Keep in mind I don't do well with confrontation, I usually get so angry I start crying...
Two weekends ago I had run out of blood test strips for our monitor on my last patient that morning. I removed the chip from the monitor, and grabbed a new box, intending to replace the new chip and put the new strips in the basket. I got sidetracked by a patient request and didn't follow through with my intentions.
When I got back to work that night, the box of strips was still unopened in the basket and the last readings were the ones I did that morning. The nurse who was on should have done 8 different readings. I also checked the other monitor (our back up) and there were no readings on it that coincided with the numbers the nurse had written in the MAR. Needless to say I was very angry, especially as she recorded that she had given sliding scale insulin to one patient.
I tried calling my DON on the phone to get her input on how she would like to handle this. No answer. I recorded everything on the monitor and the MAR. Worked my shift and reported off to the same nurse. She did the same thing that day. For two days the only readings on the monitor were the readings I had done myself at HS and in the morning on our patients who do not get sliding scale.
Luckily I did not have to report off to the same nurse on Monday morning or I would probably been fired for verbal abuse of a co-worker...
I did, however, write up a two page letter to the DON, highlighting the readings, the falsified numbers in the MAR and the circumstances that led up to it. As of last Tuesday, nothing has been done about this. The DON did tell me on Tuesday that she had gotten my note. I asked her what had been done, she said, "Nothing yet."
I am very upset by this. What should the next step be? Talk to my Administrator or the BON?
Yeah, everybody knows this.And we can all concur that this is the same in all states. However, the way this person wrote her "dilemma" lead me to believe she was actually looking back at glucose levels from another shift. That to me sounds not kosher, and it is a witch hunt.Because first of all, SHE DOESNT KNOW that the sugar wasnt tested. Shes assuming. I mean, c'mon, looking back to see if what you see charted was what you see on the glucometer? Puuuuulease. She has no proof of a med error, no proof of something not being done and charted as done. If I see something charted, i have to assume it is done, I have no proof it wasnt , even if I think it wasnt, I have to act like it was. Reporting to the BON?????????? A little overzealous, are we? I hope her coworkers, the ones she is actually working a shift with, knows what they are dealing with.... if shes looking up previous shifts glucometer readings... imagine the damage she can do while shes working right beside you.........scary, some people are.......
Ok, but maybe I am thinking of my workplace, and the computerized MAR. You click on insulin, and it shows how much was given, and where, and why. Then one tab over is the lab screen which shows the latest lab results, including the uploaded glucometer results and time the blood sugar was taken. All in all it takes less than a minute to check.
And the MD's at my hospital usually like to ask the nurses, "what's his sugar been running lately?" So the latest sugar level and coverage given is part of the nurse to nurse report. We get a lot of COPD and polysubstance abuse patients, so we like to follow the blood sugar trends.
As for reporting to BON, no you report to the NM or DON of your facility first, however one of my instructer's in nursing school used to work for the BON, and she stated that ANYONE can report to the BON, even if it is considered "insignificant". The not so major reports are redirected back to the facility in question.
Keep in mind I don't do well with confrontation, I usually get so angry I start crying...
Two weekends ago I had run out of blood test strips for our monitor on my last patient that morning. I removed the chip from the monitor, and grabbed a new box, intending to replace the new chip and put the new strips in the basket. I got sidetracked by a patient request and didn't follow through with my intentions.
When I got back to work that night, the box of strips was still unopened in the basket and the last readings were the ones I did that morning. The nurse who was on should have done 8 different readings. I also checked the other monitor (our back up) and there were no readings on it that coincided with the numbers the nurse had written in the MAR. Needless to say I was very angry, especially as she recorded that she had given sliding scale insulin to one patient.
I tried calling my DON on the phone to get her input on how she would like to handle this. No answer. I recorded everything on the monitor and the MAR. Worked my shift and reported off to the same nurse. She did the same thing that day. For two days the only readings on the monitor were the readings I had done myself at HS and in the morning on our patients who do not get sliding scale.
Luckily I did not have to report off to the same nurse on Monday morning or I would probably been fired for verbal abuse of a co-worker...
I did, however, write up a two page letter to the DON, highlighting the readings, the falsified numbers in the MAR and the circumstances that led up to it. As of last Tuesday, nothing has been done about this. The DON did tell me on Tuesday that she had gotten my note. I asked her what had been done, she said, "Nothing yet."
