Nurse performs a nursing action off the clock. What are the repercussions?

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So I work in home health care. Long story short on my shift my client's regular day nurse arrives to help the patient's mom out with her yard. While she was here she just came in, started talking to the patient, then started suctioning him on my shift. I just sent an email to the office because what If something would've went wrong?

7 hours ago, FutureRnNnc said:

While she was here she just came in ,started talking to the patient, then started suctioning him on my watch. I just sent an email to the office because what If something would've went wrong?

Contrary to the most beloved of nursing traditions faithfully passed to new generations of nurses, we actually are not responsible for every single move everyone else makes. If she drops by and fouls everything up on her day off, she will be responsible.

The concern you actually conveyed here (responsibility for her actions should they have caused a problem) makes it sound like you are looking to inflate your report. Have a professional discussion with her and if there's no resolution either report that she is hanging around while off duty or else let it go.

??

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54 minutes ago, Hoosier_RN said:

documenting that *task* done by Sue Smith, RN, add whatever documentation you would normally add, sign FutureRnNnc, RN

This covers in case something is noted wrong later, there is a trail

Others have stated that you should have talked to the other nurse first, and you should have. That is how professionals approach an issue. As a manager, that would probably one of the first things that I would ask you, as well as what the other nurse's response was. When disseminating the information and trying to find a resolution, this would be information that I would need to know. If you didn't approach this as an adult professional, you come across as a tattletale, so be mindful of that as well

Thank you for your response but I know enough about her to know that conversation would not go well with her. She lacks professional boundariesand this isn't her first rodeo.. I'm not too concerned with how I come across to the employer because at the end of the day it was unethical and the state board of nursing is over any manager . And all they care about is trying to run a business .

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48 minutes ago, JKL33 said:

Contrary to the most beloved of nursing traditions faithfully passed to new generations of nurses, we actually are not responsible for every single move everyone else makes. If she drops by and fouls everything up on her day off, she will be responsible.

The concern you actually conveyed here (responsibility for her actions should they have caused a problem) makes it sound like you are looking to inflate your report. Have a professional discussion with her and if there's no resolution either report that she is hanging around while off duty or else let it go.

??

Thank you, and this is not her first rodeo of crossing professional boundaries. She cannot handle a professional discussion . That is why I took the route of an email to the clinical manager over the case. I work in home and prefer not to get into a cheated discussion in front of patient's family because she has issues and I mean issues. This is why the client is unable to stay covered on the days I've picked up. And if the employer sees the report as an " inflation" the state board of nursing is above them. ?‍♀️ what she did was unethical.

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Okay, YIKES.

Would you guys let someone fall out and die in lieu of giving CPR just because you weren't on the clock, as well.? (Obviously CPR is a protected area, I'm just making a point).

No, she shouldn't be performing nursing duties off the clock. Fine. But I'd hire a hardworking nurse who went out of their way to do a duty off the clock, to one who doesn't even do their duties WHILE on the clock.

We dont lose all nursing knowledge and skills when we clock out and we dont regain it magically when we come in. She had the skill and saw an opportunity to, as she saw it, help. We all have to CYA, sure, but when did we as nurses become more concerned with that than providing patient care?... OP, are you quite sure she didn't just step on your toes and upset you by making you feel undermined, as though she was implying you couldn't handle it on your own?... Because hey if thats the case and she's 'that' type of nurse then I totally get it. But all I see from your post is that she was a good, albeit laid-back, nurse with good intentions who was putting a patient over legal nuances in an effort to help both you and said patient.

From the title I thought you meant you knew a nurse who started an IV and gave fluids to a drunk friend or something. I mean, Jesus...It's bad practice to work off the clock, sure, but again- she was off the clock, not unlicensed! Imo with something minor like that, which was over and done within seconds, and caused no harm to the patient, it would've been more appropriate to casually remind her that if something had happened it could be bad for you both. "So if you could maybe just be more cautious about what you're doing when you're not on, I'd really appreciate it" etc. Going straight to the Super is not cool and is generally frowned upon by most nurses unless there is a serious immediate risk to a patient.

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Specializes in Peds.

As someone who works in PDN.yes the nurse that was not supposed to suction was in the wrong.

First,she violated professional boundaries.

You do NOT go over to a patient's home if you are off the clock.

That is just how it is.

OP,most people do not understand private duty home health and boundaries.

You should ask to have this moved to the PDN forum.

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10 hours ago, KatieMI said:

(meanwhile, putting the kettle on) popcorn or cookies, anyone?

(helps herself to a cookie and tea) But I am enjoying the Rashomon style of posting going on here.

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Specializes in Dialysis.
53 minutes ago, CharleeFoxtrot said:

(helps herself to a cookie and tea) But I am enjoying the Rashomon style of posting going on here.

I'm having popcorn, and brought my own hot cocoa.

