New RN not safe

cubangirl · Oct 20, 2008

My facility recently hired an RN who has two years of experience in an acute care setting. We are LTC/subacute. There is also a language barrier, although she did get her degree in the US.
Since she has been in our facility, she has made numerous med errors, including not giving an anti-seizure med, but signed out that she did. Since this particular med is a controlled substance, we knew she didn't give it when we counted narcs at the end of the night.
This weekend, her CNAs were coming to me to check skin issues on her pts. because she would not come and look, document, and she stated that a pt. having an anxiety attack was "whining". Another co-worker and I handled the situation by having a staff member on light duty sit with her 1:1, brush her hair, put music on, etc...
A pts. family asked me "does he always get so many meds at 5pm? Did something change because I wasn't giving him that many at home at 5..."
No, the pt. does not get a lot of meds at that time. His meds are carefully spaced time wise due to parkinson's disease.
This nurse has been seen giving all meds for a shift at one time--4,5,6, and HS meds at 3-3:30 in the afternoon. It didn't dawn on me what she had done until she asked me to ID a resident for her, and I called her on it. She sais "OH, but it's just tylenol". I told her that yes, it's just tylenol, but it's scheduled TID and she'd just received a dose three hours prior and wasn't due for anymore until midnight. She said "oh".
Other A&O residents have complained about the timing of medications, and several of my co-workers have discussed the situation with managment. Management told a co-worker that this nurse is highly skilled and intelligent and that it was "just a communication barrier".
Um, NO, multipe med errors in a few short weeks is NOT a communication barrier! There is more but I've get to get to work, I'm hoping she's not on tonight.
So...what's next? Management didn't want to hear our concerns, now where do we go?
BTW, we have other nurses for whom english is not there first language and we do NOT have these sorts of "communication problems".

Medication errors have nothing to do with english not being one's first language!!

I studied here in the US but English is not my first language, and not being careful and not knowing what you are doing I'd say is another type of barrier!! :banghead:

lunden · Oct 20, 2008

you guys need to go above the current management on hand. everyone has a boss, before a pt suffers over these med errors.

Triage24 · Oct 20, 2008

I am all for supporting each other as nurses. But this nurse you are describing is dangerous, period. I am a former Med/ Surg Manager and I can tell you, this has to be addressed. What is happening here is your current managment simply does not want to create a wave. Sadly what happens in these cases is when something does happen these kind of managers will give the famous, nobody told me anything as a answer. Document, Document and Docuement and use occurence reports. If you have to, notify your State board, you do not have to give your name(s). If she is this dangerous in a Sub-acute setting it scares me to think what acute care was like. Good luck to all of you.

Batman24 · Oct 20, 2008

Document everything and start a paper trail by filling out IR. All the nurses who find these med errors should do the reports as well. It's easy to ignore when it's a verbal complaint but once there is a paper trail it's much harder to ignore because they have written documentation and are aware of the liabilty issues.

If you need to go above this manager's head I would as patients could be really harmed in this situation. You followed chain of command and it was brushed aside so she tied your hands.

debi49 · Oct 20, 2008

She is not just unsafe, but lazy and a fraud (signing she had given meds but didnt). I cant believe she lasted 2 years in acute care!

suzanne4, RN · Oct 20, 2008

She is not just unsafe, but lazy and a fraud (signing she had given meds but didnt). I cant believe she lasted 2 years in acute care!

How do you know that she lasted two years in acute care? She could have quit multiple jobs before she was let go.

Suspect that this is the case.

suzanne4, RN · Oct 20, 2008

It comes down to documentation. Continue to write up everything that you see that is being done incorrectly and make sure that you have additional documentation to back it up. If management where you are is not willing to do anything about it, next will be for you to do.

And this will mean contacting the BON for your state and reporting her. Administering meds like she is doing is grounds for her to actually lose her license. That she trained in the US does not mean anything, but the fact that she is practicing very unsafely and is causing an issue to the patients or residents there.

Patient safety needs to be a first priority. And if you need to report this nurse to the state, then so be it.

RN1982 · Oct 20, 2008

I agree with Suzanne, continue to write up any errors including all witnesses, that way you don't look like you are picking on her.

Thornbird · Oct 20, 2008

Definitely take it to your state Board as well as your management. Document everything and keep a copy. The Board can't do anything if there's nothing to show and nobody to talk to.

Sadly, unsafe, dangerous and impaired nurses just pass from job to job because nobody reports it to the BON. You have an obligation to report this nurse.

rjflyn, ASN, RN · Oct 20, 2008

I might add make sure you keep copies of everything. If management is turning a blind eye to this obvious a problem I would not go as far to say that they wouldn't make paper work disappear as well. That said anytime you voice a concern it should be in writing.

Rj

hotmama2be · Oct 20, 2008

To Cubangirl-

Don't take this the wrong way but you don't know the whole entire story and don't take it as a personal attack.When it comes down to it patients come first , not someones emotions about being offended. We are all adults here and we need to think like adults and put the patients FIRST always .