dishonesty in clinical rotation

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Hello, all...seeking advice or information...I am a first year LPN student, going part time, mornings. My dilemma involves a couple of fellow students.

We have just started our clinical rotation in a LTC facility, one I happen to have just left after 14 years of employment as a CNA.

One of the residents assigned to our care has often been found to be dressed by the overnight shift, which has been their routine for many months. He often refuses to be undressed, rebathed and redressed, and we report this and document it, and perform whatever else we can that falls within our skills to date. I was assigned to bed bathe him today, as a matter of fact, and the scenario played out exactly as I write it above.

Monday, though, two other SPN's were assigned his care. As team leader, I offered assistance to the various pairs of caregiver/students, and was in and out of nearly all of the rooms, fetching linens and taking notes for them. I entered Mr. B's room 30 minutes after we received report and got out on to the unit, and found him fully dressed in bed, with the students assigned to his care standing at bedside. With no other motive than to find out what his status was, I asked if he was found to be dressed, or did the students provide him with care (a complete bed bath!) and dress him. The response was that they had indeed done his complete bed bath, and dressed him, and begun to assist him with his breakfast, within the past 30 minutes. My gut said that they weren't being honest, but let it go after confirming that I understood that THEY had done the bed bath, not the night shift workers at the LTC facility. Later, during the exit conference with the instructor, they repeated this information. Another fellow student tapped me on the shoulder, and informed me that she had been in the room shortly after we received report, at about 8:20 a.m., and Mr. B. was dressed at that time. She had not been aware of my misgivings, so that had nothing to do with her telling me that; I see it more as because of my assignment as team leader that day.

Today, when our regular instructor returned, we had an opening conference, and the two students told her that they had bathed Mr. B. yesterday.

It sounds pretty petty in the re-telling, but the four of us who are aware of the dishonesty are pretty disturbed by it, and are inclined to report the behavior to the regular instructor. :o Our first week in class, we were told every day that honesty and reliability is a requirement of the nursing program, and that cheating, dishonesty and untrustworthy behaviour would not be tolerated, and would be grounds for dismissal from the program. I naturally don't wish to be the catalyst for someone being removed, but I also don't want to be in a professional or accountable position with these two women, who are lazy enough to not do their assigned work and dishonest enough not only to lie, but to repeat the lie at least 3 times.

Any thoughts?:o

I appreciate your concerns, RN2be--it so happens that the two students in question were already under scrutiny for unrelated incidents, that nobody outside the faculty was aware of. We did make sure when relating the incident to our instructor that we emphasized we were certain of nothing, but all she had to hear was that the man was fully dressed at 8:45 a.m. (and, I neglected to post yesterday, he has had a progression in a previously-identified area with potential for breakdown...now from a Stage I to a Stage II on his sacrum).

Our instructor knows what should take how long, and the fact that they were under suspicion already makes me feel as though I chose the proper course. Nobody would be released on my say-so, anyhow...there are steps to be taken, and a warning would always come first. She also has other options for confirming our information, like the regular staff on the unit (did the night shift dress the man, or not? The staff will know that...)

I like that you express your reservations--it helps to keep things balanced...:D

And, proud2basn...

You go girl! We are nothing as nurses if not patient advocates! I am proud of you!

Thanks a bunch, will try to continue to live up to it...

This is a stiff accusation and I hope you are right. I think it would have been better if you had looked at the bath basin to see if it was bone dry or looked liked it had been used. Then you would have at least had something else to go by then your suspicions. I do not mean to play the devil's advocate- but as a nurse it is always best to gather some evidence before coming to a conclusion-especially about something that could ruin someone's career.

Hello, Rapheal...a couple of thoughts on your post..

We did make sure when relating the incident to our instructor that we emphasized we were certain of nothing

Besides this, there were three people who independently of each other, had the same suspicion.

We are also all students, and are transitioning from CNA to LPN, and learning about leadership roles, and how to conduct ourselves on a different level than we have been used to. As a CNA, I would have pulled the basin (as a matter of fact, I have--and been told, "I used the paper towel to dry the basin"), or perhaps waited until the following day to ask the night shift if they had dressed Mr. B. or not.

No one would be dismissed or had their careers ruined based upon only my say-so, or even the one incident that has occurred. The fact that the students were already the subject of some interest among the clinical instructors should demonstrate that events had been going on that I wasn't even aware of. It was only because I was team leader on that day that I even took this to be so much my concern. Couple that fact with the breakdown in the residents' skin status, that was not reported the previous day, and I have a sense of having done the right thing.

Thanks for making me think, though--never a harmful thing!

No problem. I am glad you did not take my post in a negative way because I know you are just concerned about your patient getting the best care. Good luck in school and your new career.

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