Dealing with incompetent nurses

  1. I work third shift in LTC and have been faced with a problem regarding a co-worker who is dangerously incompetent. I think because of staffing shortages on our shift, her incompentency is not being addressed by the DON & administrator.

    I am curious to learn what nurses in other fields (hopitals, home health, corporate, etc) have been able to do about those in their midst who don't measure up.


    Never enter into a battle of wits with an unarmed person.
  2. Visit ohlpn profile page

    About ohlpn

    Joined: Aug '01; Posts: 57; Likes: 14
    Specialty: 16 year(s) of experience in Assisted Living


  3. by   Agnus
    I would address the problem with my nurse manager first. I would attempt to be factual in my assessment and report of this problem, leaving opinion statements out. Just as I would if charting on a patient. I would followup on my report. If after a reasonable time I still felt it were necessary I would, go up the chain of command. With factual information to support my complaint I would report the nurse to her state board. It is very important to have facts not opinions guiding my action. It takes more effort to gather and document valid facts than oponions.

    I was once reported to a state board when I was a CNA. This was retaliation for applying for unemployment. The employer had not a single peice of factual information to support their complaint. So after the unemployment board rejected an apeal saying I was not elegible for unemployment as "I abondoned my job" (I had gone home sick with the consent of the charge nurse, without accepting a patient assignment). They filed a complaint with the state board. The state board also rejected the complaint as there was no prima facia evidence to support patient abandoment. At no time did anyone ever present any factual evidence. (the case closed with the understanding that it could be reopend later if some evidence were to be presented.)

    Everything that was presented was purely opinions. I know this as I was present at the hearing with the unemployment board. They did not file a complaint with the state board until after they lost the case with unemployment. The best they could come up with is that a few of people thought that I had a bad attitued on the day in question. Have facts and have then documented.

    Perhaps all this nurse need is some training to bring her up to speed. Perhaps, you could tactufully provide that yourself as a collegue, in a spirit of mutual support. She may be new or rusty to this area of nursing and would appreciate any help offered in a non critical and sympathetic spirit.
  4. by   IluvMyPtsPeriod
    I wanted to say that as much as I agree with the first response to this question, I feel that when a patient may be at risk you need to move fast! Definately gather info, but don't take weeks, or even days! In Massachusetts we have duty to report any behavior that puts a patient at risk!
    You can report anonymously to the DPH and let them investigate, but definately be sure you report to the D.O.N. and keep some notes on when and what you reported (for yourself, not in the chart).
    Is this a new nurse? Does she need a preceptor? Have you tried to point out some of the problems to her?
    Good Luck!
  5. by   cintorn
    I had this same experience in a small hospital. I reported exact happenings to my supervisor. I didn't provide things such as the fact the other nurse didn't do her fair share etc. so I didn't sound whiney. I only reported things that directly impacted patient care and safety. When the DON refused to do anything about the situation I found another job. Do you really want to work for someone who isn't interested about quality care to people? Be sure to have all your ducks in a row when speaking to your supervisor and have details. Don't say anything you cannot back up with facts.
  6. by   WriteStuff

    You don't specify what you mean by "incompetent."
    Patient safety is always the bottom line. Is she doing, or failing to do things that compromise patient safety, or confidentiality? If so, those things that are observed to be true need to be documented, documented, and documented. Such documentation (of the facts only, without anyone's opinion), should then be forwarded to her immediate Supervisor.
    I have always made it a rule for myself to ALWAYS keep a copy of that kind of documentation, where my name is attached. Once the documentation is in the hands of her Supervisor, it is the Supervisor's responsibility to follow-up.
    Failing to respond to "incompetence" is dangerous because it keeps patients, clients and residents in harm's way. Whatever the reasons behind this Nurse's behaviors, it must be addressed.
    Good luck.

    Bonnie C., RN
  7. by   ohlpn
    My incompetent nurse is a retired RN recently hired at our nursing home. She is often the relief charge nurse on our shift but prefers to be called the supervisor. Heaven help us when she is our "supervisor!" She rearranges the hall schedule so that her two halls are always fully staffed with STNA's at the expense of the other four halls . . . one night recently, she pulled aides to her halls resulting in 5 aides for two halls. That left 3 aides to cover our 4 halls. Our 4 halls had greater patient accuity & the census was greater. There is no reasoning in any of her decisions.
    Many of the A&O residents complain that she does not do their wound treatments, yet she signs for them. On a night that she was our "supervisor," a fairly new nurse called on her to help with a resident who was possibly stroking out. The supervisor sat with the resident and "held her hand," did no assessment, and kicked the new nurse out of the room. Luckily, she came to me and together we notified the physician who ordered the resident be shipped to the hospital (resident was a full code). Turns out, the resident had a massive stroke & was in ICU for 8 days. Needless to say, I got lectured by the "supervisor" about going behind her back . . . I had to inform her that the residents nurse notified the doctor with vitals & other pertinent information, something SHE should have done. There are problems with this nurse every time she is scheduled; she fails to notify families when conditions change, she tries to talk residents out of taking pain medications when they need it & like I stated earlier there is evidence she is not doing all of her treatments. I have spoken with the DON & Admistrator about these problems (several other nurses have reported her as well), and she is still employed here. Apparently, she has not even been conferenced about some of these concerns. Oh well . . .

  8. by   P_RN
    Two words: Occurrence report.

    One for the legal department and one for you.

    How would we feel if that were our grandma that she "neglected?"

    Factual statements only: Patient with change in LOC, altered vital signs, charge nurse notified, staff nurse notified physician and patient was transferred to ER.

    Then a sticky note that says: Ms Dooflotchy did NOTHING to prevent harm to this patient. Ms. D refused to notify physician....and note that this is a "copy" of a note in your attorney's file.

    This isn't tattling BTW. An occurrence report is just that. A sentinel event, concise and to the point while fully covering your own posterior (in a non accusatory way you understand )