Protection against 'problem' nurses - page 8

Nurses fired for stealing drugs would get reported. So would pharmacists who lost their jobs for making repeated and serious mistakes. Also listed would be respiratory therapists who hit and abused... Read More

  1. by   CCU NRS
    Ok I have not read every post but I would just like to throw in my 2cents.

    I was working with a woman that had recently been hired and I noticed she wasn't doing much Pt care but always hung around near the calll lights at the desk and was always availabe to go give pain meds for anyone that called. As most of the other nurses were busy and she didn't seem to be they would just say thank you and let her give the pain meds.

    I also noticed she was going to her locker very frequently and out side to smoke quite a bit. I sort of watched her and walked in a couple of times when she would go to the locker room and when I would walk in she would jump and turn covering whatever she was doing in her locker.

    I suggested to the charge nurse that she quietly have pharmacy check how much narcotics this nurse was pulling from the pyxis just because I thought she was acting strange, they found that that day alone she had pulled 14 4mg Morphine on various Pts and 25 Demerol of various dosages on various Pts. This seemed like a lot. Pharmacy checked her previous work days and found similar habits always large quantities of Morphine and demerol and never any P.O. meds.

    While data was being gathered she apparently became suspicious and without going through proprer channels, told the Unit secretray she was having a very bad Period and bleeding really badly and she had to leave and could not find the Charge nurse and asked her to please let her know she had left, also she had taped shift report.

    She never returned to work she called in sick a few days then just called to say she was moving her husband had gotten a job offer and she would not be back. There was never any follow up because she left the facility without ever having been caught.


    Now about something that happened to me.


    I was charged with assault, a Pt filed charges on me for assualt and as I am required to do by my nursing board I sent them a letter informing them of the charges and that it was going to be seen by the district court etc. The Pt was an 80 y/o male that was having runs of V-fib/V-tach and was symptomatic with syncopal episodes, what he claimed was that I slapped him in the face, I don't remember evry episode but do beleive that at one point I was attempting to revive him by lightly slapping him around(edited because of the prior phrase, I did not mean slapping him around what I meant to imply was that I lightly slapped him to revive him, I actually laughed when I read slapping him around LOL) after an episode and in his confusion he thought I was slapping him with malicious intent. I was interviewed by the police and he gave a statement and one of his daughters was upset with me as well for admonishing her about removing wrist restraints and I feel that she was an instigator, never-the-less I was charged.

    When the case got to the Prosecutor charges were dropped in favor of the circumstances being likely as I had reported them and the fact that he was a confused Pt suffering lapses and syncopy.

    So under these guidlines I assume I would be on the list and the nurse I wrote about that was never caught would not?
    Last edit by CCU NRS on Mar 14, '05
  2. by   acynicalnurse
    Just my opinion / experience.

    In australia we have a registration board (government run "in the public interest") that keeps some record to some extent and is related to legislation

    But
    I do as an agency RN i hear and see no one reporting anything at times, Likewise the next up in the chain of command if you will: does nothing, and then other times where a person doesn't admit fault and so a witch hunt ensures and it becomes a political excercise forced by management and or the "leader" knows but again without proof or conflicting reports given can do nothing.

    What i have hated more is that lots of times the "talking" to that someone gets leads to a person resigning and then no record is ever keep. so this person goes on to the next job many times without no report going to a board for RN to be reviewed or anything else being done to monitor etc these people that undermine the profession, the well being of the pt

    my hubby thinks i too political or out spoken cos i verbally report lots but nothing ever occurs especially if i look for guideance from the superior or where the duty of the person above me is negated due to management and or "a wish to keep any staff" not to mention the *****ing that does and can take place manipulating any real effect of a reporting system becomes redundant.

    I am becoming more cynical at times and disheartened that nurses who stay in the trade don't do more for their pt's, their fellow nurses or themselves(no access to real retraining or counselling)

    Don't know if this helps or will make any difference really. In our state we have a mandated reporting system for children against abuse but for aged care there is nothing which is so wrong where so many are being pseudo? institutionalized (at least here in aust)

    I feel these are very true too

    "I think a conviction on a charge would have to be involved before this would fly. Neglect/abuse are serious charges, if guilty then by all means, have a valid record."

