20, '07Quote from Pam I Am RNI've been reading all the posts, and I see both sides. To answer your question about whether or not you report them, you cannot report them unless you are directly involved. If you see that the nurse you got report from charted that she had flushed a lock and you had removed the lock the day before, write up an incident report. If you yourself know that a med error was made, write up an incident report. If a pt tells you "The nurse I had last night never even checked on me and I needed pain medicine," yet the chart states that the pt reported being pain free, tell the pt he can contact patient relations, or get pt relations in to talk to him. In other words, you can only deal with what happens to your pts in the examples you gave. And you must be very sure that something did occur before you write it up: how many times have we all heard pts complain that nothing was done for them, yet there's loads of documentation from different staff members that say otherwise, and it turns out the pt is upset because he didn't get what he wanted?I recently read about the Honest Abe Award honoring nurses for being the most honest profession. Where I work I do find many honest nurses however I see an equal number of dishonest nurses. Nurses that chart they flushed IV's when there were none to flush, nurses who chart LS exactly as the previous nurse charted in spite of improvement or deterioration , competent and lucid patients who report that their nurses didn't assess areas that the nurse charts that she assessed, medication errors that go unreported. I could go on. These things bother me tremendously as I believe that nurses should be completely trustworthy and honest. Does anybody else experience this? What do I do? Do I follow my personal ethics and report these events and risk the wrath of fellow nurses? Do I ignore them as long as the patient experiences no harm? Help!
May 20, '07QUOTE:If you see that the nurse you got report from charted that she had flushed a lock and you had removed the lock the day before, write up an incident report. If you yourself know that a med error was made, write up an incident report. If a pt tells you "The nurse I had last night never even checked on me and I needed pain medicine," yet the chart states that the pt reported being pain free, tell the pt he can contact patient relations, or get pt relations in to talk to him."
Happy incident report writing!!! Could it be possible that the nurse made an honest mistake and confused a patient with a hep lock with an iv-less patient in her charting? Did the med error cause the patient harm? Did you see the nurse give the wrong med? Is it possible that the night nurse checked in on the patient who appeared to be sleeping and instead of waking them up to ask them if they needed a pain med--let them sleep? Have fun with your reports. Guaranteed your co-workers will be waiting with bated breath for your first noticeable goof.
May 20, '07Could the excess of required charting be a factor in this? Perhaps there is not any dishonesty going on. I picture a nurse trying to get through reams of grade B paperwork so she can get on with patient care-something might get written incorrectly.
Grade A paperwork/charting includes vital signs, assessments, I&O's and things that really matter in patient care and decision making. Watch doctors pick up the flowsheet. They look over the vital signs first, then look at a few other things.
If there is an error/dishonesty in Grade A paperwork, then there is a problem. If it is on a form that if it was missing, nobody(except the compliance committee) would notice it was missing, then don't worry.
May 20, '07..."Errors are not a “bad apple” problem. And furthermore, finger pointing and placing blame would be a pointless and counterproductive exercise. To reduce medical errors, we need rigorous changes throughout the entire health care system. To paraphrase the report, it may be human to err, but it’s also human to create solutions, find better alternatives, and devise new approaches for the challenges ahead."...http://www.iom.edu/Object.File/Maste...Err-8pager.pdf
The culture of 'blame the nurse' by management continues to contribute to mistakes.
We know the causes are inefficient systems, new charting systems & other technonlogy, and unsafe staffing.
How can a nurse be expected to pass medications to forty or more patients? And document accurately?
May 20, '07I too have been reading all the posts and can see several things.
First, I do not believe in snitching just for the purpose of snitching. No one is Queen Police Nurse of us all and like others have said there could be an honest error happening.
I have found obvious errors in charting before when it's quite noticeable that is should be a different pt. I just brought it to the nurse's attention. Most times they were appreciative. If I see something charted that looks "off" , again, go to the nurse.
Now of course you need to use some judgement here. Charting ahead of time is a major no-no but that is on THAT nurse's license. If I'm not directly involved and can't prove it and especially if it's not harming a pt., I'm not running to the supvr. and tattling.
Now if you see something life threatening or causing direct harm to a patient, obviously a different scenario.
May 20, '07I too have read all the posts - what an interesting topic btw.
Anyway, my take on this is that in 15 years as a nurse, I have "snitched" if you want to call it that when an error has been made or when I have seen outright dishonesty. However, I'm sure much has slipped by me too because frankly I never had the time to go looking for anyone else's mistakes. I made enough of my own - lol.
May 20, '07If I spent my shift writing incident reports on relatively minor, non-patient-harm issues, I could probably spend at least an hour every shift. Therefore, I rarely write something up unless it is more serious.
On the more serious stuff, like the pt who had their Dilantin missed the previous shift or the ER admit that I get with a BS of 600 and no diabetic orders with no interventions initiated in ER, YES, I do take the time to write an incident report AFTER my shift when I have my pts needs dealt with.
On my unit, the "Incident Report Queen" is an advanced practice nurse that has been with the hospital for a million years. This is the woman who WILL spend 2 hours a shift writing up incident reports, all the while ignoring her pts. The woman who will not carry a stethoscope to a room, yet charts breath sounds/cardiac assessments. And the one that once stepped OVER one of her pts that fell on the floor who was being tended to by another nurse because "I need to go to the bathroom."
Enough said.Last edit by IMustBeCrazy on May 20, '07
May 20, '07Geez, sorry for giving an opinion.
Med errors do not have to cause harm to need an incident report. And if someone is sleeping and the nurse decides not to wake the pt for an assessment, how does the nurse know the pt was pain free???
Forget it. Sorry I butted in.
May 20, '07Does anyone really think it is OK to document that a dressing was changed, medication given, or an assessment was done when it was not?
If the patient refuses a medication do not chart that you gave it. Chart the patient refused the medication and what you did.
Dod you notify the physician?
If not the medication dose may be increased or a change may be made because if it is charted it is assumed ot was done.
If you were understaffed and didn't have time tell all levels of management. Document what, when, and where with what your supervisor said. Discuss it with your colleagues and DO SOMETHING!
It is not about getting through the shift.
It is not about being a tattle tale or a snitch.
It is about patient care. It is NURSING!
Who thinks it is OK to ignore potentially unsafe dishonest actions?