Charge nurse asking me to lie

[julz68]

The other night I had a pt admitted that had a trach. I'm a new grad and have only been off orientation 5 weeks. The ER nurse told me in report that this pt has had the trach for a while and knew how to take care of it himself as he lived at home alone. Only thing was he had MRSA in his trach site so I would have to set up isolation. It was a busy night and this pt was my 5th one. I wasn't quite sure what I needed for a pt with a trach and went looking for my CN to ask her. I could not find her, she wasn't at the desk and her portable phone was also sitting at the desk so it did no good to call her.

My pt came up, I settled them in, did the admission assessment and the 5000 questions you have to ask and then had other things to do with my other pts. I looked for my CN a few more times to enquire about my admission, but found her busy helping another nurse in an iso room. I told her I had questions regarding my admission and to please help me when she was able.

Well, 3 hrs later she came down to my end of the hall to get updates. When I told her about my pt having a trach, she freaked out. She said our floor (medical floor) does not take trachs. I had no clue! She had to call the supervisor to try and get that pt placed elsewhere. Then she took me aside and started saying, "You have to do what I say so you don't get in trouble. You need to say that the ER nurse didn't tell you about the pt having a trach and you found it on assessment. You also need to say that when you saw it you tried to call me but my battery was dead on my phone and I was busy so I didn't know about it until later. You need to say exactly what I told you or you will get in trouble and I don't want to see that happen. You're new and you didn't know." I was shocked and dumbfounded! This conversation took place right before end of shift.

After I punched out I went straight to my managers office but she had the day off. I called a coworker I could trust and talked to her about it on the way home. She told me to get a hold of the NM asap even if it means to call her at home and tell her everything. First of all, I will not lie about this. Especially to throw the ER nurse under the bus! No!!! She told me about the trach on report so I'm not gonna lie about that! I think the CN wants me to lie about everything so SHE won't get in trouble. I did not know and was never told that our floor could not take trachs.

So I did call the NM right when I got home and told her the whole story and apologized for taking a trach admission and that I didn't know I wasn't supposed to. I did not, however, tell her the conversation between me and the CN and her telling me to lie. I have to work with this CN a lot since she's on my weekend rotation and I don't want to be on her bad side. She has put me in a very difficult position and I do resent her for that, but I also don't want a hostile work environment.

Would you have told the NM about the conversation? I'm torn on that one. What if the NM asks the CN what happened and she tells her that the ER nurse did not give the trach info on report? I don't want that nurse to get in trouble for something she didn't do!!

Advice please! This happened Tues night/Wed morning and I don't go back to work until next Tues. I haven't been able to enjoy my days off since this whole situation is eating me alive!

[Barnstormin' PMHNP]

I would also like to add to the previous comments that no matter what, the truth is the only acceptable path in nursing. Just imagine if you had gone along with the CN and someone else spilled the beans about the admission and you were caught in a lie. I'm sure the CN would throw you under the bus in a heartbeat to save her "20 years". Even if you get in trouble for this, which I doubt, you will not have a lie hanging over your head. I think newbie honest mistakes are much easier to forgive than newbie lies. I can see why you are so nervwracked and worried about the CN, but know that you did the right thing and have nothing to regret.

[squidbilly]

I think you absolutely did the right thing! I think it would be wise to tell your CN directly that while you appreciate her trying to protect you from the consequences of accepting this patient (which is what she wants you to think, even though it's abundantly clear she's trying to cover her own butt), you are not comfortable with lying. You should tell her you felt it necessary to give your NM the honest story, and that you ommitted the part where she tried to coach you to lie.

[weemsp]

I suggest you break up that wall of text with some paragraph breaks or shorten your story somehow. A lot of members see a block of uninterrupted text like that and won't read it. I didn't. Too long and daunting and time consuming, sorry. Be considerate of your reader to be a good writer.

No need to be rude. It is NOT inconsiderate to tell her story as it happened....paragraphs or not.

If you find it too " time consuming" to read a fellow AN's post for advice...then move along...nothing wrong with that.

[gecr62]

You should never do anything that is going to make you feel uncomforable or that you believe to be wrong. If she is asking you to lie she will lie about you and get you in trouble. Unfortunately nurses are our own worst enemies. We are like sharks eating our young. I am a nurse for over 30 years and I am pretty much done with this carreer. I wish you only happiness in your future. No matter what you have to be true to yourself and your patients. Do not ever be affraid to do the right thing. Good luck and God Bless.

[heron, ASN, RN]

For real? Seriously?

Yes, for real and seriously. For many of us with somewhat older eyes, tracking through a large block of text is very difficult both on paper and on a computer screen. It is not a matter of being lazy ... it's a matter of physiology.

And yes, run-on paragraphs, like run-on sentences, are less than effective writing ... ask any professional editor.

Do we expect professional level writing from AN posters? Of course not, that's silly. Just readable, otherwise why post?

