I work at a skilled nursing facility as an LPN. We have a charge RN who has several years of experience. She is a very capable and knowledgeable RN. Let's call her "nurse X". To be blunt she is also very good at kissing a** to administration, and she is one their "good side."
Although she has good clinical skills, I have worked with her long enough to notice she isn't very ethical. We have a lot of dementia patients with frequent falls. This nurse frequently restrains patients (she will put a bedside table and position it in front of their wheelchairs so they cannot stand up or wheel themselves away). She will close the doors of known fall risk patients if they are being "too loud."
About 3 days ago we received a new admission with several broken bones from a s/p fall. He has not been able to get out of bed, and has been very restless, but manageable. He yells out intermittently, but since he cannot get out of bed all we can do is reposition him, provide verbal redirection, etc. which for the most part has been working.
I gave him a PRN pain medication early in my shift. About 2 hours later he fell asleep. He snored deeply and loudly throughout the entire shift. I thought it was odd that the pain pills I gave him would knock him out this much.
To make a long story a little shorter, one of the nurses working on the shift told me "Nurse X went in there and gave him something. She said it was something that was gonna take care of him yelling." I looked in his MAR thinking maybe she gave him something while I was on my lunch, but there was nothing showing he was given anything. He didn't even have any PRN's available besides the pain pills I already gave him.
At the end of the shift she asked me to co-sign medications that she disposed of (discontinued medications that needed to be destroyed). I noticed she disposed of a card of Seroquel. I found out that she took one of these pills and gave it to that patient WITHOUT A PHYSICIAN'S ORDER SO THAT HE WOULD "BE QUIET" DURING OUR SHIFT!! No wonder he was out cold! Looking back, I would bet my paycheck that she has done this to other patients too.
I am very upset about this. I want to report her, but I know she will deny it and I have no proof that she did this. I know she will find a way to deny that she gave this medication and she will know that I reported her. What would you do in this situation?
Specializes in Post Acute, Med/Surg, ED, Nurse Manager.
I would report her to the state hotline for abuse. That is abuse of pt rights. I would also document the name of the nurse who stated she gave him something as she is complacent. It is not ok at all. That could equal a harm tag if not documented. Plus it is one of your patients on your shift. You don't have to be able to prove it to report it.
Furthermore don't waste meds with her again. Yikes.
Thanks everyone for your input. I spoke to the nurse about it and she did admit she gave him the AP without a doctor's order. Luckily he had no adverse reactions. Will take it from here.
Wow. I would've put the odds against that at about a gazillion to one.
i would write up a statement about this and include the statement from the other nurse who gave the med. Only the facts.
The prn that you gave...was it ia narcotic? How does she have access to meds? I can see her argue that your PRN caused the sedation. This would then turn into a he sad, she said.
Valcorie34, BSN, MSN, RN
158 Posts
I would report her to the state hotline for abuse. That is abuse of pt rights. I would also document the name of the nurse who stated she gave him something as she is complacent. It is not ok at all. That could equal a harm tag if not documented. Plus it is one of your patients on your shift. You don't have to be able to prove it to report it.
Furthermore don't waste meds with her again. Yikes.