possible violation

MountainGoatRN, BSN · Oct 10, 2021

I'm confused, you are an ER Nurse with an ICU hold and still had other patients on top of that? The topic seems more about exerting power by an unreasonable and unsupportive director. Give yourself a break, we are not ICU nurses in the ER, but what was the concern of the pt being "investigated?"

Ernurse11521 · Oct 10, 2021

the previous nurse failed to report findings to the physician on not only the ICU pt but the altered mental status as well which caused the doctors to miss information and then ultimately leave a train wreck in the morning. From my perspective the ICU could have been prevented. It's very common for us to be holding an ICU pt and have several other patients at the same time. Since pt was intubated in the E.R. it is our job to continue the care until they admit pt and a bed is assigned so I had this pt for a couple of hours and was not able to leave the room due to titrating three different medications. I got way behind on my charting because I still had other pts that were there and needed work ups and medications. I left the floor a half hour after my shift and was actively charting. I'm more concerned on the time limit I was given to chart and if I had not completed the charting, how it would affect my RN license. I'm looking for some law or rule that says not allowing a nurse to finish documenting is a violation on their nursing license.

JKL33 · Oct 11, 2021

14 hours ago, Ernurse11521 said:

I'm looking for some law or rule that says not allowing a nurse to finish documenting is a violation on their nursing license.

You're on the wrong track riding a train headed in the wrong direction.

What is jeopardizing your nursing license is acquiescing and/or accepting responsibility when someone else demands that you do the impossible, when that puts patients in jeopardy. If it is physically impossible for any prudent nurse to do what is being demanded, you need to say no. Flat out say no. Call the supervisor and tell them that the staffing level is dangerous and you will not take responsibility for another patient.

I'm going to be straightforward here, please don't take it personally: You are making things worse for yourself when you make unrealistic threats instead of putting your foot down. The main power you have is the power to make choices and follow through on them. The BON is not going to crusade for you over some he-said-she-said managerial baloney.

You need to find a way to go into business mode here, pronto. I know it's hard but stop being afraid of horrible, weak people and toughen up so that you can protect yourself and your patients. You have to know BS when you see it, and not play games over it. No nurse should ask anything like, "and what will happen if I can't get it done in fifteen minutes?"--ever. Ever, ever, EVER. What a nurse should say is, "I will not be finishing in 15 minutes. Do not threaten me. I did not make the assignments and I am not responsible for the staffing. I did the best I could." Trust me, these people are weaklings and if you convince them you're serious they will find someone else to terrorize.

Remember too, that since timely documentation is considered part of prudent nursing, you are shooting yourself right in the foot by running your *** off doing tasks and deciding to worry about the documentation later. Now they have you right where they want you: You accepted responsibility and can be made to look like you were irresponsible; like you were imprudent because good/timely documentation goes along with good nursing, and you can be made to look like a poor worker/employee because of "overtime" and "time management" and all the backlog of charting you have to do. Plus whatever else they can make up.

You don't threaten people. Rather, they make their choices and you make yours.

allnurses Guide · Nov 9, 2021

On 10/10/2021 at 1:59 PM, Ernurse11521 said:

Hey all,

I'm reaching out in hope I can get some advice on a situation I was in. I am currently an er nurse in NJ. I believe my license was threatened by my er director. I got stuck in an unfortunate situation where I was finding mistakes from previous nurses in my assigned pts charts. I had a ICU pt as well as an altered mental status. Even after my ICU left the e.d. I had a consistent flow of patients and was unable to get my charting done. I ended up having to stay over two hours past my shift to document on a couple of my patients. I was told by my er director that I had to leave and how it was unacceptable to be charting for so long after a shift. She originally gave me a fifteen minute time period to chart on a ICU pt that had a lot of complexities that will end up being investigated. I questioned her on what happens if I cannot finish in fifteen minutes and she responded with "you will" I asked again if I did not and told her I will have to go to the board of nursing for jeopardizing my license by not allowing me to finish documentation. I even offered to clock out just so I could finish my charting. I also offered for her to dock my pay after 8 p.m. when I was charting because it was not about the money, it's about my license and my pts. Now I fear punishment for being at the hospital late for charting. I don't know if this would be considered a jeopardization of my nursing license? I have not been able to find rules governing what actions jeopardize a nursing license. Any information would be helpful!

I think the first thing you need to do is go to your state's BON's dicipline page and see the kinds of things nurses typically lose their licenses for. This will give you better answer to your specific question. I have never worked ER or ICU so appreciate but really don't know what all you do. Still this doesn't seem to be something that one could lose their license for. Nurses lose their licenses for malpractice, malfeasence, accusations of unprofessional conduct, misconduct, dereliction of duty, gross negligence or incompetence in complaints brought by patients, coworkers or employers, drug use/diversion and acts of moral turpitude.

Hppy

toomuchbaloney · Nov 9, 2021

Refuse unsafe assignments.