Retaliation for voicing concern over unsafe pratices

May I make a suggestion here? Management folks tend to get very defensive when the work "incompetence" is thrown at them as SUBJECTIVE term. Much better to use phrase "nursing practice issues" as that can be described in concrete objective terms using state board of nursing standards, department policies and procedures, nursing textbooks, ANA Standards of Practice and Code for nurses, specialty organization standards: AACN standards apply here

I'd recommend printing out those emails with glowing praise and having copy of last evaluation. HR required to allow you access to employee files and for employee make any corrections, add explanatory note-since you've left, lawyer might need to help you gain access.

I'd write down time line of all issues you brought to Managers attention, note any documentation supporting your concern, etc and your managers response or lack thereof to each issue.

Each state has its own practice act with interpretations by each state board of nursing(SBON). Link to all SBON here:
http://allnurses.com/nursingboards-a-k.shtml

Google search "Determining competent practice + nursing" came up with these interesting articles



The ANA supports the professional obligations of the nurse to safeguard patients.
It is the nurse's responsibility to:

• Provide competent nursing care to the patient.
• Safeguard patients and avoid actions that place the interests of the patient(s) in jeopardy. The right to refuse an assignment should be narrowly construed and the nurse must balance such a refusal against the obligation to provide for patient safety and to avoid abandonment. A refusal of an assignment may be justified when the risk of harm to the patient(s) is greater by accepting the assignment than by rejecting it.
• Exercise informed judgment and use individual competence and qualifications as criteria in giving, accepting or rejecting an assignment. Nurses are individually accountable for the care of each patient.
• Clarify assignments, assess personal capabilities, jointly identify options for patient care assignments when the nurse does not feel personally competent or adequately prepared to carry out a specific function.
• Determine what will put a patient in immediate, serious danger. The nurse may be held legally responsible for judgments exercised and actions taken in the course of nursing practice. ...

Nurses are accountable for judgments made and actions taken in the course of nursing practice. Neither physicians' orders nor the employing agency's policies relieve the nurse of accountability for actions taken and judgments made.
http://www.nursingworld.org/readroom/position/workplac/wkassign.htm


Nursing Management - Fulltext: Volume 36(5) May 2005 p 14-16 What ...
Nurses have the legal obligation to report conduct that's incompetent, ...
safety are affected by incompetent, unethical, or illegal practice by any person. ...
www.nursingmanagement.com/pt/re/ nursemgmt/fulltext.00006247-200505000-00006.htm


Assuring Competence
A Regulatory Responsibility
Figure 1: Standards for Competence
www.ncsbn.org/resources/complimentary_ncsbn_competence.asp


North Carolina Board of Nursing
Section: § 90-171.37. Revocation, suspension, or denial of licensure.
(5) Is unfit or incompetent to practice nursing by reason of deliberate or negligent acts or omissions regardless of whether actual injury to the patient is established;
www.ncbon.com/NPA.asp


Nursing Practice Act
Administrative Code (Rules)
Learn About North Carolina’s Nurse Practice Act-and Earn CE Credit!

Kansas Nurse: Kansas guidelines for the registered nurse in ...

Connecticut Nursing News: Continuing education: Scope of practice ...



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Depending on facility, review boards may be helpful. Ones I've been involved in as part of Grievance Task Force about 60% sided with management, 40% sided with employee and able to overturn termination decisions. Take a look at your facility's process. Often employee is able to bring colleague to provide support to you along with lawyer. Some allow you to choose members of pannel from those on a list so cross section of departments represented. Look carefully at this option, and don"t choose only those in nursing-- maintenance and radiology staff often look at issue as department outside and are able to look objectively at situation, instead of having "department blinders" on.

Good luck in taking this stand.

Edited for clarity, spelling and links!

May I make a suggestion here? Management folks tend to get very defensive when the work "incompetence" is thrown at them as SUBJECTIVE term. Much better to use phrase "nursing practice issues" as that can be described in concrete objective terms using state board of nursing standards, department policies and procedures, nursing textbooks, ANA Standards of Practice and Code for nurses, specialty organization standards: AACN standards apply here

I'd recommend printing out those emails with glowing praise and having copy of last evaluation. HR required to allow you access to employee files and for employee make any corrections, add explanatory note-since you've left, lawyer might need to help you gain access.

I'd write down time line of all issues you brought to Managers attention, note any documentation supporting your concern, etc and your managers response or lack thereof to each issue.