    "And I don't believe that unsubstantiated alligations should be part of any registry."

    JO
  3. by   Crumbwannabe
    edited for brevity ...the pt was an 80 y/o male that was having runs of v-fib/v-tach and was symptomatic with syncopal episodes, what he claimed was that i slapped him in the face, i don't remember evry episode but do beleive that at one point i was attempting to revive him by lightly slapping him around after an episode and in his confusion he thought i was slapping him with malicious intent... when the case got to the prosecutor charges were dropped in favor of the circumstances being likely as i had reported them and the fact that he was a confused pt suffering lapses and syncopy.[end quote]

    i bet he was having symptoms if he was in v-fib. may i gently ask why you would treat a lethal dysrhythmia by slapping someone to revive them? i personally use acls protocols.
    Last edit by Crumbwannabe on Mar 14, '05 : Reason: insert
  4. by   SmilingBluEyes
    I was sorta wondering myself, crumb.
  5. by   CCU NRS
    Quote from crumbwannabe
    edited for brevity ...the pt was an 80 y/o male that was having runs of v-fib/v-tach and was symptomatic with syncopal episodes, what he claimed was that i slapped him in the face, i don't remember evry episode but do beleive that at one point i was attempting to revive him by lightly slapping him around after an episode and in his confusion he thought i was slapping him with malicious intent... when the case got to the prosecutor charges were dropped in favor of the circumstances being likely as i had reported them and the fact that he was a confused pt suffering lapses and syncopy.[end quote]

    i bet he was having symptoms if he was in v-fib. may i gently ask why you would treat a lethal dysrhythmia by slapping someone to revive them? i personally use acls protocols.
    he did this many times and they were all very short but they did cause syncopy the defibrillator could not even charge before the rhythm would resolve then it was a case of determining if the pt had lingering effects or was mentally intact. i have ammended my ealier post after reading the way i wrote it, "slaping him around" i was writing and using around to mean to consciousness, but when i reread it i see how it sounds pretty bad lol anyway. he did this the first time when his physician was present she wanted me to wake him afterward and be sure he was ok. i did then attach him to a monitor and defib pads but these were very short bursts if someone wasn't standing right there when it happened it was over before the defib even had time to charge. it had been a really bad day all in all.

    let me start at the beginnning.

    80 y pt esrd dialysis 3x a week admitted for sepsis, had gone to dialysis prior to day shift starting, during dialysis this usuallly cooperative pt became anxious, agitated and having feelings of impending doom, he was transferred to ccu, on arrival he was stable but anxious and continued having the feeling of impending doom, telling me he was going to die, all vs were stable and he was chronic a-fib which was known and he was otherwise stable, i called his cardiologist and reported his feelings and that he was seriously frightened, i was given orders for ativan, i wasn't too happy about the choice but figured who knows if he settles down maybe he will be alright. i gave ativan and he didn't change at all didn't alleviate any of his fear or anxiety, i called again after an hour or so to report this and ask if we should possibly do a spiral ct, possibly he is impending doom d/t pe? i was informed that he had a - d-dimer and pe was unlikely and why don't we just try some respirodol first, he also said go ahead and give him some morphine, i think if you can get him calmed down he will be ok, he also added that he really is very sick and he might die and he might really be having impending doom because he was going to die. i was not very happy with these answers so i called his nephrologist, who thankfully came to see him, she was concerned, while she was there he had his first episode, she was in the room alone with him and he went into v-tach and fainted she called out to me by name and yelled get in here and call the code, i ran in looked at the monitor and asked what happened and she looked at the monitor and said i swear he was in v-tach i wouldn't just panic like that, wake him up and see if he is ok, i think i slapped him lightly to arouse him and he woke up with a shocked look on his face and looked at the doctor and asked what is going on here. he had several more episodes through out the day and we had a defib attached with pads etc but he never stayed in v-tach or v-fib long enough for anyone to see it and get the defib charged, he finally calmed down and then when the doctor spoke with him again about the entire situation he and his family made a dnr decision, he went home with hospice the next day and died friday night. prior to leaving the facility he asked to speak with my supervisor and he told her he wanted to press charges, she asked him to explain what happened then she explained what she thought had occurred, then the doctor that was there talked to him and explained what had occurred, but he felt he had been assaulted and was allowed to call the police and make charges and give his statement. i was also called in on my day off and asked to explain the situation and give a statement to the police then i was put on administrative leave of abscence until the matter was settled.

