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".
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 .
i dont understand you quarrel with her post, and it has not been edited....she was stating that using the lang barrier was ..hhmm not germaine to the discussion....not defending it
i had a very similar experiance at a facility that i started at over the weekend. it is a psyche facility and he wanted to give all 7-3 meds at 830 am so he could sit and study or read the rest of the day. i refused to do it and insisted on the second med pass, but then when trying to find a person that he couldnt find in the am for meds, he wanted to give the patient her am meds with her afternoon meds.... signed off on all treatments and said that no one ever does them.... and all tubes of creams and whatnot were untouched in the drawers but signed off on. during the second med pass, i couldnt take it anymore... i told him to finish the pass and i started to leave.... i ended up finishing the shift, but i made a report and i quit the job after 2 days of working... i told them all the details and said that i couldnt work like that. i didnt feel my license was safe... they said that they would watch him, but he knows he is in trouble now and will of course be on his best behavior. apparently there have been several nurses practicing that what at the facility. what a terrible experience. i cant believe nurses can be that clueless about meds and their effects on patients.... this is a life or death issue for the patients if you ask me
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.
And don't forget to make and keep copies for yourself. You might consider mailing them registered mail with a return receipt. JMHO and my NY $0.02.
She's still working at her other job!! Today she worked 6-2, and then drove back to work at her hospital. She complained about the low rate of pay LTC offers and asked several of us (LPNs, not RNs) why we put up with it. I explained to her that field for LPNs is narrowing, and that those of us who work here love what we do. I LOVE my residents!
I asked her during her orientation why she took the job if she felt the pay was so poor. Answer: "They are helping me with my green card". They had her sign a year contract.
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!
The CNAs for her wing came to me over the weekend to do treatments. We have a resident with an unusual sore on the coccyx, which we have had a couple of different tx's for, and since this resident's skin is particularly fragile, and she slapped a band aid on it. She didn't even wash the area or use the right cream, which was a debriment cream. The CNAs know what she gets, say the band aid and asked me to come and take care of it when I could.
i had a very similar experiance at a facility that i started at over the weekend. it is a psyche facility and he wanted to give all 7-3 meds at 830 am so he could sit and study or read the rest of the day. i refused to do it and insisted on the second med pass, but then when trying to find a person that he couldnt find in the am for meds, he wanted to give the patient her am meds with her afternoon meds.... signed off on all treatments and said that no one ever does them.... and all tubes of creams and whatnot were untouched in the drawers but signed off on. during the second med pass, i couldnt take it anymore... i told him to finish the pass and i started to leave.... i ended up finishing the shift, but i made a report and i quit the job after 2 days of working... i told them all the details and said that i couldnt work like that. i didnt feel my license was safe... they said that they would watch him, but he knows he is in trouble now and will of course be on his best behavior. apparently there have been several nurses practicing that what at the facility. what a terrible experience. i cant believe nurses can be that clueless about meds and their effects on patients.... this is a life or death issue for the patients if you ask me
I'm afraid that may happen with her too. I had an opening to speak with my DON today and asked her how she would like us to handle such situations. She said first deal with the other nurse directly and if that didn't solve the problem to come to her. We've been talking to our other two managers.
I told DON that I would attempt to STOP anything I felt was unsafe, but that if I felt obligated to report situations to her as well. I'll have to find out more a paper trail. I'm not entirely sure how to go about that aspect.
I'm also feeling a little worried about the fact that she's an RN and I'm an LPN.
I have not been in nursing that long myself, this is my second career. I finished my LPN last December, passed my boards in early Feb. and have been at this facility since then. I'll finish my RN in December.
Thank you for all of the great advice, I needed the kick to do what I know needs to be done.
i worked with this nurse would give all meds, even sleep meds at 5p
the DON thought so much of her that she had her train the new nurses an d they did the same thing
Do not let the fact that you are a LPN and she is a RN stop you from doing the right thing. This does not give her a pass to cause danger to patients. In fact in the eyes of your state board she is held to a higher standard.Now if she doesn't have a green card how is it she working to begin with. Someone may can explain this but I don't know how this is done. When we keep talking paper trail we mean document everything in the nurses notes. Be very careful do not make it ever appear vindictive. The way to docuement this type of things is facts, facts and facts. Use occurence reports, learn to write them and then write a lot of them. Most of us recommend contcating the State Board, they will investigate. Give them details and facts. You do not have to give your name. When all else fails, yopu must ask yourself do you wish to continue to be a part of this facilty, Think about it. If your managment is no better than this do you really want to continue working for them?
Do not let the fact that you are a LPN and she is a RN stop you from doing the right thing. This does not give her a pass to cause danger to patients. In fact in the eyes of your state board she is held to a higher standard.Now if she doesn't have a green card how is it she working to begin with. Someone may can explain this but I don't know how this is done. When we keep talking paper trail we mean document everything in the nurses notes. Be very careful do not make it ever appear vindictive. The way to docuement this type of things is facts, facts and facts. Use occurence reports, learn to write them and then write a lot of them. Most of us recommend contcating the State Board, they will investigate. Give them details and facts. You do not have to give your name. When all else fails, yopu must ask yourself do you wish to continue to be a part of this facilty, Think about it. If your managment is no better than this do you really want to continue working for them?
I think the so-called nursing shortage serves to attract a bunch of people into our field who really don't give a damn about nursing- and for mgmt to accept them.
I think this nurse and your mgmt are good examples of this.
In our state you could go to the State Ombudsman or report as abuse of vulnerable adults to the proper state dept. This would trigger an investigation of the facility. This can be done without your name being raised as the reporter. In fact, in this state, failure to report abuse while in duty status is illegal.
morte, LPN, LVN
7,015 Posts
i dont understand you quarrel with her post, and it has not been edited....she was stating that using the lang barrier was ..hhmm not germaine to the discussion....not defending it