COWORKER ~Ethical dilema ~LONG ~what would you do?

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:uhoh21:

Ok I need you opinions. Sorry this is so long. I have worked in icu for 7 years. Recently(8 months ago) I have taken a job at a smaller ICU that is closer to home. My problem begins with the evening charge nurse. She makes me nervous because she had come to the unit 2.5 years ago as a GN and was given the charge position as she is the only one who bid on straight evenings. Here is what she has done. We have a long term pt that she has uses his medical record number several times in the glucometer to check her own blood sugar. The last one of hers was 41. she is not even discrete about it. I am sure the pt is billed for the BS check and it also looks like we did not treat him for a blood sugar of 41. Next she was like my dad knows this 17yo that was involved in a trauma as she gets on the computer system finds him on a med surg floor reads his h+p and lab work in front of all of us. Next she is doing a Rn to bsn program and used a poster from the education room that our director of nursing made. She made no changes to it took it to class and gave a presentation on it as if it were her own. She also recently was hitting on a male trauma pt that was in our unit. His wife would come visit and she would act very nice to her. Every night she would go in and close the cutrain and bath him by herself (he is alert). As the charge nurse she normally never baths pt's and or only helps to turn or boost. She would call from home and ask how he was doing. He has now gone to rehabilitation and she goes to visit him. His wife does not know. She is very full of herself and will give a huge BS rational for things that are not true. What is scary is that most of the staff is newer and believe her. Another nurse that I am very close to has approached me about leaving a unsigned letter for the unit manager. I am unsure what advice to give her. I am very concerned about all these situations and would feel more comfortable approaching her if it was just one issue but it just sems like constant bad judgement. I do not want to be part of someone getting fired nor do I want retaliation from her if she knows I knew about her getting turned in as she is in a charge role.Please give me your opinions!!!!!!!What would you do?

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Specializes in Neurology, Neurosurgerical & Trauma ICU.

WOW! Where do you even begin with something like this???

Well, all I have to say is this. Many of the things that you have discussed here, if all true, are very unethical, probably against hospital policy and violated HIPPA laws. Something needs to be done. I would strongly recommend speaking with your nurse manager about this. If it were one single small incident, I would say speak to her, but it sounds as if she is out of hand. If nothing else, I would document things I observed.

Good luck!

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Specializes in ER.

hi,

I am so sorry that I have no advice what so ever:) At the end of the day you are better off than she will ever be. She sounds like a very unhappy and unstable person.

Tracy

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Specializes in ER.

You are in a bad situation, but you have to do something about it. Is your nurse manager someone you can talk to in confidence? If so, then put all you have seen in writing so your thoughts will be clear. A good manager will take what you have, then monitor her, catch her doing any number of things and then confront her. You should never be directly connected to her if she is fired or disiplined. If you can not trust your manager, go over her head. Does your hospital have and ethics committee or anonymous hotline? She is doing many unethical things. It is bad enough to be seeing a patient like you described, but she is documenting false information with the blood sugar. This could affect his treatment, his insurance, etc. She is also plagerizing with the poster episode. People like this do not stop with petty things. Once she gets away with the little things, she will work toward bigger things. It sounds like this pattern is escalating. The girl has no morals and does not need to be in nursing at all, much less in a position of authority. Stop her now before she does something that implicates YOU because you and the rest of the staff are complacent about her actions. You are involved, and you must act, NOW.

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Specializes in Neurology, Neurosurgerical & Trauma ICU.
You are in a bad situation, but you have to do something about it. Is your nurse manager someone you can talk to in confidence? If so, then put all you have seen in writing so your thoughts will be clear. A good manager will take what you have, then monitor her, catch her doing any number of things and then confront her. You should never be directly connected to her if she is fired or disiplined. If you can not trust your manager, go over her head. Does your hospital have and ethics committee or anonymous hotline? She is doing many unethical things. It is bad enough to be seeing a patient like you described, but she is documenting false information with the blood sugar. This could affect his treatment, his insurance, etc. She is also plagerizing with the poster episode. People like this do not stop with petty things. Once she gets away with the little things, she will work toward bigger things. It sounds like this pattern is escalating. The girl has no morals and does not need to be in nursing at all, much less in a position of authority. Stop her now before she does something that implicates YOU because you and the rest of the staff are complacent about her actions. You are involved, and you must act, NOW.

Well said!

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:uhoh21:

Ok I need you opinions. Sorry this is so long. I have worked in icu for 7 years. Recently(8 months ago) I have taken a job at a smaller ICU that is closer to home. My problem begins with the evening charge nurse. She makes me nervous because she had come to the unit 2.5 years ago as a GN and was given the charge position as she is the only one who bid on straight evenings. Here is what she has done. We have a long term pt that she has uses his medical record number several times in the glucometer to check her own blood sugar. The last one of hers was 41. she is not even discrete about it. I am sure the pt is billed for the BS check and it also looks like we did not treat him for a blood sugar of 41. Next she was like my dad knows this 17yo that was involved in a trauma as she gets on the computer system finds him on a med surg floor reads his h+p and lab work in front of all of us. Next she is doing a Rn to bsn program and used a poster from the education room that our director of nursing made. She made no changes to it took it to class and gave a presentation on it as if it were her own. She also recently was hitting on a male trauma pt that was in our unit. His wife would come visit and she would act very nice to her. Every night she would go in and close the cutrain and bath him by herself (he is alert). As the charge nurse she normally never baths pt's and or only helps to turn or boost. She would call from home and ask how he was doing. He has now gone to rehabilitation and she goes to visit him. His wife does not know. She is very full of herself and will give a huge BS rational for things that are not true. What is scary is that most of the staff is newer and believe her. Another nurse that I am very close to has approached me about leaving a unsigned letter for the unit manager. I am unsure what advice to give her. I am very concerned about all these situations and would feel more comfortable approaching her if it was just one issue but it just sems like constant bad judgement. I do not want to be part of someone getting fired nor do I want retaliation from her if she knows I knew about her getting turned in as she is in a charge role.Please give me your opinions!!!!!!!What would you do?

