Suppose you didn't report anything knowing what you did and he had an accident with the hoyer lift with the patient in it, then what? Wouldn't you be in hot water too for not reporting? YOU DID THE RIGHT THING.

I never told the agency he was on drugs ... i only reported what i observed..and ur right too many people did know how i felt i was very upset bc the agency did call the pt , pull the HHA off the case, and was testing him for drugs..-- which they took upon themselves to do... they could have handled it differently...also, i gave the HHA the benefit of the doubt i tried to talk to him .. i asked him was he on medication or was something wrong , but he became very angry .. this was not the only time he replied angrily to me when i asked him something... even when i advised him to do things differently when he made a mistake he became very angry...

oramar

1 Article; 5,758 Posts

Jan 23, 2005

I applaud you because you approached this from the perspective of patient safety. Most of us had not had formal instruction on what the correct protocol for such a problem would be and most of us would probably make a misstep or two in dealing with such a situation. I doubt if I would have called his boss but I sure would have called mine. But my situation is different from yours in that I am a staff nurse not a private duty nurse. It is really the duty of the manager of the unit to deal with this in my situation. My manager would be like the hound of hell on the heels of anyone who came to work under the influence. However, if I had a manager that blew it off it would be my duty to go to next level. Some people say you should not have discussed this with the other nurse. But my understanding of what you did is that you were talking about what steps to take not gossiping. It seems to me that the nurse before and after and working with the HHA have a stake in this and of course you would talk. Truth is a situation like this never goes down without some gossiping and I just bet there is some. I would try not to particpate because my situation would be so touchy.

Stitchie

587 Posts

Jan 23, 2005

Patient safety comes before all else. That's what we're paid and licensed to do first -- be patient advocates.

I think you made the right call. I don't know your situation with the oncoming nurse, but if there was overlap in the HHA shifts with two different RN's, it's in the patient's best interest for that oncoming nurse to be informed of a potential safety risk.

Antikigirl, ASN, RN

2,595 Posts

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

Jan 23, 2005

I guess I was rather lucky. We had a CNA who was really having a bad time at home and was in the middle of a divorce and a horrid child custody battle. She was frazzled big time all the time, but all the sudden she was less so and a little more slurred with her speech, and wasn't walking properly. But it was mildly evident...one of those things like...I better just see if it happens again I may be being too quick to judge kinda deals!

I kept it to myself at first thinking she may have just started a new Rx of antidepressants like we all suggested to her. I watched her very carefully, but other CNA's who worked more closely with her said they smelled ETOH on her breath, and then I knew something had to be done.

Knowing this would just about be the straw the broke the camels back for her life, and knowing I am putting myself up for a lot of flack...I actually played dumb with my DON! I asked her if she had noticed anything about this person because I was starting to hear rumors but didn't know what was going on! This was I was able to guage the situation before I jumped into it! My DON also heard some rumblings in the staff about her and didn't quite know what to make of it either. We both chose to keep an eye and ear out that day and watch her. WHEW, I alerted my admin but didn't make any accusations...that was a very good move!

We recorded what we saw as we saw it only...no assumptions, no claim to know what was going on. She really was worse that day...really slurring speech, acting very oddly and a little smarty towards residents, but thankfully was doing her patient care very carefully and correctly! (all the CNA's watched her too just in case, we didn't want to rush to conclusions, but patient safety is priority!).

It was found that she indeed was drinking all the time, day and night...and found out what got her drinking so much. No it wasn't the family issues, although those didn't help....she had just be diagnosed with cancer! Oh the poor dear...I just cried! She was discharged with the option of going to rehab...but she didn't return. I saw her a few months ago and it is terminal and is going to be on hospice soon, I hugged her and wished her well...but that explained why she didn't seek her old job back . So very sad!

Another idea I almost did in this above situation was to leave a anonymous note (typed so as not to have my writing on it...they know my writing!) in the suggestion box stating only what was seen. That way I supposed I would not be hung out to dry so to speak, but still got the attention of the managment! Lucky for me however we do have a staff very serious about drinking/drugs on the job, and reporting it hasn't had ramifications for the one reporting it! In fact, it is almost the opposite...if you don't and you work closely with them..you too can get into trouble if you noticed it (and we have quite a grapevine at work...people do know if you knew and didn't say anything!).

teemarie

28 Posts

Jan 23, 2005

I applaud you because you approached this from the perspective of patient safety. Most of us had not had formal instruction on what the correct protocol for such a problem would be and most of us would probably make a misstep or two in dealing with such a situation. I doubt if I would have called his boss but I sure would have called mine. But my situation is different from yours in that I am a staff nurse not a private duty nurse. It is really the duty of the manager of the unit to deal with this in my situation. My manager would be like the hound of hell on the heels of anyone who came to work under the influence. However, if I had a manager that blew it off it would be my duty to go to next level. Some people say you should not have discussed this with the other nurse. But my understanding of what you did is that you were talking about what steps to take not gossiping. It seems to me that the nurse before and after and working with the HHA have a stake in this and of course you would talk. Truth is a situation like this never goes down without some gossiping and I just bet there is some. I would try not to particpate because my situation would be so touchy.

I could have called my boss which is the person that gets me my assignments and get his opinion-- in retrospect i think this would have been the best bet instead of calling the agency directly-- thanks

oramar

1 Article; 5,758 Posts

Jan 23, 2005

I could have called my boss which is the person that gets me my assignments and get his opinion-- in retrospect i think this would have been the best bet instead of calling the agency directly-- thanks

Once I did a post about a co-worker that was being verbally abusive towards patients for the first time in a long career. I attributed this to the fact that her son had just recently died a slow death from cancer and she was grieving. Her behavior was particularly bad one day and I had to take her aside to encourage her to seek counseling. She reported that there had been a memorial service earlier that day and she was devastated that she had not attended. I came here to discuss the situation expecting people to either support me or condemn me for not turning her in to managment or the BON. Turns out the thing that people jumped down my throat about was the fact that I did not immediately send her home. It never occured me to do this simply because I do not have the power to do it and the service was already over when she told me about it. I added this to my store of info and if anything like this happens again I will consider contacting someone who has the power to an employee home. By the way, anyone who reads this and remembers the post, this particular nurse retired a month ago. She did get counseling and improved for a while but the depression and grieving and subsequent unacceptable behaviors kept returning so she decided to retire. I saw her on her last day, it was two years since the death of her son and she still looked soooo bad. She just could not function in a health care setting in an acceptable manner and decided on her own to get out.

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