How to address a lazy nurse who continuously makes mistakes?

[Vee D, ADN]

This nurse has made several mistakes on every case for home health. She continuously takes the notepad home and/or charger several times when it's supposed to be left in the home. Resulting in all of us nurses having to revert back to paper charting until she decides to responds to our work offices messages about bringing back the notepad. Second , whenever there are new med orders she does not write them down in the Mar nor create an addendum. We have a communication log and I'm trying to be professional about this but at this point I feel like just putting a statement with her name in it on the communication log so that she knows we all know she keeps screwing up. Maybe addressing her in this manner will let her know all eyes are on her and to get it together. Here is one piece that I wrote. Would this be considered rude or unprofessional,  "notepad charger is unavailable.  Britney has it our company has  been informed and reached out to her to bring charger back. Notepad battery life at 5% will have to use paper notes until she brings back."

Also what I'd like to include. Another nurse notices Britney didn't initiate an addendum nor added on the Mar.  So the nurse from other agency  asked In the communication log , " is patient receiving × med because I don't see where it's documented nor signed off its supposed to be given for 5 days?"

I'd like to add ", med was supposed to be initiated on Britney shift. It was not given nor signed off so I initiated first dose so the new stop date for med will be x date".

Is that unprofessional or rude?

[Rose_Queen, BSN, MSN, RN]

The purpose of a medical/nursing record is to document the care a patient received. So no, documenting that a charger is unavailable does not belong in the record. Complaints of other staff actions don’t belong in the record. These issues need to be elevated to the leadership team for them to deal with. 

[Vee D, ADN]

1 hour ago, Rose_Queen said:

The purpose of a medical/nursing record is to document the care a patient received. So no, documenting that a charger is unavailable does not belong in the record. Complaints of other staff actions don’t belong in the record. These issues need to be elevated to the leadership team for them to deal with. 

 did you read the entire post? We have a communication log which is communication only between the nurses. And a notepad where we do our medical charting.  I would never document what I've mentioned in the medical charting . Have you worked home health before ? PDN?

[Rose_Queen, BSN, MSN, RN]

I misread that when mixed in with MAR and other things. Regardless, the issue needs to be delivered directly to leadership to deal with. 

[Vee D, ADN]

2 hours ago, Rose_Queen said:

I misread that when mixed in with MAR and other things. Regardless, the issue needs to be delivered directly to leadership to deal with. 

? what if our clinical manager for this client is just as bad as she is ?‍♀️? Like literally

[Rose_Queen, BSN, MSN, RN]

Does the clinical manager report to anyone else? If not, it may be time to decide if this is something you can live with on the job or whether it’s time to seek something else. 

[nursel56]

On 5/8/2022 at 2:51 PM, Jenny Lee said:

? what if our clinical manager for this client is just as bad as she is ?‍♀️? Like literally

Worked PDN for quite a while.  Since the communication log isn't intended to be part of the permanent record, you can certainly mention the nurse's name if you believe it has a chance of solving the problem even if it ruffles some feathers.

Secondly, two issues pop up that I am surprised your clinical manager wouldn't consider a problem.  One is that it sounds like she is taking the medical record home, which is a huge HIPAA violation, and the other is that this denies the other nurses the ability to see recent entries as to the patient's status.

If your management doesn't care about these things, it's doubtful the nurse who does those things will change her behavior.

It can't hurt to keep communicating your position on the matter. Hope it gets better!

[psu_213, BSN, RN]

No HH experience here, but I, personally, would refrain from calling out a person by name in a shared document.  In an email to your supervisor(s) sure, but I feel like if you use the nurse's name in the log, the log could just spiral downward and become a forum for "tattling" on fellow employees.

[crazin01]

I concur with the not using a colleagues specific name.  Perhaps just 'notepad unavailable, taken out of client home.' or something along those lines.  And yeah, that's utter BS that management hasn't addressed it.  It'd be different if you all had your own notepad to use, but sharing one in the different homes (at least that's how I'm taking it) and she takes it with her, that's not acceptable.  I would think she needs to have a written warning, since it seems to be an ongoing issue, despite her being re-directed/educated on the issue.  And if her direct manager/clinical director isn't addressing it, there has to be somebody above her.  I hate to go up the chain of command, because your direct manager should address all issues, but if she isn't, then she's also not doing her job correctly.  the buck has to stop somewhere....  

 

best of luck!  

[NurseFries, BSN, RN]

 I have worked HH and documentation is very important just like anywhere else. Sounds like this nurse needs someone to help her manage her time better. Maybe cut down on her caseload? Sorry to hear her case manager is not up to par either. I would express my concerns to the manager above the case manager. Sounds like they both need more training, reminding, and so on.  I would also include both their names in the complaint or no one will know who needs help or more training. 

[Elektra6, ASN, BSN, RN]

It’s not rude. I would call the office and keep letting them know she is taking the tablet home and not bringing it back. The no addendum/no MAR written for new meds is a MEDICATION MISTAKE and is 100% her fault and poor nursing care. She could at least let everyone know what is going on with the new meds before leaving.  That needs to be written up and reported to your supervisor.  Beware though sometimes the office doesn’t care. I worked with a nurse in PDN who didn’t chart for 10 weeks. She at least filled in the MAR and did the addendums. As for the charger, I would buy my own and keep it in my bag. Sorry you have to deal with this. 

[Vee D, ADN]

10 hours ago, Elektra6 said:

It’s not rude. I would call the office and keep letting them know she is taking the tablet home and not bringing it back. The no addendum/no MAR written for new meds is a MEDICATION MISTAKE and is 100% her fault and poor nursing care. She could at least let everyone know what is going on with the new meds before leaving.  That needs to be written up and reported to your supervisor.  Beware though sometimes the office doesn’t care. I worked with a nurse in PDN who didn’t chart for 10 weeks. She at least filled in the MAR and did the addendums. As for the charger, I would buy my own and keep it in my bag. Sorry you have to deal with this. 

I see you're in home health and you mentioned PDN which is awesome.  So you understand where I'm coming from and how PDN works. Thanks for your advice. I just reported another LPN aswell who tossed a new med in a drawer, didn't document it, didn't write an addendum nor communicate via log. I called her out via the log not using her name but stated the nurse that worked this date. I reported it to my supervisor aswell. 

 

I see you have a BSN in home health. I'm looking to go back for my BSN . Did you do yours online? I want to remain in home health because facilities like medical centers/hospitals have too many politics, nurse to staff ratios aren't safe, and overall just like having one patient. I've looked at capella, WGU, gcu, and aspen