Nice coworker but I'm concerned

[LibraNurse27]

Hi all, posting on behalf of myself and my coworkers. We work with a super nice nurse, in her 50s and been a nurse for a while. She's in the float pool but has been working with us more lately. She always helps out when asked with turns, cleaning, etc and is really friendly. But we've been noticing some scaryish stuff. Whoever is resource nurse and offers to help people finds that all her 1000 meds aren't given, and it can be 1200 already. Vitamins I get it, but these are timed meds like antibiotics, cardiac meds, heparin, etc. I also found meds scanned but not given, sitting on the cabinet next to a pt's bed, including Norco and IV valium. Pt was in etoh withdrawal and needed the valium, but it was just sitting there, scanned at 0900 but it was 1100.

I have also seen her do a lot of things without gloves. For example yesterday I started an IV on her pt and the saline lock in the kit was broken, so she held it in place while I got a new one. A little blood came out of the catheter, and she wasn't wearing gloves. Once she also put paper tape on my pt's open wound instead of the ordered dressing, and it took me forever to get it off. It was painful for the pt and ripped off more of her skin. IDK what the rationale was. One doctor has it out for her and writes her up every chance she gets. Our manager doesn't like her and floats her whenever she can. My question is, should we report this stuff? Or talk to her in person? Or... keep watching in horror and trying to catch up her work and remind her to wear gloves?

[LibraNurse27, BSN, RN]

17 hours ago, Workitinurfava said:

So the manager keeps floating her but won't keep her on her unit more and address the issues. She will say it's been reported to me by a coworker of yours to the lady  that she has been working unsafely. Hopefully she won't sit back and watch the fight after you guys say something to her.

Well something needs to be done regardless,  and the shame is  the manager won't address it before you guys. 

Yes, there is one doctor who repeatedly writes her up and talks to managers about her... but it is pretty hard to get fired from a government hospital and the California Nurses' Union is unbelievably strong. I really appreciate the protection they give us and that they help us fight for good pay, ratios, against workplace violence, etc. but I think sometimes their strength allows nurses to keep their jobs when there are concerns, without looking into the issues.

I'm very pro union but I do see the cons. I also see how the bureaucracy in government institutions is a problem, but I know we are also a safety net for our patients. I'm learning that every situation is complex, but next time I see something dangerous I know I need to speak up. thanks for your reply!

[turtlesRcool]

47 minutes ago, LibraNurse27 said:

Yes, there is one doctor who repeatedly writes her up and talks to managers about her... but it is pretty hard to get fired from a government hospital and the California Nurses' Union is unbelievably strong. I really appreciate the protection they give us and that they help us fight for good pay, ratios, against workplace violence, etc. but I think sometimes their strength allows nurses to keep their jobs when there are concerns, without looking into the issues.

I'm very pro union but I do see the cons. I also see how the bureaucracy in government institutions is a problem, but I know we are also a safety net for our patients. I'm learning that every situation is complex, but next time I see something dangerous I know I need to speak up. thanks for your reply!

Unions don't make employers keep bad employees on the job. Unions make employers follow due process before terminating a bad employee.  It sounds like the nurse manager has decided not to do her job.  The doctor can write incident reports, but as he is not part of the nursing hierarchy, those reports mean nothing unless nursing management does something about them.  Not the union's fault if the NM doesn't want to do the work of going through the proper steps necessary to remediate or terminate an unsafe nurse.  I don't agree with every position my union takes, either, but it's lazy management to blame the union for an unsafe nurse being floated instead of dealt with.

[LibraNurse27, BSN, RN]

3 hours ago, turtlesRcool said:

Unions don't make employers keep bad employees on the job. Unions make employers follow due process before terminating a bad employee.  It sounds like the nurse manager has decided not to do her job.  The doctor can write incident reports, but as he is not part of the nursing hierarchy, those reports mean nothing unless nursing management does something about them.  Not the union's fault if the NM doesn't want to do the work of going through the proper steps necessary to remediate or terminate an unsafe nurse.  I don't agree with every position my union takes, either, but it's lazy management to blame the union for an unsafe nurse being floated instead of dealt with.

That is true, they have also protected many employees from being fired for unfair reasons such as racial discrimination. I definitely believe in unions. IDK what's wrong with nursing management, or maybe management in most professions is this way? Not sure because I've always worked in nursing LOL

[Ambersmom, BSN, RN]

No, nursing management in other places is not like this(nor is it usually like this outside of nursing). I've seen people terminated for relatively minor infractions but I believe in this case the reason why nothing official has happened is because nothing has officially been reported. Going to the manager and saying she doesnt do that, or I found 2 vicodin in a cup is not the same as putting it into an incident report and sending it through proper channels, in that case management is forced to act because risk management is also looking at those forms. I personally had to defend myself when someone did an incident report on me: I was having a hell night, 2 CBIs one of whom was actively bleeding, another patient who had a seizure or reaction to a med, so my 4th patient I hung IV APAP and forgot to unclamp the line, the pump never beeped but the night nurse wrote me up (I personally wouldnt have written someone up for that but que sera sera), anyway the point is with the OPs nurse, management won't likely do anything until there are several incident reports on file and risk management says hey... And I don't necessarily think this nurse should be fired. I think she should be counseled and either some remedial training or given an official warning and a chance to clear up her practice, and if it continues then kick her to the curb.

[LibraNurse27, BSN, RN]

2 hours ago, Ambersmom said:

No, nursing management in other places is not like this(nor is it usually like this outside of nursing). I've seen people terminated for relatively minor infractions but I believe in this case the reason why nothing official has happened is because nothing has officially been reported. Going to the manager and saying she doesnt do that, or I found 2 vicodin in a cup is not the same as putting it into an incident report and sending it through proper channels, in that case management is forced to act because risk management is also looking at those forms. I personally had to defend myself when someone did an incident report on me: I was having a hell night, 2 CBIs one of whom was actively bleeding, another patient who had a seizure or reaction to a med, so my 4th patient I hung IV APAP and forgot to unclamp the line, the pump never beeped but the night nurse wrote me up (I personally wouldnt have written someone up for that but que sera sera), anyway the point is with the OPs nurse, management won't likely do anything until there are several incident reports on file and risk management says hey... And I don't necessarily think this nurse should be fired. I think she should be counseled and either some remedial training or given an official warning and a chance to clear up her practice, and if it continues then kick her to the curb.

Aw that sounds like a terrible shift. I think the other nurse should have cut you some slack because it wasn't a dangerous error, but I do see your point about creating a paper trail for more serious errors. thanks!