Turn her in she doesnt desrve to be an rn if shes gonna act like that.

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Specializes in NICU, PICU, educator.

Lots of issues...one...can you prove that the patient didn't need a BS at that time? Any finger pokes, etc? Is she using known diabetics? Are there orders for the BS on those patients? These things can leave a paper trail.

Do your computers log in with passwords and ID's or are they open all the time? We have to log in each time we and all our computers are area specific, we can't go to another area for info. Our computers are also audited monthly to see if people are going to different areas to look up labs, etc.

You do need to go the chain of command. Do you have assistant UM's or just the UM? Go to her, document things with dates, times that things are observed. If they are observed by others, ask them to sign also. If the UM does nothing, then go up the chain of command. Do you have a clinical nurse specialist? Go to her also and tell her what is going on.

You need to turn her it..it isn't easy, but it needs to be done. We just went thru something similar where I work and without documentation, you will get nowhere. Good Luck.

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Document what you witness and report her in writing to your department administrator with copies to people in authority in several different departments (nursing, HR, ethics committee,etc.) Include names of other witnesses of the incidents. This gal sounds so over the top that I would even consider reporting her to the BON!

Do not report anything that you only suspect or have not personally witnessed. For example, you mentioned the poster . You are probably 100% correct that "She made no changes to it took it to class and gave a presentation on it as if it were her own." However, unless you were in the class for her presentation, you really don't know Including things that you only suspect can weaken your credibility about the things that you do know for a fact. If confronted, she could always say that she just borrowed the poster to share with her classmates, and it would be her word against yours. (Just using the poster situation as an example here since that is something that you had mentioned.)

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I think I have worked with this charge nurse on nights before! The job made me crazy and i finally left, but if I were to stay, I would have had discussions with the Nursing Manager .The really bad problem for other nurses working with this person is, if there is a catastrophic situation in which she makes another bad decision, you must all be called on to explain it. And it will come up if you felt this could have been avoided. If your going to stay there, and I know you probably want to since its close to home, you have no choice. Good luck and thinkof all the patients you will help in the end...:)

:uhoh21:

Ok I need you opinions. Sorry this is so long. I have worked in icu for 7 years. Recently(8 months ago) I have taken a job at a smaller ICU that is closer to home. My problem begins with the evening charge nurse. She makes me nervous because she had come to the unit 2.5 years ago as a GN and was given the charge position as she is the only one who bid on straight evenings. Here is what she has done. We have a long term pt that she has uses his medical record number several times in the glucometer to check her own blood sugar. The last one of hers was 41. she is not even discrete about it. I am sure the pt is billed for the BS check and it also looks like we did not treat him for a blood sugar of 41. Next she was like my dad knows this 17yo that was involved in a trauma as she gets on the computer system finds him on a med surg floor reads his h+p and lab work in front of all of us. Next she is doing a Rn to bsn program and used a poster from the education room that our director of nursing made. She made no changes to it took it to class and gave a presentation on it as if it were her own. She also recently was hitting on a male trauma pt that was in our unit. His wife would come visit and she would act very nice to her. Every night she would go in and close the cutrain and bath him by herself (he is alert). As the charge nurse she normally never baths pt's and or only helps to turn or boost. She would call from home and ask how he was doing. He has now gone to rehabilitation and she goes to visit him. His wife does not know. She is very full of herself and will give a huge BS rational for things that are not true. What is scary is that most of the staff is newer and believe her. Another nurse that I am very close to has approached me about leaving a unsigned letter for the unit manager. I am unsure what advice to give her. I am very concerned about all these situations and would feel more comfortable approaching her if it was just one issue but it just sems like constant bad judgement. I do not want to be part of someone getting fired nor do I want retaliation from her if she knows I knew about her getting turned in as she is in a charge role.Please give me your opinions!!!!!!!What would you do?

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I think you have a legal (and moral) obligation to report these things. She has violated the HIPAA law and confidentiality laws on more than one occasion. :angryfire On the pt she used the #'s on for blood sugars, if the chart was ever audited by the insurance company, they could deny the whole bill for false charges(they have a right to do that legally). :crying2: You need to report this to the ethics committee or someone in charge with as many names and facts that you can put together. She is a huge liability to the hospital and needs to be stopped. Please take a stand and do what is right and just. I know it won't be easy but it HAS to be done!! Good luck to you, your going to need it. :uhoh3:

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I agree with everybody here...these are not nitpicky things (barring possibly the poster) and its hard to work around with people who are unconcerned about unethical, unprofessional conduct. As a charge nurse she is setting a horrid example for coworkers. By all means send an anonymous letter if you are afraid of retaliation, along with some proof if you can...paper trails if possible. You can do the same with the ethics hotline or privacy officer of your facility to report HIPAA violations. I see more and more unprofessional behavior today as you describe, unfortunately, but to be honest I often don't have the energy anymore to intervene with unethical nurses. Of course as agency I don't feel such an obligation as it isn't 'my' unit/hospital/patient affected. Good for you for caring and let us know if you make any headway.

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Your hospital by law has a Corporate Compliance hotline, and I would take advantage of it. You can make an anonymous report if you have to.

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