boss took away pts o2

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scenario - pt was a friends pt. she had to send him out for an xray of his hand per doc order when he bashed his hand againts the wall and made obvious defomities. he did not wish to send him off stating he didnt see a deformity though doc said it is there ad he will go. then - pt is required by law ( on continuos o2 order ) ( this is at a state prison infirmary) to have staff with due to o2. boss told security he would go wthout o2 so staff didnt have to go. pt fell out of chair on way out door. again - nurse assessed and was going to hook up o2 - boss came and took o2 cannula put it on pt but did not put o2 on - didnt even put tank on chair. told pt o2 was on and fooled him. and sent him on his way without the o2. luckily nothing further happened. should this nurse report the boss? and where? oh and she has a problem as boss has her on probation and is trying to "get her". no matter what he has tried failed, but makes her life mmiserable........ she is an excellent nurse and he is messing with her because he does not like the fact she stands up for pts and staff. i told her that it is her license if she allows that pt out the door without any o2 having a cont order - - even though she charted the boss took off o2 and faked the o2 on for transport. who would be held liable if a boss overrides our decisions and how would we chart it ( chatrting "because the boss did it - is basically an admission we did NOT do it. ) - any ideas? thanks. ( by the way doc saw all this and said NOTHING! in my opinion they both need to be reported somehwere. but whwere do you go - without the risk of loosing your job?) we are liable to not only do what docs and bosses tell us whn its right but are we not also required these days to question and NOT do things that are wrong? help please. and thank yo in advnce.

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Specializes in Advanced Practice, surgery.

By the boss do you mean prison staff or nursing staff.

I assume that you mean prison staff as I can't imagine any nurse removing O2 from a patient. Clearly this situation is unacceptable, and because I am unsure of your management structure it is difficult to suggest what the best course of action would be.

Is there not a senior nurse / DON that you can go to with this problem, if you are in charge of providing care for these patients then a non nurse has no business interfering and over-riding your clinical care.

Personally I would report to who ever I could, this Boss must have a senior of his own, report there as well. Compromising patient care in this way is not acceptable

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unfortunalty it was the boss ( read manager ) of the unit and he is an RN - however i contend that it isnt his pt so we would still be liable shoudl anything happen when he did it , when we are fully aware and when he takes over our pt. howwever - standing up to him would cost your job unfortunatly - so how does one go around that? his boss would be the warden - but even if he gets a slap on the wrist, she still wuold likly loose her job as he has been looking for any excuse to get rid of her ( though non of his bull has stuck so far as she is that goood. he cant find a way to get rid of her so far ) and as i sadi she cant go to the doc as the doc is new and afraid if his wrath as well. the doc was present when it went on!! and just turned her head to the fact he did it. even the prison staff guards) were appalled and going to report it but never did. this is not the firsttime he has done dangerous stuff and noone tells out of fear for thier job. personally i am leaving - i cant work with a nurse who would do hrm to a pt that way. regardless if that pt "needed" it or not physically - he does need it emotionally ( physically too but he survived the ride which is short) any further thoughts?

By the boss do you mean prison staff or nursing staff.

I assume that you mean prison staff as I can't imagine any nurse removing O2 from a patient. Clearly this situation is unacceptable, and because I am unsure of your management structure it is difficult to suggest what the best course of action would be.

Is there not a senior nurse / DON that you can go to with this problem, if you are in charge of providing care for these patients then a non nurse has no business interfering and over-riding your clinical care.

Personally I would report to who ever I could, this Boss must have a senior of his own, report there as well. Compromising patient care in this way is not acceptable

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Specializes in Advanced Practice, surgery.
unfortunalty it was the boss ( read manager ) of the unit and he is an RN - however i contend that it isnt his pt so we would still be liable shoudl anything happen when he did it , when we are fully aware and when he takes over our pt. howwever - standing up to him would cost your job unfortunatly - so how does one go around that? his boss would be the warden - but even if he gets a slap on the wrist, she still wuold likly loose her job as he has been looking for any excuse to get rid of her ( though non of his bull has stuck so far as she is that goood. he cant find a way to get rid of her so far ) and as i sadi she cant go to the doc as the doc is new and afraid if his wrath as well. the doc was present when it went on!! and just turned her head to the fact he did it. even the prison staff guards) were appalled and going to report it but never did. this is not the firsttime he has done dangerous stuff and noone tells out of fear for thier job. personally i am leaving - i cant work with a nurse who would do hrm to a pt that way. regardless if that pt "needed" it or not physically - he does need it emotionally ( physically too but he survived the ride which is short) any further thoughts?

I'm appalled that a nurse could behave like this, further thoughts I think you've got the right idea working in that type of environment I'd want to get out too. If your boss is an RN and over riding the decision of another RN then surely if it's documented then the responsibility will lie with him (bear in mind I'm in the UK and if another nurse made a clinical decision on one of my patients that was detrimental it would be their professional responsibility to defend that decision. I would document concerns and hand the patient over to that nurse.

