Nurse not passing meds...should I report to BON?

JulieCVICURN, BSN, RN · May 11, 2011

If you have reported to your DON that even after the warning the behavior continues, I would escalate it up the next level in your organization, such as the CNO or COO. I would not go over them to the BON unless nothing continues to be done. It could appear to the BON that your facility did not do anything to remediate this situation and your CNO or VP of Nursing will not be happy that they were left out of the loop and not given an opportunity to address it. Follow the proper chain of command. If that gets no results, you can report if you want, but I'd advise against it at this point.

merlee · May 11, 2011

Go to the DON again. Tell her you feel this is a serious issue os neglect, and the licensing agency - for your facility - needs to be notified - will she call them, or should you?

This is a tough call for you - what is this nurse doing all during the time of the med pass? Someone must get the meds to these patients.

Best wishes!

EmergencyNrse · May 11, 2011

I would pull her off the floor. I would send her home and have staffing fill her position until both of you could meet with the DON. Neglect is only part of it. I would say Gross dereliction of duty...

Not safe, not standard of care, poor nursing.

No way would I let her continue on my ward/floor. I can't say that I even believe remediation would help with this one. It's more of an integrity issue... of morals and character. Falsifying the MAR??? Does she make up her vitals as well? Does she falsify her assessments as well... Fire her!

TheCommuter, BSN, RN · May 11, 2011

My view might be unpopular, but here it is...

Everything happens for a reason. Rather than bestow more punitive action upon the nurse who is suspected of not administering meds, the DON instead issued a warning and a slap on the hand. The DON did this for a reason. Politics are involved.

Your DON fully knows what is going on in her facility, but instead she is choosing to turn the other way for a reason. She might personally like the crappy nurse. All I know is that your DON knows how this nurse works and, in all likelihood, is secretly tired of your reports. However, she is pretending to address your complaints and scrutinize your evidence to appease you, although I suspect she secretly wishes that you would back off.

I would report this to the next person in the chain of command, whether it be the facility administrator, corporate nurse consultant, etc. However, keep in mind that this DON will not be happy that you escalated your concerns and reported above her head. This means that you might be targeted in the future.

LissaLynn · May 11, 2011

My opinion won't be popular either but here goes...have you approached the nurse and asked if she needs help or if perhaps there is something YOU can do to help? Perhaps they are overwhelmed? All to often I watch nurses drowning while their supervisors stand back and watch then criticize them for it.

Then again, this nurse could just be lazy and not doing their job, but more often than not, there is something else there.

steelcityrn, RN · May 11, 2011

Continue to monitor as you are a supervisor. Continue to be aware of the need to assess her medication rounds. You as a supervisor need to make her aware that you are making sure all medications are delivered and signed off as given at the correct time. Next time you have proof of this, I would think the next step in getting her fired or reported to the B.O.N. will happen. As far as the woman who died on her shift, much proof would be needed that she had anything to do with that. I would not mention this at work, as without proof that is a slanderous statement.

Whispera, MSN, RN · May 11, 2011

You're her supervisor. Have you talked with her about what you discovered? Have you offered to help? If you haven't, what's holding you back? It's my opinion that if a supervisor sees something going on that's not a good thing, she needs to confront the trouble directly and not jump over the person to the next higher-up without giving the trouble a chance to explain.

If you have confronted her/tried to help and the trouble continued, and you have reported her to the DON and nothing has happened...then report the new stuff to the DON one more time. Maybe more has happened than you know. Lots of times bosses do things to confront trouble but don't tell anyone. If you still don't see any change, that's the time to go to the CNO, CEO, or whatever the chain of command is in your facility. Does your facility have a phone line where people can anonymously report things they see happening that they don't want other to know they're reporting?

I also think, just in case, you should be looking for options for another job. If there's a chance you could become a target of trouble, it's always good to have an option of another place to go.

NoviceRN10 · May 11, 2011

You're her supervisor. Have you talked with her about what you discovered? Have you offered to help? If you haven't, what's holding you back? It's my opinion that if a supervisor sees something going on that's not a good thing, she needs to confront the trouble directly and not jump over the person to the next higher-up without giving the trouble a chance to explain.
If you have confronted her/tried to help and the trouble continued, and you have reported her to the DON and nothing has happened...then report the new stuff to the DON one more time. Maybe more has happened than you know. Lots of times bosses do things to confront trouble but don't tell anyone. If you still don't see any change, that's the time to go to the CNO, CEO, or whatever the chain of command is in your facility. Does your facility have a phone line where people can anonymously report things they see happening that they don't want other to know they're reporting?
I also think, just in case, you should be looking for options for another job. If there's a chance you could become a target of trouble, it's always good to have an option of another place to go.

As a supervisor shouldn't you be addressing this with the nurse herself? I would shadow her and let her know that you are watching her and expect her to do her job properly.

caliotter3 · May 11, 2011

I agree that it is more likely that you will be the target for termination or trouble, instead of the nurse who seems to have some kind of inroad with the DON. You probably should be looking elsewhere for work at the same time that you continue to address this issue. It is apparent, at least for now, that the DON does not share your concerns.

caliotter3 · May 11, 2011

BTW, I once worked with a nurse who did the same thing. She falsified a good deal of her job, including not doing fingersticks at all, in order to have enough time to sleep during the night shift. She slept all night long in the direct presence of the house supervisor. Yet, when it was time for layoffs, personnel who did their work were shown the door and she remained. Politics is more important than job performance, just like in other lines of work.

JulieCVICURN, BSN, RN · May 11, 2011

I already responded once, but wanted to clarify that in no way do I think you should continue to let this behavior slide under the radar. Especially as a supervisor! You need to continue to escalate this through the proper channels. As others have said, though, be prepared to have a lot of people less than appreciative of your efforts. Office politics are a horrible thing to navigate, but you know that for the good of the patients she can't be allowed to continue to work this way.