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

[ccrn28f]

: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?

[NRSKarenRN, BSN, RN]

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.

do not report anything that you only suspect or have not personally witnessed.

dear nm:

i am writing to make you aware of the actions of _______ rn while

charge nurse.

1. she was observed using xyz medical record number several times in the past few days in the glucometer machine to check her own blood sugar. the last one of hers was 41 (she is not even discrete about it---bias leave out. did rn tell unit staff about this? if so add that statement) 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.

2. on ___date, she stated she knew a 17yo that was involved in a trauma, looked in the computer system, and read his h+p and lab work in front of all of us.

3. recently we had a a male trauma pt in our unit mr.___. every night ___rn would go in, close the cutrain and bath pt by herself. as the charge nurse she normally never baths pt's and or only helps to turn or boost.

(hitting on him is an assumption---what was said, observed is a statement of fact.)

sincerely,

________ rn

________ rn

this is the type of paper trail that as a nurse manager i need to be able to address staff behaviour. leave out personal bias and just state the facts.

if not documented/not brought to mgr attention, nothing can be done on hearsay.

you also have a professional obligation per lisence to report breechs of nursing standards.

compliance officer outside of hippa violation would feel these items need to be addressed on nurse manager level.

[NurseRatchett]

I'd report her to my NM just for the using of a patients blood glucometer! That's just nasty and unprofessional. Her personal treatment of the male patient i'm sure violates hospital policy, not to mention his wife would kick her !@# if she knew about it.

[purplemania, BSN, RN]

for the safety of your patients you need to report her to risk management or your manager or both. In Texas our Nurse Practice Act REQUIRES a nurse to report unlawful conduct, and this case certainly would apply. Not to do anything is to condone it. She needs to be stopped before someone is hurt. I hate you are in this situation, but now you need to act.

[Jami RN, BSN, RN]

My suggestion is to document your concerns, along with others who have witnessed this individual's actions, and take them to your Employee Relations team in Human Resouces. Their job is to conduct objective and confidential investigations into employee misconduct. That would alleviate the discomfort of going through the Nurse Manager.

[TracyB,RN, RN]

Ooooh, ickky, ickky, ickky.

DOCUMENT, DOCUMENT, DOCUMENT, just the facts, ma'am, nothing but the FACTS.

I would send a copy of what you document to everyone in your hospital's chain of command.

Good luck.