[julz68]

Thank you all for your replies! Well, all but one anyway :)

I feel better now that you all said I did the right thing. From the very beginning I knew I wouldn't go along with the CNs story, I was just so astonished that she would even ask such a thing! I now see her in a different light and have lost respect for her. I do hope she didn't tell her story to our NM tho...I really don't want to have to be put in that position. And if she did, I hope they ask me about it for the ER nurse's sake. I sure don't want to see her in trouble for "not telling me about the trach on report" when she most definitely did.

[julz68]

Yes, for real and seriously. For many of us with somewhat older eyes, tracking through a large block of text is very difficult both on paper and on a computer screen. It is not a matter of being lazy ... it's a matter of physiology.

And yes, run-on paragraphs, like run-on sentences, are less than effective writing ... ask any professional editor.

Do we expect professional level writing from AN posters? Of course not, that's silly. Just readable, otherwise why post?

Again, I'm sorry. My phone doesn't double space or do paragraphs. Obviously if I was on a computer it would look much different as I would not be using my thumbs on a 5" screen. At least I use proper grammar, spelling and punctuation; not text speak. But that's OK, you're also entitled to your opinion :)

God Bless and have a nice day

[PMFB-RN, RN]

Your CN was setting you up for failure. Nurses are among the most trusted professions and I hate to hear this kind of thing. Please take my advice as a nurse who has been around a while. NEVER do anything to make anyone else question your professional integrity. We can't lie about our patients or our actions. You can lie about how big the fish you caught was but never lie about your patient or the care you provide.

There is no reason YOU should get in trouble for this. Sounds to me like your CN was trying to cover her own butt. In the future you need to be VERY careful in your interactions with this person as she obviously lacks integrity and is a dishonest person. Yes you need to report this discussion to your NM. She needs to know if one of her charge nurses is a person without integrity.

This is a black and white issue.

[julz68]

Your CN was setting you up for failure. Nurses are among the most trusted professions and I hate to hear this kind of thing. Please take my advice as a nurse who has been around a while. NEVER do anything to make anyone else question your professional integrity. We can't lie about our patients or our actions. You can lie about how big the fish you caught was but never lie about your patient or the care you provide.

There is no reason YOU should get in trouble for this. Sounds to me like your CN was trying to cover her own butt. In the future you need to be VERY careful in your interactions with this person as she obviously lacks integrity and is a dishonest person. Yes you need to report this discussion to your NM. She needs to know if one of her charge nurses is a person without integrity.

This is a black and white issue.

I totally agree with you. That's why I called my NM right away and told her everything, except the part about the CN telling me to lie about it. That's what I'm struggling with right now. I'm not sure how to go about it since I'm brand new and she's been there for over 20 years.

[wooh, BSN, RN]

Bed management is usually a high school grad that has a list of diagnoses/MD services that go to which floor. There's no critical thinking, it's just x goes here and y goes there. Our floor doesn't take vents and we've had bed management try to send us a vent telling us that they brought their home vent with them so it's ok.

Mistakes happen. It's really not that big a deal. You move the patient to where they belong when you can. Why the charge was trying to orchestrate a big cover up is beyond me. I could see the desire to do so (not that it would be right, but could understand the desire) if there had been a bad outcome. But patient was fine. Move them and move on with life.

[CapeCodMermaid, RN]

I worked in LTC. We are expected to take care of people with trachs. We had to send one of our residents to the hospital where she HAD to go to the ICU because the floor nurses there don't 'do trachs'...yeah, but you look down on us.

Don't make a habit of telling lies no matter what the reason. Some day you'll get found out and that's worth than the truth from the start.

[amoLucia]

To julz68 - In all fairness to you, I went back to read your long 'wall of text' for which you subsequently explained about your data entry device. If that be true, a big apology is due. But I admit that I do find long texts dizzying and really, truly, honestly difficult to read. Now, having said that...

Maybe I'm the only one seeing something here (or else I'm reading too much into this), but you commented that she connected with you 3 hours later ?!?!?! Was that for real? Three (3) hours? That says something to me why she was so concerned that you lie for her.

Where was she for 3 hours? As she was CN, she should have been in touch with you more closely and in a much more timely fashion, (esp with a new admission). My concern is - was she off the unit for that time or could she be sleeping? Thus her story about being incommunicado with you. (Note the dead phone battery comment.)) Is she hiding something? Has she had like this problems before?

Maybe I'm just a suspicious person. But I really disliked myself being off my own unit even briefly. So I question why such a big hoop-de-do about the mixup trach admission.

You're rightly concerned about her asking you to cover up something. Might my questions be a part of it, too?

P.S. - You'll notice that I break up my own texts. I get dizzy if my OWN are too long but I use a laptop. I even edit & shorten my sentences for length!

To CCM -I just LOVE your comments & perspectives!