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I would say you should report what you know.
This is fraud. It is this kind of bull that makes insurance costs to high. And puts people out of work when businesses fold up due to the cost increases of carrying the policies.
I teach my kids not to tattle, but I also teach my kids to be honest.
...let them know that you were there & saw everything. there was no one on the exam table during the emergency; how & or why could two people trained in using body mechanics be able to put their backs out...together. it's not like they lifted the table with a patient on it or anything...my question would be to them...if they injured themselves as they claim, have them demonstrate exactly how it was done.
once you talk with them & they realize that you're not willing to be a party to fraud..tell them that you'll step back to allow them to do the right thing & retract their claim...you know... as long as their back injury has a"sudden recovery" ...you won't report them. but if they play stupid...then you'll have no other recourse except to report them. i'm not sure if that sounds like black-mail or extortion :imbar but perhaps it'll be effective.
Be careful it just could be this was a different situation or time they are talking about. Maby they moved the table later for some reason.
You might simply say to the supervisor That you could not stop thinking about what you heard in her office that day. Tell her that if the injury happened during the code that you have some information that she should know.
As everyone has said, report it. I am an Occ Med/WC Nurse,and I would say that this is like cheating on an exam. If you know of it, you have a moral obligation to report it. I would further state that most claims involve an investigation, and always ask who else was present, and if they witnessed the injury. Since you were a participant from the beginning to the time you left the room, you would have knowledge of what was going on up until the time you left. Do your duty as a witness.
Q.
2,259 Posts
I have a moral dilemma and I'm not quite sure how to handle this. Here is the situation:
On Wednesday last week, in our clinic, an elderly man coded. Naturally, the MA ran into the nurse triage room and called for some help. I was the first nurse to arrive to see this man basically aphasic in his wheelchair. The MD and I assisted him to the floor, could not find a pulse and began CPR. Soon the crash cart arrived, and several of our urgent care staff arrived. An IV was started by one of our triage nurses. At this point, I stepped back and allowed the other staff to take over (my background is L&D and have only been at this clinic for a year and have only coded neonates in my career
) I was standing behind the exam table and was basically cornered in there, but took the time to observe. The paramedics arrived and once they assumed care, we left as it was quite crowded in there.
2 days later, on Friday, I was in a supervisor's office about to interview for a new position. Before the interview officially started, the supervisor was talking with another individual (who I do not know) and was mentioning how 2 of the urgent care nurses are filing for workman's comp as they injured their back moving the exam table.
At this point I flipped out because I was there the whole time and no one moved the exam table! I was behind it! Alot of people didn't notice me because I actually was behind one of the urgent care nurses! My dilemma is...do I report this obvious fraud? Or do I not? I have information that I am not privy to (their medical conditions of injury) so there is a confidentiality issue. I am at a loss on what to do.