Dilemma WHAT CAN I DO

Sleepyeyes · Aug 2, 2002

I wouldn't go anywhere without really strong proof; otherwise, it's slander.

MollyJ · Aug 2, 2002

HE should consider anonymous reporting of his concerns (to the home's admin OR to a shift super OR to the licensing agency for the home).

Remember folks, reporting a concern means just that. Just like in child protection services or Adult protection services, it means you HAVE a concern; it doesn't mean you have to investigate or validate the concern.

IF HE is willing to report his concerns that are based on his first-hand observations AND not scuttlebutt, then it should be reported.

I agree that over-reporting is as dangerous as under-reporting, so the decision to report is always a very considered decision BUT if a person has reasonable concern in this area, they should report.

MollyJ · Aug 2, 2002

Anonymous reporting to a supervising person or agency who has a need to know IS NOT slander, because you are reporting in a confidential way.

Shooting your mouth off in the cafeteria can be slander. Nurse's lounge gossip can be slander.

Here is Black's Law Dictionary definition for Slander

slander A type of defamation. Slander is an untruthful oral (spoken) statement about a person that harms the person's reputation or standing in the community. Because slander is a tort (a civil wrong), the injured person can bring a lawsuit against the person who made the false statement. If the statement is made via broadcast media -- for example, over the radio or on TV -- it is considered libel, rather than slander, because the statement has the potential to reach a very wide audience.

Based on the definition you can see why it is critical that you descriptively report your concerns without labeling the reportee.

If you say something like, "Mary came to work. She was irritable and no one could get along with her. She was edgy and constantly on people. Her boyfriend, Bill came to see her. We noticed he slipped her a small envelope. He didn't stay long. She went to the bathroom and then went into her patient rooms. About 1/2 hour later, she was in a much more mellow mood BUT she couldn't sit still and kept cleaning and rearranging her rooms over and over. I (the relief charge nurse) told her to let her post-op get some sleep.

Mary has had alot of mood ups and downs and she mentioned to one of the other nurses, which I overheard, that she really only needs 2 or 3 hours of sleep a night.

Frankly, Mary's mood swings remind me of a relative who was on speed. I'm not qualified or willing to label Mary, but due to the mood swings and the increased number of drug errors in her record over the last 6 months, I have some concerns.

NOW a supervisor may:

1) note the concern and do nothing;

2) talk to Mary;

3) add this in to other concerns she has about Mary or other reports of concern. Let's say that Mary is on the Professional Assistance program and only the HN knows that--she'd be a referral at that time.

Maybe prior to Mary coming to this unit, there was a concern at her previous unit with missing Ritalin and she seemed implicated but was given the benefit of the doubt.

Maybe, Mary's best nurse friend has expressed additional and explicit concerns to Mary's head nurse, too.

Or, finally, the Headnurse got a report from another nurse working with Mary about Mary's hygiene. She was indignant that Mary seemed to smell like CAT urine. Mary's head nurse knows that this strong ammonia smell can be a byproduct of Methamphetamine manufacture.

Working up to a referral to the professional assistance program can take some time. Sometimes it takes time for the picture to develop. However, it is information, confidentially given and handled that fuels that much needed referral.

A single confidential report that never gets followed up by another report (a false or jumping to conclusions report) is likely to "die a natural death" and not cause another concern to a nurse manager or a nurse employee. Also repeated reports that seem to come ONLY from nurse/employee may reflect a separate interpersonal concern between those two nurses. A pattern of a number of different persons leading back to the same concern should be much more concerning to a supervisor.

NurseKimberley · Aug 2, 2002

I agree with Molly -- if he was concerned enough to come home with this 'ethical dilemma' that tells me he thinks there is enough evidence to report his concerns to a supervisor, and it really shouldn't be a dilemma, if someone is possibly using drugs while they are supposed to be caring for patients, that is cut and dry.

SmilingBluEyes · Aug 2, 2002

HE needs to take action. NOT you! He is the one who knows the "facts" and it is incumbent on him to take responsibility for what he knows. You don't KNOW the facts,but what he has told you. In your situation, I would encourage him to take proper action and then consider MY part done.

flowerchild · Aug 2, 2002

Speed. What is it? Is it a legal prescription like Mehtylphenidate? Or is it OTC caffeine pills? Could it be she takes some herbal pick me up pill? Or is this truley a caregiver who is on an illegal substance?? Better to get your facts before you say anything IMO.

kittyw · Aug 2, 2002

Originally posted by MollyJ
Here is Black's Law Dictionary definition for Slander

slander A type of defamation. Slander is an untruthful oral (spoken) statement about a person that harms the person's reputation or standing in the community. Because slander is a tort (a civil wrong), the injured person can bring a lawsuit against the person who made the false statement. If the statement is made via broadcast media -- for example, over the radio or on TV -- it is considered libel, rather than slander, because the statement has the potential to reach a very wide audience.

The defense for a slander suit is that it was the TRUTH.

Soooo..... I'd suggest he keep a record for a week or so of this person's actions then report it ... just the facts. Keep the record with date, time, what happened, to whom, list of witnesses, etc. to cover his a$$ and so that admin or whoever has a clear record to base their actions.

jevans · Aug 3, 2002

Many thanks to you all for your advice. Reading has made things clearer.

Molly j thank you so much for your indepth answer.

Hubby also says thanks:kiss

Flowerchild speed is any form of uppers, not normally OTC

j

jevans · Aug 8, 2002

i spoke to a senior rn of the nursing home today!!!

guess what??

she had a very good idea who this carer was from her irratic behaviour at work. they did not know however what was causing it.

she plans to monitor this person more closely in the future

so to you all-

thank you :kiss :kiss

j

Youda · Aug 9, 2002

Check with the State regulations concerning long term care. Some States have "immunity" laws that protect an individual for reporting good faith SUSPICIONS as you have. Please remember that it is not your job to do an investigation or prove your the information. Some States make it a criminal misdemeanor NOT to report these kinds of suspicions. Many States only ask for a "suspicion" for a reporting. You can also call the Division of Aging, or Health and Human Services, for your State. You can usually do that anonymously.

fab4fan · Aug 11, 2002

If he is concerned, then it is HIS responsiblity to take the necessary steps. If you haven't witnessed the behavior, then it really isn't appropriate to report it.

Yes, we need to be concerned with pt. safety, but we should also be careful not to do something that could stigmatize a fellow professional.