Dishonest Nurses

[Pam I Am RN]

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!

[IMustBeCrazy]

If 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.

[TazziRN, RN]

Geez, 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.

[pickledpepperRN]

Does 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?

[Jenzee]

Geez, 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.

Don't feel bad Tazz. Like I said earlier I wish someone had been watching my back when my nurse pushed my phenergen too quickly. It might not seem like a big error to some but then again they are not sitting here with an arm that hurts a month after the fact. An error doesn't have to be life threatening to be life altering or painful at the very least.

I wouldn't want the nurse that did that to me to get in trouble but she does need some reteaching. I mean heck like I said aside from pushing the meds. too fast she wiped her runny nose and then put that finger on my arm (after the alcohol prep.) to stabilize my vein. I didn't report her but I did ask the nurse the next day why she was pushing to so slow knowing I'm a nursing student she explained. When I asked if it was something that only she did, she replied "Hospital policy sweetie."

Again errors don't have to be big to be harmful.

Don't ever feel bad about voicing your opinion btw. That is supposed to be the beauty of a forum like this.

[Kinjo]

My opinion errors should be reported so that others can learn from them,especially med errors. If these errors are not reported how will we be able to correct the system that leads to this errors?

[Jenzee]

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!

Well said!

[Cattitude]

Does 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?

I think there is a huge potential for miscommunication on this issue right here in this thread.

I trust that the nurse before me is doing the correct things. I do NOT have time to check on what every other staff member does. *If* I come across something that is in error, I will go to that staff member.

How is that ignoring an action? How should I assume that someone is intentionally being dishonest? If something is blatantly in error and obviously about to cause patient harm then by all means, sound the alarms. But some of the examples the OP gave were things that may NOT be errors or mis-actions at all. OR they may be honest errors.

Unless you are on the unit 24 hrs a day, you really can't say for certain what another nurse did or didn't do. As far as med errors? Heck, I reported myself for a coumadin error. I also had a nurse write an incident report for an abx. I forgot to give as a newb. She told me that if she could have avoided writing it she would have, she STILL came to me and discussed it. *That* is my point. If it can be discussed with the "offender" than by all means, do it.

Supervisor discussions should be limited to severe situations, JMO.

[Cattitude]

My opinion errors should be reported so that others can learn from them,especially med errors. If these errors are not reported how will we be able to correct the system that leads to this errors?

I'd love to see some stats or an article that cites that incident reports help reduce med errors. Or that they help correct the system.

Personally, I think proper staffing might help a LOT more.

Both of my med errors happened when we were short staffed and I rushed.

[pickledpepperRN]

I'd love to see some stats or an article that cites that incident reports help reduce med errors. Or that they help correct the system.

Personally, I think proper staffing might help a LOT more.

Both of my med errors happened when we were short staffed and I rushed.

I agree with both of your posts.

I've written more incident reports on my errors (generally late treatments or meds) than anyone elses.

Since unsafe staffing IS in my opinion the cause of so many errors we must work together to ensure enough nursing staff to provide the care that is the ONLY reason for a hospital or skilled nursing facility to exist.

[IMustBeCrazy]

Geez, 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.

I for one enjoy reading your posts. I agree that med errors don't have to cause harm to need an incident report. But if I have a decision about providing good care to my pts during my shift, or writing up an incident report over the 200 mg Ibuprofen that I noted was taken out of Pyxis and not charted....well, I'll leave a note for that nurse to do a late entry and continue with my day.

Hope your day gets better. :smilecoffeecup:

[Nurse_Wretched]

Pick your battles wisely! Don't hold yourself responsible for other nurses' jobs unless you want to be fried, used up, and burned out. If there is a truly dangerous mistake, let the nurse manager deal with it...

[Morainey, BSN, RN]

I was once really, really annoyed with the nurse following me because she caused a major scene during morning report about a non-error (misinterpreted orders or something like that, but she read them wrong and then got all worked up). So I wrote a couple of incident reports about little stuff she did that would normally make me groan and fix them and move on - like IV tubing being labeled on a patient I know was there

Bottom line - if it's a serious error, like a med error or something that causes patient harm - never hesitate to speak up. But stuff like "a saline flush was documented but the IV felt like it hadn't been flushed!"... let it go. Flush the IV yourself and move on.