Concerned and venting

Nurses General Nursing

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Hello all.. I am an LPN who has worked in a LTC facility for the last 4 years. I have rencently encountered a problem that I don't know what to do or who to go to with it. My facility hired another LPN about 2 months ago. He is a foreign nurse and there is a language barrier...we have all orientated him and tried to explain things to him. His charting is awful (everyone is "ok"), doesn't sign his name properly (first initial, last name and title) instead he uses his middle name and title, he has tried giving NPO/G-tube residents medication PO, accu checks with insulin coverage to wrong pts, and recently had a res with a low grade temp..he didn't know what to do so he gave him 2 Tylenol 3's without checking for med allergies (luckily he wasn't allergic to it) nor did he check the MAR for PRN meds or standing order sheets. The same night he aslo gave a serax to a resident or someone because the count was off by one..it had to be him cause the other LPN working with him that night has been there for 19 years and very professional. My concern is we brought this to the attention of our DON and she did suspend him for a few days but put him back on orientation. He has his state nursing lisence...just like me and the rest...this is all basic stuff you learn in nursing school. The DON said we need to give him a fair chance...I feel he had one when we were orientating him..I don't give second fair chances when my residents are in danger with this man working the floor as a nurse. None of us want to retrain him because he does not listen...he sleeps at the nurses station, will fall asleep while giving report and when not sleeping he sits on the phone talking with whomever. As for the missing serax, I'm also concerned because there was no investigation to find out where it went or who gave it. The facility is short staffed but not that short. Any advice on the next step I could take? I am really concerned over the well being of the residents. Thank you

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Specializes in Medical Telemetry, LTC,AlF, Skilled care.

Ouch, that is a very sucky situation. Frankly, I would probably start writing him up everytime he fell asleep or was neglectful of his duties, eventually the DON has to take action.... I wish I had more advice to give you, that must be horrible and I hope he is "taken care of" here soon so your residents will be safe

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Specializes in Med-Surg, Peds, Ortho, LTC and MORE.

Any advice on the next step I could take? I am really concerned over the well being of the residents. Thank you

There are several things you can do, first start a personal journal and document what you have seen. Then do fill out the incident AKA variance reports and copy those to add to your journal. Do make sure that the original is turned in to your DON, and a copy is also placed in your Administrators hands. You can place a complaint against this nurse to your State Board of Nursing. Since this is a Long Term Care Facillity, you can also call the omsbudman that is overseeing your facillity. You can ask the pharmacist who does the month pharmacy checks to double check the narcotics.

This is a small list of things to do, I am sure others might find more things that can/could be done.

Reigen

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Specializes in Education, Acute, Med/Surg, Tele, etc.

Wow...I agree with the above poster. If worse comes to worse you can notify the BON for your state. Also, a suggestion you can give for your Management...till he proves safe effective Medication Administration he should NOT administer medication without an RN present for the pass. (because it is the RN's that have to assign that to an LPN in most states).

If it was me, I would be going over med pass in private in a lesson format (we had our pharmacy fill a card of meds with M&M's color coded for certain meds so we could teach about them...really works well, and you could have a treat when you are done!). I would be going over the 5 rights (guess there are 8 now...so I would brush up on those after really grinding in the 5's!). RIGHT: Patient, Medication, Route, Time, Date, Form, Reaction, MAR. and with him reaction is going to be a focus since he seems to be givving meds without thinking about the reaction of the medication! I would not sign off on him to pass meds until I saw him do med pass for a week with no mistakes!

ALSO, if I saw someone falling asleep at work...wow I would be ticked. That is an instant write up, (as well as other items like med pass, treatments, tranfers of pts, ADL's...if they are done wrong..write up!).

It is hard to choose between giving someone a chance, vs them not doing their jobs correctly. But in Medicine...if you are a danger...you must correct it quickly or dismiss them!!!

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Since pt safety and med administration is an issue, you have ample reason to report him to the BON.

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Specializes in Neuro ICU and Med Surg.

This is my 2 cents worth,

DOCUMENT, DOCUMENT, DOCUMENT!! Keep a written journal/log of things he did that were unsafe. For example, if he tries to give a pt with a J-tube oral meds, document day and time in your log. Then pass log to the DON. This guy could kill someone. As for the missing narc, why didn't they investigate. I worked at another hospital and we had to do narc count and no one left until we determined where the missing meds went. Also report him to the board of nursing. This guy is scary and dosen't need to be nursing. :nurse:

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Thanks to all for the advice. We have all written him up, including the RN floor supervisor, and nothing seems to be getting done about him. As for the RN's and medication administration, they have nothing to do with it unless it is IV meds. They are pretty much in their offices working on paper work. Don't get me wrong they assist when asked for it but other than that they have their own things to do. We are told that if it is anything to do with patient care (including meds and treatments), orientation, and physicians then it is up to the LPN's to take care of it. The DON will not place him with an RN for orientation. We have been keeping journals on him and all the mistakes/neglect/etc but feel that its not gonna do any good. He is still under probation and feel there are many reasons to let him go but while under suspension, the DON said many were "hounding" her for letting him go but not sure who the "many" are....its definitely not the staff. Please don't take this wrong but I have a feeling that he is holding the fact that he is a male and from a different country and saying that he is being discriminated against for it....But that is far from the truth. With the amount of knowledge he is displaying in nursing, I am wondering how he got his nursing lisence to begin with. We weren't even sure he had one until we looked it up on the nursing board website. I guess I am gonna have no choice but to contact the BON and omsbudman. Again, thanks for the help...I will keep you updated on the outcome.

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