As far as what actions to take (for your friend) I guess that would depend on how tough she is, this probation sounds like bullying (although I am not sure of the background behind that so I am making assumptions here) it smacks of "do it my way or I'll get you sacked" If it were me, I'd report to the seniors and document like mad but that's a really difficult road to take and not one that I would take lightly.

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thanks. yes he is well bullying an she has it well documented. my concern is i was taught that no matter what it is our pt it is us who would take the fall.( matter of fact there were 3 nurses whi just finished winning a lawsuit that took over 3 yrs to get it isnt like the guy takes pts th thrugh and it was all over this same kind of crap. they were vindicated but the horror of 3 yrs of trials and lawyers etc wsa unecesssary ) he idnt a floor RN so he doesnt take pts so that she can "turn the pt over" - she has to keep the pt or is bound to be labeled as abandoning them. thank you for your opinions - sound like i am pretty well founded in my ideas - just looking for validation lol. i am "just" agency so i am leaving in a hurry- i hope she will also cause its just dangerous in y opinion. id rather loose a job then my license.

I'm appalled that a nurse could behave like this, further thoughts I think you've got the right idea working in that type of environment I'd want to get out too. If your boss is an RN and over riding the decision of another RN then surely if it's documented then the responsibility will lie with him (bear in mind I'm in the UK and if another nurse made a clinical decision on one of my patients that was detrimental it would be their professional responsibility to defend that decision. I would document concerns and hand the patient over to that nurse.

As far as what actions to take (for your friend) I guess that would depend on how tough she is, this probation sounds like bullying (although I am not sure of the background behind that so I am making assumptions here) it smacks of "do it my way or I'll get you sacked" If it were me, I'd report to the seniors and document like mad but that's a really difficult road to take and not one that I would take lightly.

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how about reporting him to the state board.....and informing the patient that was sent out without the o2.....so he can file a complaint as well......removing/not providing an ordered drug, ie the ox. ON PURPOSE, not "missing" the order, doesnt sound too good when it comes to licensing a nurse....

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Specializes in PICU.

What were the sats? Was the patient on O2 for comfort or necessity?

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Specializes in Cardiac, ER.

If the doc was standing there, maybe you should have charted "doc at bedside" and leave it at that,..as mentioned earlier I guess it depends on why this pt is on O2,.sats etc.

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Specializes in ER, IICU, PCU, PACU, EMS.
If the doc was standing there, maybe you should have charted "doc at bedside" and leave it at that,..as mentioned earlier I guess it depends on why this pt is on O2,.sats etc.

That's an excellent idea. Or (I know, hindsight....) since the Doc was present, ask him/her "So...do YOU still want the patient to be transported without O2?" In that way, you have either a change of orders or a verification and can document in the orders either way. In the nurses notes, you could document that the Dr was present, question asked and the response of the RN manager. In this way, you now have the Dr as a documented witness who is aware of the situation and the blatant disregard for pt orders and the standard of care by the other RN.

Yeah, I'd run out of ASAP too!!:uhoh3:

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k checked some facts - 88 % was sao2 - however pt has significant history of copd and chf- was reporting he cuoldnt breath ( also sinificant anxiety problems which have often set him off in attacks) as well as many other significant history of illnesses - we have often thought he has not been long for this world but he keeps poopping back- you know the kind lol - doc is also on probabtionn and though i can not excuse it i do understand her position to tyrn her head and pretend not to see it. - though i am still hoping the security staff report it as they said they wold - then the doc will not be happy she didi that , not only that this man often needs a mask to get his saots up because his conditions make him quite frail and his conditions frgaile.- anywho- hospital had to put on o2 and they were reportadly livid- this man has been transfered many tiimes and NEVER without o2. and security knew this as well and were not happy - especially after he was already on the floor once on leaving.

question - though he did apply the nasal canula is this not prescribing ? in essence he "prescribed" a placebo - who is he to do that because he doesnt want to pay staff to go with. that is out of our nursing scope of pracitive. now- i know these guys are many times not good men or they wouldnt be there - but are they not still human being s and have the right to approriate health care . if it were out in the public i can almsot assure you any family would have had the bosses butt in a hurry- because these guys a lot of times have no family or at least available family..... who then is there to advocate for them if not us? \\

i know i have viewed my charting sytyle anew - and have several friends who used to chart " because the bboss did it" and the like, and thinkinng it covers our butts, but the more i have thrown it aorund my head- the more i realize that we are only admitting OUR negligence in OUR care. this man was abusive in my opinion - take o2 away in public we have our heads on a plate for abuse.......it wasnt even negligence it was blatant abuse.

the nurse had written it up however its a matter of who to go tto. perhaps the warden? i dont now what will be done but i appreciate everyones input., so as to better deal with it if it shoud arise aagain. so thank you.

What were the sats? Was the patient on O2 for comfort or necessity?
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