ethical dilemma....nurse lied.

Nurses General Nursing

Published

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..

Specializes in SICU.
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.

Oh this is TOUGH. :o I am uncomfortable about it but tend to agree with Canoehead. You SERIOUSLY open a can of worms for yourself if you stir this pot, both with your coworkers and your reputation.

Most importantly, the patient ultimately was fine. If you choose to keep quiet, learn the lesson involved. Don't skimp on safety and don't ever, ever lie again because you'll be haunted by it.

Good luck with this, hun... let us know what you do and what happens...

I am also a new nurse on orientation and was in a similar situation with a preceptor acting unethically (read my previous posts). I went to my manager and I am starting with a new preceptor this week. I feel RELIEVED, I know what it feels like to be losing sleep over this kind of thing. She put you in a terrible position. You can not go on with a preceptor that is teaching you to act in an unprofessional and unethical way. That is no way to start off. She/he is suppose to be your mentor and role model.

Speak to your NM. If she/he is a good manager, you will not have to explain anything. Just get away from this preceptor before she/he drags you into any more TROUBLE.

Good Luck, you'll be okay.

Specializes in SICU.

Yes, KayceeLee brings up a good point. Whatever you decide to do, get another preceptor if you can.

The one you have now isn't going to forget that you've got something on her. Always be super careful around this nurse, and NEVER trust her to look out for you.

Specializes in Neuro, Critical Care.

Tough situation. At that point in time you made that decision. In this part. sitation the pt. is ok. Learn from your mistake and move on. I have to agree with the other posters that say not a word. Dont make trouble for yourself. If the pt was not ok i would say tell the truth. Accidents happen, now im sure you will be sure it never happens again.

Specializes in Emergency.

If you don't go forward now and rectify this situation you will carry this burden for the rest of your nursing career, if not for your whole life.

It's situations like this that prove what your true character is. As difficult as it is, don't think about yourself or the other nurse, but what your main function of being a nurse is - being a patient advocate. This is especially true for those patients that can't speak for themselves.

Good luck with your decision.

Specializes in Med/Surg, Geri, Ortho, Telemetry, Psych.

I think this is actually the first time that I am speechless. I just don't know what to advise you to do. It's never too late to tell the truth. You may suffer terrible consequences, though, if you do it now. I think I would have to weigh the facts in my head. You said the patient had a lump and had to stay two extra days, but no permanent damage. Well, what if there is damage and you just don't know it yet? Ok. Now, what about the nurses you work with. Some may feel they can't trust you. But trust you to do what? Risk your license to lie for them. This is a hard one. I'm just not sure. I think I would have to tell them. I would apoligize and tell them I was just scared and didn't know what to do, caught off guard. Not that that may help, but I would say it anyway because it's what I feel. I hope you can find the answer within yourself so you can sleep at night. I'll be praying for you. Very difficult situation. But now matter what you decide, at least you have learned this lesson: you will NEVER let yourself be put in this situation again. :o

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

[quote=GingerSue;

"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.

Wonder what else she might telling lies about?

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

/QUOTE]

We all know of hospitalized pts who fell and hit their heads. How often have you seen the NM and Risk Managment talk to each party involved. I think they know something is fishy with the 3 accounts of the incident.

Like Ginger Sue said, I'd be worried about the pt telling the truth later. Like when the hospital bill arrives! If the pt was oriented then she was protecting the preceptor. She could come forward with the truth later. Things like this are too important and very tricky to lie about.

Of course I'm speaking as an RN who was in a similar situation but LUCKILY the outcome was good. The nurse who tried to alter the facts of the incident had to meet with the NM but she held no grudge against me. If anything her nursing care improved 100%.

Specializes in Lie detection.

This is really tough. On one hand the preceptor put you in a really bad position. So many things could go right and wrong with either decision.

This preceptor is definitely wrong and if you say something she may end up getting fired or worse.

OR she may lie even more and say that YOU are lying. If she is a valued employee, they may just believe HER. Just be careful. Since you are new, they may get rid of you, yikes.

Thank goodness the pt. is ok. that is the main concern.

Keep us updated please.

Specializes in Brain injury,vent,peds ,geriatrics,home.

Remember,YOU are a Patient advocate!

Specializes in Med/Surg, Geri, Ortho, Telemetry, Psych.

Ok. It's me again. I've been thinking hard on this one and I have come to a decision. IF IT WAS ME, I'm not saying it is, but if it was, I would come forward and tell the complete truth and to hell with what anyone thinks of me. I am here to take care of my patients; not the other nurses, not the facility, not the insurance company, not the doctors. I am the patient's advocate and I will do everything in my power to do what is right for him/her. Not me. That being said, I want to tell you that I have been in positions where I did what was right for the patient and I suffered severe consequences, I was publically reprimanded in the nursing newspaper in my area by the state board of nursing, as my punishment was only an written reprimand, not a suspension. But even that goes on your nursing record and will be there forever, for all to see. I would do it again. I don't care about the consequences. I can always find another job. And if I ever lose my license, I can always do a million other things. I'm not saying I don't care about my license - nursing is my calling and I would be lost without it. But I only have one judge, and I think he wants me to do what is best for my patients; for the people who cannot take care of themselves. I hope this helps you. I'm really worried about what you decide to do, whether you can live with your decision or not. Good luck, honey. :kiss

Specializes in Diabetes ED, (CDE), CCU, Pulmonary/HIV.

Listen to Tazzi. You are still on probation; your preceptor is not. But don't cover for her again. I don't know how much I would trust her though.

Specializes in Diabetes ED, (CDE), CCU, Pulmonary/HIV.

In general when you are working as a nurse, covering a mistake up is a worse offense than the actual mistake. In the future, own up to your mistakes. In this case, you and/or your preceptor should have filed an incident report (for risk management) and notified the pts doctor of the fall.

But once you've become a part of a cover up it becomes extremely hard to take the high road after the fact.

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