Dangerous nurse?

[jigi]

Hi,

I work in the community setting and there is a new grad RN nurse which works with us (she was previously an Enrolled nurse prior to completing her new grad and has been in the field for a long time).

A patient had a VAC dressing and she changed it without being accredited to do so, she did not drape the underlying skin resulting on suction directly to good skin and damaging the skin. All of the skin on the patients' buttocks was damaged as well as some tracking up his lower back. A colleague of mine was suprised when she found out that she had done the VAC as this a competency which is saved later on in the new grad program and said this to her. She then proceeded to say that she knew she wasnt meant to do it and asked the other colleague to cover up for her. An incident report was filed.

This nurse also was looking after a chronic pressure area on a patients bottom (he is wheelchair bound). Another nurse went in one day and noticed that there was a large fistula tracking into the patients urinary tract so that you could actually see his catheter! This hole would not have developed overnight and the new grad nurse had done nothing about it.

This nurse also saw one of my patients, he as multiple wounds on his foot (3). The nurse had attended the other 2 wound dressings and was wrapping the patients foot up., The patient and his wife pointed out to the nurse she missed a wound dressing, she did nothing about it, documented that she had attended the dressing in the notes and on the computer. I know for a fact that she did not as I removed her dressing and there was indeed no dressing on that particular wound. I lodged an incident report and she denied it all when the manager approached her about it (acting temporary manager).

I feel the issue here is that not that she made a mistake but she is denying and lying about the fact.

Has anyone been in this situation before and what course of action should I take?

[JustBeachyNurse, LPN]

Are you in the US? If so see your company's corporate compliance information as falsification of records is fraud.

[jigi]

Located in Australia.

The manager who approached her was in an acting position for a month and inadequately dealed with the situation appropriately. She spoke to the nurse before I had even put the incident report in.

The nurse just lied about it and said 'If I documented it then I did it, maybe it fell off'. There was no way that it could have just fallen off as the 2 x outer layers of the dressing were still intact (picture some cotton wool wrapping around the whole thing as well as tubifast to hold it all in place).

My workplace is just becoming a joke, things get reported and yet nothing gets done about it.

[WinterLilac]

I've been in a very similar position to you and it's dreadful. I'm also in Australia and here we have strict termination guidelines; they can't just sack someone on here say. In saying that, document everything in your own journal/diary, note times/dates/objectiveinformation eg. 'noted no wound dressing in situ upon attending wound care at 0945hrs'

What you may not know is that the management may be currently investigating this nurse but they can't tell you that.

You can also lodge a complaint with AHPRA who will then investigate.

Word of advice from someone who has been through this: Protect yourself and don't try to be judge jury and executioner because you could jeopardise your own registration. Make sure you are practicing professionally and within your scope of practice so if this nurse gets a beef with you or finds out it was you who lodged the complaint, she/he will not have any ammunition.

This nurse sounds like a real danger but have faith that something will get done.

Take care

[Tenebrae, BSN, RN]

Honestly I'd consider looking for a new job.

Re the vac dressing, I've done multiple VAC and renasys changes and unless the surrounding skin was broken in which case i would apply a hydrocolloid around the wound margins however I wouldnt standardly drape good skin. When applying the VAC, I always ensure that the VAC connection is directly over the foam/gauze.

[l1234567]

Is it government or private?

[US RN in Oz]

There's virtually no one I respect less than a nurse who lacks integrity.

I would keep a journal. Documentation is key. Whenever the is an incident, note the date, time, place, any witnesses and honestly what happened. This will come in handy one day.