Arbitration

If you are too passionate, it might look like you are an extremist, you have to tone down the case to the OBJECTIVE portions alone, leaving your two cents at home, ( my humble opinion) . You may add things like "Pt Best Interest" if it applies.

State objectively what was done ( or said - witnesses help) and what you found ( bring copies of charting if that helps) and what treatment the nurse gave (again - from the chart or her testimony or witness). Let the arbitrators make their own conclusions, you dont have to hit them over the head with it,

Try to be calm about it, I dont know the situation, but when I started working as ADON at my facility there was a nurse who everyone thought was the cats meow, charming and gave the impression of being a hard worker and cooperative.

She was a big liar,

I started noticing that when I came to her unit she directed me away from certain rooms so I insisted on entering and found one CNA drunk and sleeping on a pts bed. She had foleys in more than half her pts (management was thrilled with the reduced need for expensive diapers) and used more Clonex and sleeping pills than ordered,(claimed they fell and had to be thrown out- every week!!). In time I discovered she was giving out meds to make her pts zombies without a doctors order. Management was happy as they saved money on a Rec aid on her unit, nothing they can do with her zombies, and everyone all thought that the pts were just end stage alzheimers. All this I could not prove in a court of law, I had no witnesses and it was her word against mine, (she didn't sign for the extra Clonex, and was friends with the pharmacist) the staff obviously took her side, and would call me a liar.

I was over her like a wet blanket, and she slipped up, I found a tube fed pt aspirating on her vomit as she had given her Osmolyte with the head of the bed down, and without her kangaroo pump- I called this nurse immediately to take care of it and she said it was no big deal, she would deal with it later, I ended up cleaning up the pt, suctioning her, taking vitals and calling the doctor (it was aspiration pneumonia) I wrote it all up and she was fired instantly. She was in shock, as she was sure the management would stand behind her , after all she saved them tons of money. (Management was aware of the other problems as I had written them in notes but knew that I had no witnesses)

After she left, she took the weight book and other paperwork with her, messing us up temporarily but in the end it was OK, Our DON was afraid her friends would quit and go with her, but they didnt. We pulled out all the foleys, (guess what, they didn't need them after all...) It took a while but the staff has warmed up to me and realize that I have the pts best interest in mind..

SO remember be objective, bring whatever written evidence you have, bring witnesses if you can, keep your opinions on the matter to yourself but if asked say you cant safely supervise a nurse who does x,y and z.

GOOD LUCK!

I have found that you bring in actual documentation from the regs and the proof that the CNA was abusive per the regs. Also, anything in the employee handbook or policy and procedure book that she did not follow. Stick to the facts and don't let personal feelings get into play.