Norton Audubon Hospital in Kentucky fired 14 nurses and disciplined 9 other nurses for sedating patients with Diprivan without an order. The hospital has also notified the Kentucky Board of Nursing of the matter.
As nurses we have to make sure that we are practicng within our scope of practice at all times, regardless of the practicing setting (home health, ICU, med/surg, etc). Practicing outside your scope of practice (LPN, RN, APN, etc) can lead to employment (disciplinary action taken in the workplace), administrative (Board of Nursing investigation), and/or criminal (practicing medicine without a license/certificate, which is a felony is some states) investigations.
Gi writes: "if you can get out of paying a pension because they get fired for a "valid" reason then you do have to pay for the pension benefits."
I believe you mean "do NOT have to pay..."
(I realize later I should have PMd this.) You can also edit your post by clicking on the "edit" button within the post and making whatever changes you wish.
Actually, I'm waiting to see the pension issue explode, as the nursing workforce ages. I believe the average age is now 42, according to studies I've seen mentioned in a variety of nursing journals.
We know that executives in other industries have taken extreme measures since the 1970's to avoid paying out retiree pensions and health benefits. Remember the wave of corporate downsizing that threw many people in their 50's and 60's out on the street? Moving jobs to other countries, and corporate takeovers/leveraged buyouts, which ran many companies into bankruptcy, also effectively transferred wealth from employees and retirees to a handful of corporate raiders.
I don't think we'll see an exact repeat of these tactics. We can't move our hospitals to Mexico. Importing foreign workers will probably be done to some extent, but it will probably be limited by nativist anti-immigration sentiment. I think we'll see a variety of strategies, such as firing older workers on trumped up charges, attempts to McDonaldize nursing, so that tasks can be performed by lower-paid personnel with less training, use of consultants to restructure units in ways that push expensive older workers to leave, etc. And, it will be interesting to see what these corporate types come up with next!
Where are all the facts? Did the Nurses in question did indeed give medications without an order? If so, then they got what what they deserved. If not, then it is lawsuit time. The "It's not my fault, everyone else does it" defense doesn't really hold alot of water. Furthermore, it seems that the "conspiracy theory" is being bantied about quite a bit here. Is it perhaps possible that the Nurses in question really did screw up, got caught, and punished for their lack of judgement? I find that notion at least as plausable as the "they are out to get the union organizers" theory. If they trusted the physicians they worked with to cover them, then they were stupidly naive. If they gave the meds without orders, then they were just plain stupid. When do we start taking responsibilties for our own actions? I'm all for us sticking together as Nurses, but if you screwed up, then you screwed up and you need take responsibility for your actions.
Now if it turns out that they were fired only because they tried to unionize (that is to say they didn't pass the meds without orders) then they need to take out the bast**ds in charge legally. It can and has been done. Personally, I don't believe in unions and wouldn't belong to one. If want to throw away your money and time you should have every right to do so without losing your job. PROVIDED you don't do something stupid, like pass meds without an order. If you do something stupid, then don't whine about it nor blame the anti-union forces for calling you to task on your error. Again, the original article is very lean on facts and I'd be really interested in reading the Board of Nursing's findings on this incident.
Specializes in Trauma,ER,CCU/OHU/Nsg Ed/Nsg Research.
The only facts I know (aside from agency experience there- which was not good), is that they have a history of firing pro-union nurses and experienced nurses who would be retiring soon with trumped up reasons, or for no reason at all. They've done this before, so it's not entirely outrageous to think they'd do it again.
Here are some links to real-life factual stories regarding how they treat their nurses:
This is nothing new for them. They have a crooked reputation, so I have a hard time believing they are on the up-and-up on this. I have a hard time believing those nurses gave Diprovan without believing it was a standing order. Do you know 14 nurses that would do that?
I wonder if your experience has been different because you were in the military? I have witnessed instances where nurses were let go with incompetence or unsafe practice being the excuse, but the underlying reason was obviously something far removed from either and had nothing to do with job performance. It's not paranoia or conspiracy theory at all, but one of the economics of the business. If you are seen to seriously hurt the bottom line, you are out.
Let me recap as I understand the situation (pretending I am one of the RNs): A pt is pulling at a tube. Intuitively the first thing I am doing is physically restraining the pt before any damage can be done--hopefully with assistance from coworkers. So at this point I have 3 choices--1) hold until pt wears out; 2) give a med; or 3) call the MD for an order.
1) Holding isn't an option because noone has the time, and that will require a doctor's order for a restraint anyhow (and this makes me wonder why a vent pt isn't at least in some wrist restraints in the first place).
2)Giving the medication the MD might or might not order appears to be the simplest response, but for legal considerations. I don't know it is worth the risk to give the med then get the ok from the MD in the morning.
3) Calling the MD is the safe way to go, but obviously in an emergent situation you have to hope the MD responds quickly--who cares if they become pissy. But then again, what if the MD later turns around and says "I never gave that order". The question that pops in my mind is how do we safegaurd against such things? Obviously I can document that I called and the MD left an order, but it seems that if the powers to be want to 86 some nurses, they will. And where there is a will there is a way--orders come up missing, etc.
I have a hunch about this..that a sedation protocol of sorts is in place but the doctors play games with it ie "I never said to intitiate sedation protocol" one time, then "Well why didn't you initiate sedation protocol?" the next.
One pulm doc told me face to face: ALWAYS initiate the protocol for his patients... he then denied he said this later. Others have a new story each week.
Our pulm docs set up the protocol but screw with it constantly, we find both protocol and other meds ordered...(?)....when we call to clarify at night, we get the oncall doc who frequently refuses to decide 'because they don't want to step on the partners' toes.' So much coercion...and it can be a disaster for nurses (specially if someone is out to get them)
I am seeing from some posts here that unless one has been in a similar critical care situation, this type of coercive atmosphere may be hard to understand. As I said, I have a hunch this is what these nurses deal with. Hope we see more details soon.
And yes, saying the U word definitely gets management after ya in my parts...been there done that and got the T shirt. :stone
I don't think the nurses have a leg to stand on either. I would love to see their documentation, and copy of the patient itemized bill. However, I once had a patient coughing, all she requested was a bit of robitussin, however she did not have a order. It took me 30 minutes to get the doc to call back, this was on a weekend. I waited to get the order prior to adm, but my supervisor told me to just give it. I know it was a simple thing, however, there was no order, and I wasn't going to give it without the order. And oh how I despise those nurses who give you report the night before, and on your shift your patients has numerous bowel movements. Then when the nurse comes back in and you report to her about the bm's, she says "oh i slipped her alittle MOM and bombed her with a suppository." No order, nothing documented....."Thanks alot, I guess she may not have needed the lomotil that took an hour for me to get the order for and the cost of taking it out of the EDK, and thanks for all the additional documentation, and maybe you should go explain to the family why all this happened! " Yes, nurses like that should stand before the board of nursing!
Where's that head shaking "NO'' smilie??? I haven't read the entire thread, but someone mentioned they should get fired for stupidity and I totally agree. Why would anyone give a med just because they were told that's what they do? If it ain't ordered, I ain't a gonna give it...simple. If you have to wake the on call doc up, so what, make him do his job and order the darn medication if the regular doc didn't. Why is he on call then? I'd rather have the doc give the order for the med than have to call and wake him up to reintubate the patient. sheesh
sjoe
2,099 Posts
Gi writes: "if you can get out of paying a pension because they get fired for a "valid" reason then you do have to pay for the pension benefits."
I believe you mean "do NOT have to pay..."
(I realize later I should have PMd this.) You can also edit your post by clicking on the "edit" button within the post and making whatever changes you wish.