I am very upset by this. What should the next step be? Talk to my Administrator or the BON?
Thanks in advance...
Elizabeth
I am currently going through some stuff at my job also, not only does it involve her as a nurse but also as a person. I was raised not to lie no matter what et can not stand any person who can do that. So my story is very long but I had to have a meeting with the DON et this nurse last week, it was not what I thought it was going to be, et for some reason alot of my co-workers are using my name for things they have done et blaming me for everything, but I still go to work et smile cause when we took that oath we swore we would act in a professional matter at all times!!!!(and I hold myself to that)
So anyways the DON, ADON seem to baby this nurse, and I am not the only one with issues. She has actually put residents in harm, with residents being sent to hosp for what she has caused, she has also falsified records, so with all this other stuff the DON wrote me a letter stating that she understood I had issues with the practice of this nurse and that I needed to understand that It is being dealt with et that I just do not always know the outcome. Which after I thought about it she is right. It is there legal responsibility to keep discipline actions or so forth confidental. So just be patient and you may see things change, or you may actually be able to see the discipline for yourself. I can honestly say that over the last week I have seen her do things different, slight changes but one step at a time.
one of my instructer's in nursing school used to work for the BON, and she stated that ANYONE can report to the BON, even if it is considered "insignificant". The not so major reports are redirected back to the facility in question.
yes, anyone CAN report to the BON...but the issue is SHOULD you report to the BON? In this case I would say no....there was no mention of anyone suffering any adverse event from the alleged nurses's actions. There are many, many more steps that should be taken before this should ever even come to that.
I know that for most nurses, being reported to the BON is probably their worst nightmare...I know it would be for me. Given the amount of time we put into becoming nurses...and that this is the profession that for many of us is allowing us to maintain our lives/households/etc....to report something for which the is not alot of hard evidence, something that did not result in injury to the patient, seems a little excessive. And more than that...to be reported by another nurse....If the circumstances were different that reported in the OP, than maybe that would be a reasonable response...but this just doesn't seem to be the most appropriate measure. And as frightened as we all want to be that a nurse MIGHT have not taken some blood sugars, it is more frightening that so many concur with an immediate call to the BON. Hope none of your actions are misinterpretted without due justice.
Just a thought, and please keep in mind that I haven't read all 7 pages yet, but this post hit a nerve with me. I went through this same thing a few days back. We have two seperate med carts but only one pulse oximeter and fully functioning BP cuff. The pulse oximeter and cuff was on the other med cart which my fellow GPN was using the entire shift. She never said anything to me about it. The next day, the story was the same. She kept possession of the pulse oximeter and cuff. Well, a couple of days later on my way out to my break one of my preceptors stopped to ask what Mrs. So and So's pulse was because the previous shifts had been holding her lanoxin. I told her the pulse rate and BP and that I had administered the med. Later that day at change of shift I told the oncoming nurse to hold a second because I had left something in the bottom of the cart, from which I pulled an electronic blood pressure cuff one of my co-workers loaned me. Then I noticed my nurse manager and my preceptor both heave a sigh of relief. "Oh, THAT'S how you do the pulses and BPs!" said my supervisor. I assumed the other GPN reported that I was not checking the parameters, and I asked her- which she sheepishly admitted to. I told her very nicely that she should have come to me and expressed her concerns, but because she didn't people were suspicious of me and it could have really hurt my reputation as a nurse and damaged what people believed to be my character. Sometimes there really is a good explanation. Perhaps not in the instance of the glucometer, but everyone deserves the benefit of the doubt.
Falsification of a medical document (which is a legal document) is a crime. You did the right thing. Your DON may have to take it to the person above him/her, also because of privacy laws is prohibited from sharing any information about the follow-up with you. Just know that you did the right thing and keep doing it. NoCrumping is wrong. We are patient advocates and that means watching out for them. Blood glucose readings are vitally important.
yes, anyone CAN report to the BON...but the issue is SHOULD you report to the BON? In this case I would say no....there was no mention of anyone suffering any adverse event from the alleged nurses's actions. There are many, many more steps that should be taken before this should ever even come to that.
