Is your surgery dept. anything like this?

[RNMommy2]

This is my first time to post but I would love to hear the response of other surgical nurses to find out if this is typical. Frequently I am the only nurse scheduled for preop and recovery. Recently a tech was hired who has a lot of knowledge but has not finished school. Yesterday we had 5 surgeries. When the first one comes out of surgery with a general anesthetic I am busy in preop pushing 3 preop meds for the next scheduled pt. I also have a pt to work up in the next bay including all history, consents, orders and starting his IV. The tech can't push the meds and is not supposed to work up the next pt or recover. I went to my supervisor who had just walked in the door and she said she would sign the tech on in her name so she could recover. This child is screaming and trying to get out of the bed. Later on that morning we brought an add on to the holding area. The patient told everyone she was npo but in fact she was not. Again, the tech had been working her up because I was recovering 2 pts. I hate to even think what would have happened had she aspirated and a nurse was not even preoping her but it was logged in as though one was. Is this typical?

[P_RN, ADN, RN]

RNMommy I believe you are rationalizing. What is going to happen when there is a disaster in the OR? YOU are the nurse. YOU have the duty. I believe I'd work at Burger KIng before I'd place my license and the wellbeing of your family in jeopardy by staying there one more day.

[Jolie, BSN]

In the meantime I am just trying to do my job and not have my name on anyting I have not done personally.

Sorry, I didn't mean to blast you. My frustration lies with your employer, not you.

What I didn't make clear in my previous post is this: I don't think that simply making sure that your name appears only on your charts will protect you legally. Going back to the example given in your original post, YOU did not falsify the child's chart, your supervisor and the tech did. But as the RN who was physically present in the unit, you were functioning as the supervisor of the tech. You knew that the care she was giving was outside the scope of her practice and was being fraudulently documented under another RN's name. I believe that in a court of law, you would be held responsible.

As unfair as it may be, the supervisor could probably claim that she had no idea that her log-in had been "stolen" by you and/or the tech. She could also claim that you had not notified her as to how busy you were, otherwise she would have come down immediately to help out. Believe me, in the case of a lawsuit without airtight documentation on your part, the hospital would back the supervisor. You would be out in the cold. And the tech would be looking at the possibility of losing her eligibility for licensure.

I know that you have to support your family, but you must also be realistic about the possibility of losing the license that enables you to do so. If there is no possibility of leaving this position, then please consult a healthcare attorney for advice on how to protect yourself legally, consider obtaining professional Liability Insurance, investigate safe-harbor legislation in your state, and consider reporting this situation to the state BON, and Board of Health (or agency that licenses hospitals).

[RNMommy2]

I guess to a certain extent I am. The tech does not go in the OR and she does not give meds. She will be leaving to go back to school in a few weeks. At that point they may not even have a tech. Like I said I am interviewing and I can not quit without another job or I will not be able to pay my mortgage and other bills.

[RNMommy2]

Jolie,

The things you have said are true. I have worked very hard to get my license and don't want to do anything to risk losing it. It may not even be an issue in a few weeks but there are other things that make me consider obtaining alternate employment that have nothing to do with what I have posted here.

[elcue]

RNMommy,

Jolie's points are very articulate. Pay attention to her advice.

Everyone who has been reading your posts is nervous for you. I honestly find myself thinking about you from time to time when I'm not even logged onto this site:"How is that girl doing? Has she found another job?" etc, because the details you posted are so shocking that it makes me worry about a sister nurse.

However, it has been over a month since you made your first post here, and you're still working there. (You never did say how long you've been working at that place.) Without exception everyone who has responded has said get out of there, it's illegal, unethical, and dangerous. As Jolie said, we understand you have your family to support, and we're not trying to flame you. We are really concerned.

It seems pretty clear that your supervisor would not stand up for you in a legal action and say you didn't participate in these illegal and unethical practices.

You can't "unknow" what you know, and because of that, if some legal action does take place, you could be complicit because you failed to speak up about what you knew.

I'm sorry, but I have to question your ethical center because you have known what you know for so long and have failed to speak up in the interest of patients whose care is being compromised. (You don't know how hard it was for me to actually write that.)

Please be brave and do the right thing.

Linda

[chica2]

Never heard of such a thing! Not only are the pt.'s at risk but so is your license! I've been in the O.R. for 17 yrs. and worked in many different places over the U.S.,believe me, some were loosely run and chaotic. I will have to say I've NEVER worked under such conditions!

[ewattsjt]

I am a CST (Certified Surgical Technologist) in a pre nursing program. My mouth about hit the floor on this one. Student or not, the tech was outside their scope of practice. The tech could help in recovery by having jobs delegated to them but there has to be a direct supervising RN to delegate the task. What is being left out in most of the posts is the fact that the tech was a student. Student techs are not to be left alone or act as an employee of the facility. It would be like leaving a nursing student to recover. A student is a student regardless of what program they are in.

This was a possible terrible situation for the patient(s), placing their life on the line for a few dollars or a little time saved. That is what it really boils down to. Otherwise an RN would have been recovering.

Everyone who knew about this placed their job, license, and or certification on the line. If management really sees nothing wrong with this practice, you need to quit talking about leaving and do so before you loose your license on another situation similar to this.

[BMW10]

It has now been two months since RNMommy2 relayed her frightening story. Hopefully she listened to all the solicited advice, especially from Jolie and Linda. And if she did not, indeed, remove herself from her dangerous situation then report the illegal activities to appropriate authorities...well, shame on RNMommy2. Her job AND career, nevermind patient safety, are in jeopardy. If her supervisor, who may not even be an RN so in which case has no license to loose, gets wind of recent discussions she has reasonable cause to fire this RN for NOT stepping up to the plate so therefore is 100% responsible and accountable for any consequences. I know. Been there, done that. I lost my job and tenured pension, was on the street at 59 after nearly four decades in the O.R. because of an 'error' committed by a tech under my 'supervision'. If you are the only RN in the room you are fully responsible for everything that transpires "on your watch." Period. Not reporting it and failing to accept responsibility for someone else's behavior, be he subordinate or supervisor, will come back to bite you where the sun don't shine!! You cannot undo nor correct, only get out then try to rectify. Hopefully that has happened.

[RNMommy2]

Just an update....I am no longer in surgical nursing. I am now in another specialty but wanted to let you know I did heed to the advice and got out of a bad situation. Thanks for all of your feedback.

[BMW10]

You go, girl! Tough decision, I know, but you won't regret moving on and starting afresh. And now that you're out of there please consider reporting the incident if for no other reason than to CYA! What's to loose?

[nursekatie22, RN]

HOLY CRAP!! That's scarey!

[ewattsjt]

Good for you!!! Let's hope for the patient's sake, that the facility has seen their err.....