    i was off for 2 weeks awaiting the court to see the case then the prosecutor dropped it as i mentioned.
    Last edit by CCU NRS on Mar 14, '05
  6. by   mattsmom81
    Regarding your earlier question CCUNurse: 'So under these guidelines I assume I would be on the list and the nurse I wrote about that was never caught would not?'
    __________________
    You both would make the Group One database in Dallas Fort Worth. Her because she quit without proper 2 week notice. You because you were reported for suspect behavior. And by the way, even if you are vindicated by the BON, the fact you were reported stays on Group One ...forever.
    Last edit by mattsmom81 on Mar 14, '05
  7. by   CCU NRS
    Quote from mattsmom81
    Regarding your earlier question CCUNurse: 'So under these guidelines I assume I would be on the list and the nurse I wrote about that was never caught would not?'
    __________________
    You both would make the Group One database in Dallas Fort Worth. Her because she quit without proper 2 week notice. You because you were reported for suspect behavior. And by the way, even if you are vindicated by the BON, the fact you were reported stays on Group One ...forever.
    Actually in my case the Board never got involved other than my sending them 2 letters the first to explain I was being charged and the second explaining that the State Prosecutor declined to file, on grounds of opposing stories and lack of evidence, calling it basically a he said she said type situation.
  8. by   Crumbwannabe
    Quote from CCU NRS
    He did this many times and they were all very short but they did cause syncopy the defibrillator could not even charge before the rhythm would resolve then it was a case of determining if the Pt had lingering effects or was mentally intact...
    Speaking strictly from an E/P lab point of view it is a rare, but not impossible, event to see VF spontaneously convert. Also 1 single VF episode is standard of care to implant an ICD, on the willing patient. I assume the patient was either placed on the customary antiarrythmic drips, or the DNR was signed right then and there.

    But if this occured with an MD present who left the patient without placing him in the care of an interventionist, seems to me they would be going for the money from the doc & hospital for such a gross neglect/abandonment. I dunno, I wasn't there. But Chief of Staff, Risk Management, and every other son of a gun and their uncle should have been notified. 'Zygomatic thumps' just don't work here.
  9. by   CCU NRS
    Quote from Crumbwannabe
    Speaking strictly from an E/P lab point of view it is a rare, but not impossible, event to see VF spontaneously convert. Also 1 single VF episode is standard of care to implant an ICD, on the willing patient. I assume the patient was either placed on the customary antiarrythmic drips, or the DNR was signed right then and there.

    But if this occured with an MD present who left the patient without placing him in the care of an interventionist, seems to me they would be going for the money from the doc & hospital for such a gross neglect/abandonment. I dunno, I wasn't there. But Chief of Staff, Risk Management, and every other son of a gun and their uncle should have been notified. 'Zygomatic thumps' just don't work here.
    Well he was a very sick guy and his Cardiologist really didn't want to do anything with him he had a long history of PVD and CAD and CABG and IDDM and ESRD and he was septic at the time, he was not a good candidate for much of anything and the nephro basically called the family together and gave them all the info and then told them it was in their hands if they wanted to take further action the Pt was ready to sign DNR but the family needed time, it was deceided within a matter of hours but no not immediately. He was on our unit attached to defib for that time and never had any runs long enough to be shocked, but did have several Mostly V-tach but at least one V-fib or asystole if you prefer.

