Tell me what you think....

Specialties Ob/Gyn

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I had a coworker (also very good friend), Stacey, who works in L&D to do something that cost her job. Tell me if you agree she should have lost her job or not. One night while not having any patients in labor or triage (WOW!! Imagine that!), she became very bored so she went down to her 2nd home (ER where she left for L&D) to visit. One of the ER buddies is pregnant...around 8 weeks. Stacey decides to take her to OB and do an U/S to see the baby's heartbeat. Well someone found out..i would assume that the u/s was printed onto paper for evidence and prob passed around to those in the ER. A couple days later, Stacey received a phone call from the nurse manager to see her and the HR director. Stated the company that owns our hospital recommended either suspension or termination, and GUESS WHAT...she got fired! I know that doing U/S is out of the scope of practice, but should she have really been fired for this?! This has really upset our floor tremendously...especially since we only have 3 RN's working nightshift now and extremely short staffed!!!!!!:(

You said it best when you said she acted outside of her scope of practice. Technically she could lose her license. I am sure that no harm was done and it was done with all good intentions. Would I have fired her...I would say probably not, depending on her previous work record. But what your friend did was careless, remember scope of practice. Hopefully she will bounce back and be gainfully employed soon.

Specializes in ICU/Critical Care.

This was a valuable lesson to learn. You do not practice outside your scope of practice and she did. I hope she realizes her mistake and doesn't make the same one twice. I wish her luck in her next job.

Specializes in Family Practice.

I think firing her was over the top. I love to play with our u/s machine. I'm not giving a diagnosis, or a plan of care. Just simply looking at a baby from time to time. We have a portable u/s and frequently use it to verify a Heartbeat if we can't get it with a doppler.

Specializes in OB.
I think firing her was over the top. I love to play with our u/s machine. I'm not giving a diagnosis, or a plan of care. Just simply looking at a baby from time to time. We have a portable u/s and frequently use it to verify a Heartbeat if we can't get it with a doppler.

Check with your legal dept. on this. It's my understanding that any time you perform an ultrasound (even just for a heartbeat check) you are legally liable if you do not pick up an existing problem which would be seen by a properly trained person. Also think twice before using the ultrasound ust to verify a heartbeat. What if you place the ultrasound on a patient, coworker or other person and don't see cardiac activity? Do you really want to be in the position of breaking this news to someone? Or calling a doctor to say "I was just looking at Jane Doe from Med Surg on ultrasound and found no cardiac activity".

I do think firing this nurse was probably an overreaction. A better way of handling it might have simply been to have her do an inservice for the dept. on the legal/ethical issues of this.

Specializes in Nurse Manager, Labor and Delivery.

I don't know about the legalities (although being fired seems to be a bit over the top), but I do know that I absolutely REFUSE to check anything when asked by a coworker or friend. No doppler, no US...NUTTIN!!! I am always terrified that I will find something wrong. Case in point......radiologist at local hospital scanned wife after hours to see what the sex of twins were.. One twin was found to be dead. GULP. Its one thing to be in office setting and find this out, but after hours, with your spouse, alone? Yikes. It creeped me out from the moment I heard they were coming in. My coworkers don't even ask me anymore.

Im not sure. My first reaction is that the hospital I work at would probably fire her too. There are only a few nurses who are trained to use the u/s on my floor and they need Drs orders and it has to be charged in the computer to the patient. I am not sure there is a way to scan a person who isn't a patient and I am sure there would be a paper trail anyway. I think it was careless of her to do it, if only for the reasons stated before... what if something was wrong?

Specializes in Nurse Manager, Labor and Delivery.

We have a portable US machine that lives in a drawer, so it is quite easy for anyone to scan anything. There is no paper trail, or tracking on it to see if it has been used.

Specializes in L&D, QI, Public Health.

At first I thought she should get fired too, but now that I think of it, I've asked the nurses on the floor to give me an EKG before. They were willing but we never got around to it.

Just to be clear, when you guys say doing the US is out of the scope of practice, does that mean you need a special certification to do an U/S or that they are doing it without doctor's orders?

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