Looking for advice

[NurseV123]

Hello everyone,

First of all, I'm disappointed I even have to come here to write this, but I'm looking for advice about a situation that is going on at the home health agency I currently am employed by.

A little background, we still do all of our charting on paper so when we go out to do a SOC we fill out a paper oasis that gets entered into a computer system by an administrative assistant and they generate the 485 plan of care that the admitting nurse then checks over for errors and sends to the physician who is signing the orders.

So here is my situation, the management at my agency decided they wanted to check to make sure the RNs were checking the 485 thoroughly before sending it to the physician so they instructed the administrative assistant to purposely include errors on the 485 so see if they were caught before they sent them to the physician.

So here is my question...I am in 100% agreement these should be double checked before they are sent to the physician, but having management instruct the data entry person to purposely faslify these documents to try to catch an error to me is ethically wrong. Especially since we were never approached and asked to make sure we were checking them they just out of the blue added orders and changed medications to see if we were "on our toes". Several of the plans of care got signed and send off to physicans with errors that weren't caught. The RNs at this agency are very busy, they function as both visiting nurses and case managers with a case load of no less than 20 patients at a time. The point of mentioning that being that they already have a lot to keep straight and purposely trying to set them up for failure seems wrong to me. I fully understand that anything I sign my name to I am responsible for; but we are all human and things can get missed and it seems unfair for management to do this.

Thoughs on this? Am I alone in thinking this is ethically and quite possibly legally wrong? I would really appreciate any insight into this. I have already starting looking for different employment simply because this is not an environment I'm willing to continue working in, but I'm just looking for some thoughts from those of you who are in the sane areas nursing

Thanks for any thoughts in advance!

[Have Nurse, ADN, RN]

Hello everyone,

First of all, I'm disappointed I even have to come here to write this, but I'm looking for advice about a situation that is going on at the home health agency I currently am employed by.

A little background, we still do all of our charting on paper so when we go out to do a SOC we fill out a paper oasis that gets entered into a computer system by an administrative assistant and they generate the 485 plan of care that the admitting nurse then checks over for errors and sends to the physician who is signing the orders.

So here is my situation, the management at my agency decided they wanted to check to make sure the RNs were checking the 485 thoroughly before sending it to the physician so they instructed the administrative assistant to purposely include errors on the 485 so see if they were caught before they sent them to the physician.

So here is my question...I am in 100% agreement these should be double checked before they are sent to the physician, but having management instruct the data entry person to purposely faslify these documents to try to catch an error to me is ethically wrong. Especially since we were never approached and asked to make sure we were checking them they just out of the blue added orders and changed medications to see if we were "on our toes". Several of the plans of care got signed and send off to physicans with errors that weren't caught. The RNs at this agency are very busy, they function as both visiting nurses and case managers with a case load of no less than 20 patients at a time. The point of mentioning that being that they already have a lot to keep straight and purposely trying to set them up for failure seems wrong to me. I fully understand that anything I sign my name to I am responsible for; but we are all human and things can get missed and it seems unfair for management to do this.

Thoughs on this? Am I alone in thinking this is ethically and quite possibly legally wrong? I would really appreciate any insight into this. I have already starting looking for different employment simply because this is not an environment I'm willing to continue working in, but I'm just looking for some thoughts from those of you who are in the sane areas nursing

Thanks for any thoughts in advance!

If "Management" are nurses, it may be a Board of Nursing issue as well. This is not an exceptable practice. Technically, they are knowingly falsifying records regardless of the motive. Falsification of records is against the law.

[kbrn2002, ADN, RN]

That may be one of the most insane things I've ever heard. It's difficult enough to double and triple check orders and care plans without worrying about random mistakes purposefully entered. There is real potential for disaster here if an intentionally wrong med order slips through with catastrophic consequences.

[Qing]

While I agree it is very important to double triple check orders, falsifying documents is against the law. It feels like they are more than willing to throw nurses under the bus, so it may be best to look for other employment. There should be a better system in checking the orders, not falsify the records to make a point.

[nursel56]

Thought I'd heard it all...

Add to that, I have good reason to say that the physician isn't going through that 485 line by line to check if the nurse made an error before he/she signs it either, so to deliberately remove a layer of safety is just nuts.

[NurseBlaq]

Update: we were told it's a perfectly acceptable practice because it's techniqually just a data entry error and it doesn't became a legal document until the RN signs it.

It's time to go! I would not want to sign my name to anything for anybody who's purposely putting my license and livelihood in jeopardy.

[slauren]

I wouldn't want to work for a company like that.