Charge nurse asking me to lie

Nurses Relations

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The other night I had a pt admitted that had a trach. I'm a new grad and have only been off orientation 5 weeks. The ER nurse told me in report that this pt has had the trach for a while and knew how to take care of it himself as he lived at home alone. Only thing was he had MRSA in his trach site so I would have to set up isolation. It was a busy night and this pt was my 5th one. I wasn't quite sure what I needed for a pt with a trach and went looking for my CN to ask her. I could not find her, she wasn't at the desk and her portable phone was also sitting at the desk so it did no good to call her.

My pt came up, I settled them in, did the admission assessment and the 5000 questions you have to ask and then had other things to do with my other pts. I looked for my CN a few more times to enquire about my admission, but found her busy helping another nurse in an iso room. I told her I had questions regarding my admission and to please help me when she was able.

Well, 3 hrs later she came down to my end of the hall to get updates. When I told her about my pt having a trach, she freaked out. She said our floor (medical floor) does not take trachs. I had no clue! She had to call the supervisor to try and get that pt placed elsewhere. Then she took me aside and started saying, "You have to do what I say so you don't get in trouble. You need to say that the ER nurse didn't tell you about the pt having a trach and you found it on assessment. You also need to say that when you saw it you tried to call me but my battery was dead on my phone and I was busy so I didn't know about it until later. You need to say exactly what I told you or you will get in trouble and I don't want to see that happen. You're new and you didn't know." I was shocked and dumbfounded! This conversation took place right before end of shift.

After I punched out I went straight to my managers office but she had the day off. I called a coworker I could trust and talked to her about it on the way home. She told me to get a hold of the NM asap even if it means to call her at home and tell her everything. First of all, I will not lie about this. Especially to throw the ER nurse under the bus! No!!! She told me about the trach on report so I'm not gonna lie about that! I think the CN wants me to lie about everything so SHE won't get in trouble. I did not know and was never told that our floor could not take trachs.

So I did call the NM right when I got home and told her the whole story and apologized for taking a trach admission and that I didn't know I wasn't supposed to. I did not, however, tell her the conversation between me and the CN and her telling me to lie. I have to work with this CN a lot since she's on my weekend rotation and I don't want to be on her bad side. She has put me in a very difficult position and I do resent her for that, but I also don't want a hostile work environment.

Would you have told the NM about the conversation? I'm torn on that one. What if the NM asks the CN what happened and she tells her that the ER nurse did not give the trach info on report? I don't want that nurse to get in trouble for something she didn't do!!

Advice please! This happened Tues night/Wed morning and I don't go back to work until next Tues. I haven't been able to enjoy my days off since this whole situation is eating me alive! :(

Be true to you. What/how/why charge is trying to cover things up is beyond your control.

The only thing you can do if the nurse in question gives you a hard time on future shifts is to say that you are not good at going along with or making up stories. That you are a poor liar. That you need a job. You are new and did not know. That you are fully prepared to be re-educated on proper admissions.

The charge nurse is attempting to cover up her mistake at your expense. That's on her. Regardless if she has been a nurse for 20 minutes or 20 years.

You are only as good as your reputation as a nurse.

When in doubt and you can't find your CN, follow policies and procedures for your facility. You should have easy access to this information or at least know where to find it. Never lie or distort the facts. That hurts your credibility. You never know when you might have to go to court and your integrity is in question. Something like this could always come back to haunt you in an unrelated situation. Always follow the nursing code of ethics.

Specializes in hospice.
I suggest you break up that wall of text with some paragraph breaks or shorten your story somehow. A lot of members see a block of uninterrupted text like that and won't read it. I didn't. Too long and daunting and time consuming, sorry. Be considerate of your reader to be a good writer.

Really? You're giving her "TL: DR?!" Get over yourself, I read it just fine.

Specializes in hospice.
Maybe I'm the only one seeing something here (or else I'm reading too much into this), but you commented that she connected with you 3 hours later ?!?!?! Was that for real? Three (3) hours? That says something to me why she was so concerned that you lie for her.

Where was she for 3 hours? As she was CN, she should have been in touch with you more closely and in a much more timely fashion, (esp with a new admission). My concern is - was she off the unit for that time or could she be sleeping? Thus her story about being incommunicado with you. (Note the dead phone battery comment.)) Is she hiding something? Has she had like this problems before?

This is a very insightful comment. When I worked in the hospital, there were certain charge nurses who were notorious for "forgetting" their Vocera on the desk and being impossible to find. At least a few times, I know they were off unit for extended times, usually visiting buddies on other units. Someone upthread asked why this charge nurse was trying to orchestrate a big coverup when the patient was fine. If she's already on management's radar due to unprofessional behavior and has been warned, that would explain her panic to cover this up.

I applaud your decision not to lie. Stick with it. However, there is such a thing as a lie of omission. This nurse displayed extremely unprofessional and unethical behavior, both in her dealings with you, and in her neglect of her patients. Being the charge nurse and not carrying your contact device, and being unlocatable by your staff for three hours, is neglect. It violates her license and could get the hospital sued out of existence. I encourage you to reconsider telling the NM about the entire conversation. I know you're afraid you might lose your brand new job if they decide to back up the CN and retaliate against you, but think about this.... if they would do that, do you REALLY want to work there?!