5 hours ago, Runsoncoffee99 said:

As someone who works in PDN.yes the nurse that was not supposed to suction was in the wrong.

First,she violated professional boundaries.

You do NOT go over to a patient's home if you are off the clock.

That is just how it is.

OP,most people do not understand private duty home health and boundaries.

You should ask to have this moved to the PDN forum.

Some of us have worked pdn and totally understand. No, the other nurse shouldn't be there off the clock, and that should be reported. Company may be aware, have ducks in a row, and not and issue for them. Who knows? My concern is that a patient needed suctioning bad enough that an off duty nurse did it while the on duty watched. Maybe a little more going on here than just this side of the story?

Pass the cookies, my popcorn is stale...

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6 hours ago, Runsoncoffee99 said:

As someone who works in PDN.yes the nurse that was not supposed to suction was in the wrong.

First,she violated professional boundaries.

You do NOT go over to a patient's home if you are off the clock.

That is just how it is.

OP,most people do not understand private duty home health and boundaries.

You should ask to have this moved to the PDN forum.

Than you so much. Yes I've come to notice based on the replies that none of these individuals understand pdn at all. Some sound like they lack professional boundaries themselves. My employer reached back out to me. They were not happy with her and said she should not even be at the house off duty along with providing nursing duties. Management said they will follow up with her because this was highly unethical and that this couldve even turned into a workers comp issue..

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6 hours ago, LPNpaired said:

Okay, YIKES.

Would you guys let someone fall out and die in lieu of giving CPR just because you weren't on the clock, as well.? (Obviously CPR is a protected area, I'm just making a point).

No, she shouldn't be performing nursing duties off the clock. Fine. But I'd hire a hardworking nurse who went out of their way to do a duty off the clock, to one who doesn't even do their duties WHILE on the clock.

We dont lose all nursing knowledge and skills when we clock out and we dont regain it magically when we come in. She had the skill and saw an opportunity to, as she saw it, help. We all have to CYA, sure, but when did we as nurses become more concerned with that than providing patient care?... OP, are you quite sure she didn't just step on your toes and upset you by making you feel undermined, as though she was implying you couldn't handle it on your own?... Because hey if thats the case and she's 'that' type of nurse then I totally get it. But all I see from your post is that she was a good, albeit laid-back, nurse with good intentions who was putting a patient over legal nuances in an effort to help both you and said patient.

From the title I thought you meant you knew a nurse who started an IV and gave fluids to a drunk friend or something. I mean, Jesus...It's bad practice to work off the clock, sure, but again- she was off the clock, not unlicensed! Imo with something minor like that, which was over and done within seconds, and caused no harm to the patient, it would've been more appropriate to casually remind her that if something had happened it could be bad for you both. "So if you could maybe just be more cautious about what you're doing when you're not on, I'd really appreciate it" etc. Going straight to the Super is not cool and is generally frowned upon by most nurses unless there is a serious immediate risk to a patient.

Bye you're unethical. Comment disregarded.Management handled it and said her behavior was highly unethical and couldve even led to a workers comp issue had she gotten injured.

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From what I have seen with more than one agency over the years, reporting the nurse’s presence and actions while off the clock will result in negative repercussions for the reporting nurse. If that nurse is admonished at all, it will occur with an equivalent ‘wink, wink’. The next time she feels like going to the client’s home when she is not supposed to be there, she will have bells on her toes and a song on her lips. If anything, the patient’s family will put the reporter in her place or fire her with the agency. Be careful what you seek. The nurses who left the case know how to keep their best interests taken care of without shooting themselves in both feet.

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55 minutes ago, Hoosier_RN said:

I'm having popcorn, and brought my own hot cocoa.

Some of us have worked pdn and totally understand. No, the other nurse shouldn't be there off the clock, and that should be reported. Company may be aware, have ducks in a row, and not and issue for them. Who knows? My concern is that a patient needed suctioning bad enough that an off duty nurse did it while the on duty watched. Maybe a little more going on here than just this side of the story?

Pass the cookies, my popcorn is stale...

The patient did not need suctioning and she should not have been there. Comment disregarded you're unethical bye

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1 minute ago, caliotter3 said:

From what I have seen with more than one agency over the years, reporting the nurse’s presence and actions while off the clock will result in negative repercussions for the reporting nurse. If that nurse is admonished at all, it will occur with an equivalent ‘wink, wink’. The next time she feels like going to the client’s home when she is not supposed to be there, she will have bells on her toes and a song on her lips. If anything, the patient’s family will put the reporter in her place or fire her with the agency. Be careful what you seek. The nurses who left the case know how to keep their best interests taken care of without shooting themselves in both feet.

You guys are too concerned with how the family feels versus your license. Some of you need a backbone. My job reached back out to me and stated,"asked has she lost her mind!she is not to perform nursing duties off the clock!Along with even being there because this couldve even turned into a workers comp issue. "

They transferred details to director.

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