ethical dilemma....nurse lied.

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Hey everyone,

I had a recent situation and just want someone else's advice on it. I am GN and just started my job on a neuro-step down floor. I am still orienting to the floor and have been working with the same preceptor for a few weeks now.

On my second day on the floor, we were working with a very heavy stroke patient (380 lbs.) My preceptor and I had to get this patient from the bed to the commode. We moved him to the commode, but it was extremely difficult to get this patient strapped properly to the toilet, so my preceptor just grabbed a couple pillows to prop him, in place (then closed the door).

A few minutes later there is a large thud; the patient fell and struck his head on the floor; blood is all over.

Later on, the hospital risk manager questions my preceptor about how this happened. She explained that she had secured the patient to the toilet as required by hospital policy, but the patient must have loosened the belt on her own. The risk manager asked me whether that is what happened and I was just so scared that I stupidly nodded my head in agreement.

The next day the patient is interviewed the next day and asked if he loosened the safety belt and she affirms that she did. (The patient had a large swelling on the side of his head and had to stay an extra 2 days in the hospital, but there seems to have been no permanent injury.)

Now I am so bothered by the fact that I have conspired in a lie, and I think that I ought to correct the record.

I spoke with my preceptor about my concerns and she told me to keep me mouth shut because we both would be in very serious trouble since we had both lied (and the man is OK anyway).

What should I do?

I just started this job and I don't want to lose it. I know this was such a stupid mistake to make. I'm so confused.. I'm losing sleep over this every night..

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You're losing sleep over this. You know what is the right thing to do.

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I agree, you know the right thing to do but there will be consequences. Be prepared for them.

If you decide not to tell the truth about this, at the very least take it as a lesson and never lie again.

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I agree, you know what the right thing to do is. I would also consider the example this preceptor has set for you - is this someone you really want teaching you how to do things? How can you have faith that she will not lie again about something else and leave you on the hook for it.

There will be consequences, but a good NM and RM will realize that you were put in a bad position, were under pressure and are now trying to rectify the situation.

Good Luck and Hugs.... a lesson learned.

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Specializes in Tele, Acute.

This is not the way to start off your nursing career. Please take everyone's advise and do the right thing. Good luck, I wish you the best. You are going to feel so much better and this will be a learning experience for you.

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Specializes in med/surg, ortho, rehab, ltc.

I agree...you're losing sleep & you know what to do. It's extremely unethical to lie about a pt fall. And a fall with a bump on the head could have future consequences for this pt.

The NM will take into account that you eventually did tell the truth. And she'll know that when you nodded you were shocked by your preceptor's response and intimidated because she was your superior in charge of your training.

Also the hospital will HAVE to review staffing policies. ONLY two people to get a 300 lb stroke pt to the toilet!

IMO lying about the circumstances of a pt fall is abuse. Always be honest & just state the facts.

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Specializes in ER.

Not a word...or your new coworkers will not easily trust you, for whatever reason.

But now you know that lying does NOT work for you.

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Specializes in Cardiac Telemetry, Emergency, SAFE.

While I am not a nurse, I am in a healthcare setting. I know that here, the managers appreciate honesty, REGARDLESS of what the end situation is. A patient fall is not going to make you lose your license, although as someone pointed out, your coworkers will find it hard to trust you if you "go behind the preceptors back", there is a lack of trust as well for the people that try and cover their @$$. Maybe talk with the preceptor and tell her your thoughts, at least that way she will know of your intent in advance and wont see this as "backstabbing".

Good Luck..and let us know what happens!

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Specializes in med/surg, ortho, rehab, ltc.
Not a word...or your new coworkers will not easily trust you, for whatever reason.

I see your point but IMO it's cruel to lie about the facts when a pt is too disoriented to speak for or protect himself. I wouldn't trust that preceptor with my pts.

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This is a very, very tough ethical situation, and I'm glad you posted it, because any new nurse can be put in that situation, and this is a great discussion.

The tough part is that you need to tell the truth, and the perceptor no doubt, will snitch to everyone that you went back and told the truth, which will undoubtedly have consequences...and I have a feeling that it will be more along the lines of making your life difficult at the hospital rather than an issue with risk management.

I agree with TazziRN...as unpopular as that may be...learn from it, and speak up next time.

It's hard to take the high road....it really is. That was a hard situation and alot of people would have done the same thing.

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Seek some advice from a counselor. Speak to this preceptor privately, we all should be nurse enough to admit we have been in situations where we did not use our best judgement, and but for luck/grace of God, there could have been a bad outcome, and then make a final decision. I know Canoe is speaking from the real deep down experience that all good intentions, all good deeds, and telling the whole truth is not always appreciated when the slate has been wiped clean. Good luck.

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Later on, the hospital risk manager questions my preceptor about how this happened. She explained that she had secured the patient to the toilet as required by hospital policy, but the patient must have loosened the belt on her own. The risk manager asked me whether that is what happened and I was just so scared that I stupidly nodded my head in agreement.

The next day the patient is interviewed the next day and asked if he loosened the safety belt and she affirms that she did. (The patient had a large swelling on the side of his head and had to stay an extra 2 days in the hospital, but there seems to have been no permanent injury.)

I wonder why your preceptor didn't tell the truth right from the start?

How will she react if you do correct the record?

Wonder what else she might telling lies about?

This is a good learning opportunity.

What if the patient or a family member returns at a later date with claims of not being securely positioned?

Will you stand by your patient or will you stand by your preceptor?

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