I know that for most nurses, being reported to the BON is probably their worst nightmare...I know it would be for me. Given the amount of time we put into becoming nurses...and that this is the profession that for many of us is allowing us to maintain our lives/households/etc....to report something for which the is not alot of hard evidence, something that did not result in injury to the patient, seems a little excessive. And more than that...to be reported by another nurse....If the circumstances were different that reported in the OP, than maybe that would be a reasonable response...but this just doesn't seem to be the most appropriate measure. And as frightened as we all want to be that a nurse MIGHT have not taken some blood sugars, it is more frightening that so many concur with an immediate call to the BON. Hope none of your actions are misinterpretted without due justice.
Kathryn
I would just like to clarify that I said:
"As for reporting to BON, no you report to the NM or DON of your facility first, however one of my instructer's in nursing school used to work for the BON, and she stated that ANYONE can report to the BON, even if it is considered "insignificant".
Always follow chain of command.
Maybe I should also have said that due to the other employee's confidentiality issues, those who make a report don't always know what if any reprimand/counseling the employee recieved.
Keep in mind I don't do well with confrontation, I usually get so angry I start crying...
Two weekends ago I had run out of blood test strips for our monitor on my last patient that morning. I removed the chip from the monitor, and grabbed a new box, intending to replace the new chip and put the new strips in the basket. I got sidetracked by a patient request and didn't follow through with my intentions.
When I got back to work that night, the box of strips was still unopened in the basket and the last readings were the ones I did that morning. The nurse who was on should have done 8 different readings. I also checked the other monitor (our back up) and there were no readings on it that coincided with the numbers the nurse had written in the MAR. Needless to say I was very angry, especially as she recorded that she had given sliding scale insulin to one patient.
I tried calling my DON on the phone to get her input on how she would like to handle this. No answer. I recorded everything on the monitor and the MAR. Worked my shift and reported off to the same nurse. She did the same thing that day. For two days the only readings on the monitor were the readings I had done myself at HS and in the morning on our patients who do not get sliding scale.
Luckily I did not have to report off to the same nurse on Monday morning or I would probably been fired for verbal abuse of a co-worker...
I did, however, write up a two page letter to the DON, highlighting the readings, the falsified numbers in the MAR and the circumstances that led up to it. As of last Tuesday, nothing has been done about this. The DON did tell me on Tuesday that she had gotten my note. I asked her what had been done, she said, "Nothing yet."
I am very upset by this. What should the next step be? Talk to my Administrator or the BON?
Thanks in advance...
Elizabeth
The same thing has happened to me numerous times with the same nurse and not just insulins but medications, treatments ect. I complained and all to no avail except to only have my work scrutinized and that same nurse lie on me. So even though you have the right idea I'm not even sure it pays off anymore. After 12 years in this business it seems that the worse nurse you are the higher up the ladder you go. This nurse was recently named nurse of the year and given a promotion to a nurse managers position. You would think that after all that her behaviour would change, it hasn't and she continues to recieve accolades. At least she is off the floor and can do no harm, however I do wonder when someone is going to realize what a fraud she is.
Curious to what happened? Funny that this occured at my facility too.
No I wasn't trying to be a rat, but I noticed that all my 4 pm accuchecks were rather high and that I was always covering them with a huge amt of insulin. This wasn't every day, just a few a week. I wanted to check the readings from the am, so I just paged back thru the machine....Ummm they were missing? I check our other machine and the readings were missing too. I check the MAR and accuchecks and coverage was documented. Funny thing was the CNAs and pts were wondering why they didn't need to get woke up for their "sugar tests any more".
Well, I'm I a big tattle tail, esp when I'm covering BS in the 400s and the pts havent been feeling well all day.
We are patient advocates and that means watching out for them. Blood glucose readings are vitally important. 
elthia
554 Posts
Ok, but maybe I am thinking of my workplace, and the computerized MAR. You click on insulin, and it shows how much was given, and where, and why. Then one tab over is the lab screen which shows the latest lab results, including the uploaded glucometer results and time the blood sugar was taken. All in all it takes less than a minute to check.
And the MD's at my hospital usually like to ask the nurses, "what's his sugar been running lately?" So the latest sugar level and coverage given is part of the nurse to nurse report. We get a lot of COPD and polysubstance abuse patients, so we like to follow the blood sugar trends.
As for reporting to BON, no you report to the NM or DON of your facility first, however one of my instructer's in nursing school used to work for the BON, and she stated that ANYONE can report to the BON, even if it is considered "insignificant". The not so major reports are redirected back to the facility in question.