    I also had a Pt last week that was coded in V-fib and the family was in the room when the code team ruished in and he was shocked without conversion and before the third shock the wife was already saying stop it stop it, the code was ended she did not want him intubated he was made DNR and had no rhythm and was not breathing, the code tewam left then a short time later he began breathing spontaneously, they called and wanted a unit bed for what I had been told by the code team was dead Pt, I wnet to assess the Pt and he was 02 sat 97% on a NRB and had a pressure of 80/45 and was ST 114, he was still a DNR but we movewd him to the unit and he died 2 days later, but he apparently converted on his own.

    There are stranger things in Heaven and earth...etc.
  10. by   mattsmom81
    Quote from CCU NRS
    Actually in my case the Board never got involved other than my sending them 2 letters the first to explain I was being charged and the second explaining that the State Prosecutor declined to file, on grounds of opposing stories and lack of evidence, calling it basically a he said she said type situation.
    You're misunderstanding what I'm getting at. Group One reports come from the EMPLOYER not the BON.

    Once the BON throws out/expunges a charge, it should go away right? Well it might...with the BON anyway. BUT this doesn't end Group One's involvement: the hospital looks at it this way. "a nurse did something questionable/wrong, and it went to Peer Review (or wherever...a charge was made by someone) so it goes to Group One."

    To forever come up every job interview to all potential employers...a red flag.

    So...just be glad Group One isn't in your parts. I'm glad you came out a winner in this situation; recognize in some areas of the country this would not be the end of it.
  11. by   Amethyst Veralyn
    [quote=Amethyst Veralyn;988474] In some places the popular nurses are protected by the others when they are negligent. It also happens
    where co workers assign attitudes and opinions to a suspected abusers that come out their imaginations so that what's actually on record is mostly fiction. It also doesn't
    take into account that abusive people can get help for themselves and improve their
    patient care habits.
    If they create a data bank they will be missing the names of nurses who
    never got reported so it wouldn't even be an accurate source of information.
    If a nurses name is posted on the web this way there should be a way that she can participate in this public
    discussion about her and give her own feedback. They can't just go deaf when someone can account for their
    actions.
  12. by   MatRNstudent
    Am I misunderstaning your post?!?!:selfbonk:Women don't show compassion for one another???

    EDIT: The quote I'm referring to is in the following post
    Last edit by MatRNstudent on Jan 7, '09 : Reason: ommitted relevant quote
  13. by   MatRNstudent
    Quote from mydesygn
    I realize that the posting originally started related to a "bad" nurse database. And a few years back, I would have been naive enough to believe that only "bad" nurses would be reported. Unfortunately, it has become my persoal experience that this does not happen. I have discovered that peer review is frequently being used in a punitive manner. Here's the difference: Susie is a "good" nurse, one day she inadvertently didn't calculate Intake correctly. You corrected her mistake after all she was really busy that day. However, a few weeks later Janie forgets to calculate the 8 hour total for an IV fluid, You decide to write an incident report because Janie should be accountable to her practice and she has been her long enough to know better. Well no one talks to nor helps Janie, pretty soon she has 3 minor incident reports, and finds herself in Peer Review. You get the picture... Nurses spend so much time blaming and criticizing those we don't like and excusing and protecting those we do that you cannot guarantee reporting that is fair and grounded in a desire to protect the patient. The fact that the BON has to throw out so many complints that lack merit is proof enough that we can not trust equitable reporting.

    Other "professions" such as police officers, firefighters, physicians etc.. do not report colleagues for minor and insignficant issues. My brother (a truckdriver) said himself " you don't mess with a man's livlihood, not without a real good reason" yet women feel no sense of compassion or concern for one another.

    I can only reiterate " the worst enemy of a nurse is another nurse". Until that stops, no database will weed out the "bad" nurses. After all, the bad nurse understands the politics, her "friends" will always excuse her -- she'll never end up peer review or any database.
    Ooops meant to include this quote in my posting.

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