Each state has its own practice act with interpretations by each state board of nursing(SBON). Link to all SBON here:
http://allnurses.com/nursingboards-a-k.shtml

Google search "Determining competent practice + nursing" came up with these interesting articles



The ANA supports the professional obligations of the nurse to safeguard patients.
It is the nurse's responsibility to:

• Provide competent nursing care to the patient.
• Safeguard patients and avoid actions that place the interests of the patient(s) in jeopardy. The right to refuse an assignment should be narrowly construed and the nurse must balance such a refusal against the obligation to provide for patient safety and to avoid abandonment. A refusal of an assignment may be justified when the risk of harm to the patient(s) is greater by accepting the assignment than by rejecting it.
• Exercise informed judgment and use individual competence and qualifications as criteria in giving, accepting or rejecting an assignment. Nurses are individually accountable for the care of each patient.
• Clarify assignments, assess personal capabilities, jointly identify options for patient care assignments when the nurse does not feel personally competent or adequately prepared to carry out a specific function.
• Determine what will put a patient in immediate, serious danger. The nurse may be held legally responsible for judgments exercised and actions taken in the course of nursing practice. ...

Nurses are accountable for judgments made and actions taken in the course of nursing practice. Neither physicians' orders nor the employing agency's policies relieve the nurse of accountability for actions taken and judgments made.
http://www.nursingworld.org/readroom/position/workplac/wkassign.htm


Nursing Management - Fulltext: Volume 36(5) May 2005 p 14-16 What ...
Nurses have the legal obligation to report conduct that's incompetent, ...
safety are affected by incompetent, unethical, or illegal practice by any person. ...
www.nursingmanagement.com/pt/re/ nursemgmt/fulltext.00006247-200505000-00006.htm


Assuring Competence
A Regulatory Responsibility
Figure 1: Standards for Competence
www.ncsbn.org/resources/complimentary_ncsbn_competence.asp


North Carolina Board of Nursing
Section: § 90-171.37. Revocation, suspension, or denial of licensure.
(5) Is unfit or incompetent to practice nursing by reason of deliberate or negligent acts or omissions regardless of whether actual injury to the patient is established;
www.ncbon.com/NPA.asp


Nursing Practice Act
Administrative Code (Rules)
Learn About North Carolina’s Nurse Practice Act-and Earn CE Credit!

Kansas Nurse: Kansas guidelines for the registered nurse in ...

Connecticut Nursing News: Continuing education: Scope of practice ...



-------------

Depending on facility, review boards may be helpful. Ones I've been involved in as part of Grievance Task Force about 60% sided with management, 40% sided with employee and able to overturn termination decisions. Take a look at your facility's process. Often employee is able to bring colleague to provide support to you along with lawyer. Some allow you to choose members of pannel from those on a list so cross section of departments represented. Look carefully at this option, and don"t choose only those in nursing-- maintenance and radiology staff often look at issue as department outside and are able to look objectively at situation, instead of having "department blinders" on.

Good luck in taking this stand.

Edited for clarity, spelling and links!

Just adding here...Since you think that they have tampered with your charting...And I assume that it's computerized charting...If it's ''edited'' by either you or someone else, then you should be able to know who edited it. From the IT department. Though I wouldn't mention that over the phone, it's better if you can print out the info right before the grievance process and you're in front of the board, just to avoid additional tampering from their part. I'm glad you want to clear your name, but for me personally I would not return. But your reputation is what you're basically after.

You know...I can think of 3 instances in which 3 seperate employees failed to document any vitals or ANY type of assessment on a CC patient in the hospitals ICU.Would you like to know what happened to those 3 nurses? One got a transfer request shed asked for..with a good reference....one got Performance Improvement counseling....and the other got no form of reprimand at all. The great " crime" for which I was alledgedly fired for was "documentation of vital signs before the time had occurred".Like documenting 8 am vitals at 7:30 am.The problem is....I was actually doing frequent assessment vitals on a patient every 15 minutes because the patient was rapidly changing. Now...after telling that incompetent nurse that I was going to inform risk mgmt of her unsafe pratices...she ripped my frequent assessment vital sign sheet out of the chart while my head was turned and it is now MIA...conviently.So when searching for a REASON to terminate me.....all they could come up with was saying "she charted 8 am vital signs at 7:30 am".But...the ones who charted nada on these critical patients for an entire 12 hour shift received usually no form of reprimand.
I have checked and I am actually covered under 4 different laws in TN from retaliation.