This post was not a 'wall of text'. It was well written and included all of the pertinent information about her problem. It was free of major grammatical and spelling errors...(which a lot of AN posts are not). Get a life and don't read it if you have a problem. I bet you are really fun to work with:rolleyes:

To OP-Don't worry about this situation. You bravely reported it your manager and if the CN gets caught in a lie, that is her problem, not yours. Doing the right thing is brave and you should be proud of yourself....you did nothing wrong. GL and tell us how things go when you get back to work. But I wouldn't lose anymore sleep over it...chances are you will go back to work and no one will mention a thing. And if they do, you have the truth on your side!

The most important thing is to upfront and honest about situations. Never lie! Admitting where you went wrong and learning from it is greatly appreciated by management. It is your license at stake.

julz68 I really appreciate you posting this! These situations might seem black and white, but as a brand spankin' newbie It's definitely got me thinking and I'm sure I will encounter situations similar in the future! I love reading everyone's responses.

Specializes in burn ICU, SICU, ER, Trauma Rapid Response.
You never know when you might have to go to court and your integrity is in question. Something like this could always come back to haunt you in an unrelated situation. Always follow the nursing code of ethics.

*** A good reputation for integrity will serve a nurse very well long before anything gets to court. A number of times in my career I have taken verbal or phone orders in critical situations and then later had the resident deny giving them. I have alwasy been given the benifit of the doubt.

Specializes in Emergency Nursing.

As an ER nurse let me just say THANK YOU for having integrity and not throwing the ER nurse under the bus. Your CN is the reason why different units don't get along!

Yes, for real and seriously. For many of us with somewhat older eyes, tracking through a large block of text is very difficult both on paper and on a computer screen. It is not a matter of being lazy ... it's a matter of physiology.

And yes, run-on paragraphs, like run-on sentences, are less than effective writing ... ask any professional editor.

Do we expect professional level writing from AN posters? Of course not, that's silly. Just readable, otherwise why post?

Sounds like a personal problem, not the posters problem.

It was perfectly readable to me and several others.

Specializes in Trauma/Tele/Surgery/SICU.

You have gotten some great advice. This floor sounds like the usual short-staffed everyone running around like chickens with their heads cut off environment common to med-surg. The fact that your charge was not available to you for such a long time is extremely worrisome! I am not sure why the charge RN wanted you to lie and create some crazy long back story to CYA and her A. You say she has 20 years of experience? Is it with this particular hospital? I would wager that this RN has probably been or seen someone disciplined for a similar type of situation. This would make me worry about the culture of your work environment in general.

I believe you did the correct thing. You tried to utilize your resources (charge RN), informed your manager when you could and were truthful with her. I also think it was a smart move on your part to not disclose the conversation you had with the charge. You have to pick your battles carefully and as you said you still have to work with this person. I would take this as a lesson and I personally would not trust this particular RN to ever have my back.

Charge is a thankless, merciless role. In my experience, rarely is the most qualified utilized as charge. The only requirements I have seen in my career are a license, a pulse, and the willingness to accept the role. Most of the time the charge gets the same miserable assignment as everyone else and really cannot be there to help anyone else.

It has truly been the biggest disappointment of my nursing career to discover that despite all the flowery rhetoric about "team" at the end of the day each nurse stands alone to defend his/her decisions against fellow nurses, docs, etc. Far too many, who have been dragged through the coals, resort to throwing others under the bus as a defense mechanism. It isn't right and it contributes to low morale. Kudos to you for refusing to do that to the ER RN.

Wooh's comments about bed management are absolutely correct! It is a very common occurrence to have to fight against in-appropriate bed assignments. The very first thing I would suggest you do is to look up your facility's bed management protocol. Usually this is a ridiculously long document that designates what types of patient's can go where and is about as clear as mud. You do not need to memorize it, simply where to find it as a reference should you ever need it. I would also ask your manager directly what other types of patient's your floor does not take.

Should you find yourself assigned a patient with equipment you are unfamiliar with start brainstorming immediately where you can find help. In this case you could have asked the ER RN during report. There is absolutely nothing wrong with saying hey I am a new RN what do I need to have in the room for a patient with a trach? If she/he can't tell you start calling. Is there night management? Swat nurses? Respiratory therapists? Even the house doc? How about a floor that specializes in whatever equipment you are getting? I have called the ortho floor for traction, cardiac floor for pacers, renal floor for dialysis access questions, even the ICU for questions. Most of the time a nurse on another floor will be willing to help you out.

Specializes in OB.

I think you did the absolute right thing in a very difficult situation. You went right to your NM to explain the problem, but did not get caught up in the CN's lies. Cross that bridge if and when it comes to that, but kudos to you for not throwing anyone under the bus. I'm a little surprised by the CN's behavior--where I work, it's the CN who deals with bed management and assigns us new patients. They already know which patient is coming and what their history is, and if someone isn't an appropriate patient for the floor, she deals with that. I'm sorry you have such a tough environment but you handled it well!

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