Guest849204

I agree. I'm in ICU and have participated in and/or heard about many codes where the patient died, included cases suspicious enough to be investigated by the ME and no one has ever had their liscense taken away. The BON ss well as the justice system even tend to give people more of a break inc ases involving code blue because they recognize all the factors that make it easier to make a mistake so for a RN to be fired and have her license permanently revoked, she must have had done something both intentional and directly lead to significant patient harm. Even cases where relatively healthy patients die as the direct result of a mistake don't result licenses being taken away. Basically, unless it was an intentional action that the person in question knew it was dangerous and did not intend to benefit the patient and especially if it actually resulted in patient harm, the board wont take away a license for anything a RN might do in a code. There are only a few exceptions like being arrested for a felony will (I think) cause you to lose your license even if the felony has nothing to do with actual or potential harm, and anything related to illegal drugs. I'm not saying this person deserved to have her license revoked, just saying what the BON usually considered reason to revoke.

I'm sorry you are in such a bad situation, stay strong! That said, something much more serious than a "complaint" must have been sent to the BON. Unless they had a HUGE lapse in judgement or you got hit with some random technicality, the BON would not ask for you to surrender your license (which is the nice way of saying "either you give it up or we take it from you") unless you did something clearly wrong that caused significant harm to a patient. The BON doesn't take away nursing licenses lightly, and there are not many reasons you can lose your license for a true accident, it has to be something you either intentionally did wrong or did it unintentionally but should have known not to do it. Would you be willing to give us any more details?

If you will be asking her for a reference, don't say anthing bad about her! If I were you, I would praise her (without overdoing it/being obviopus) and then send her an anonymous letter or wait until you have secured a new job and tell her directly. If you wont be asking her for a reference and wont be coming back to that facility (or any other of its locations if its a big hospital system) then feel free to adress her directly, juse be respectful ab out it and dont blame her directly, just tell her your perceptions and what YOU think said behavior MIGHT be causing.

Also, some advice to nurses looking for a job: If your main reason for switching jobs is salary, make sure you are taking into account living expenses. Even though your salary would be hire if you move to a particular city/state, you might be making less after you factor in higher taxes and all the cost of living expenses.

It varies by location and even hospital to hospital (no one wants to work at a place known to be a bad place to work) but I do not believe there is a national nurse shortage at this time. That said, there are definitely "shortages" within most hospitals in the sense that their nurse:patient ratios are too high, but that has nothing to do with the amount of nurses available (at least not directly).

Exactly. The patient was her responsibility and when you are responsible for a patient, you are required by ethics, the law, and hospital policy to treat them as best as you can and the fact that you are covering for someone doesn't change a thing.

You did nothing wrong. Regardless of whether or not you are covering part ofsomeone's shift, once you take report and the patient is handed off to you, you are supposed to provide whatever care you think is best (provided of course you are engaging in evidence based practice and not doing anything against policy). If this were me, I would report the incident. Even if you did do something wrong, her response was very inappropriate and surely against your organizations code of conduct. Also, just because you suspect a patient is a drug seeker and even if you know they are an addict, you still assess and treat their pain the same way. Considering he fact that addiction is now a diagnoseable disease, she is doubly wrong. IMO from what you said, your coworker is not a good nurse and may actually be harming patients by improperly addressing real pain. Even if you are one of those people who think addiciton is not a disease and addicts should not get narcotics, you should realize that you arent going to cure their addiction during this admission and giving them the meds isnt going to make things worse, it might actually make things better because what if (and this happens relatively often) they sign out AMA because they arent getting enough drugs and instead go and do something illegal or dangerous? Regardless of you views on addiction, you have to admit that getting pharmaceutical quality medication while being monitored in a hospital setting is safe better/safe for the patient and everyone else than having them do something dangerous/illegal (i.e. mug someone for drug money) and use street drugs that are not only sterile, but could contain any number of harmful even deadly additives. Even from a financial perspective it costs a lot less to give and admitted patient pain meds than treat them for hep C or other drug use related disease later on. Sorry to rant, In short, your coworker was wrong and you did everything right. Even if we ignore the whole addiction is a disease thing she still behaved inappropriately in front of a co-worker and you treated you patient according to how the ANA, state BON, and most medical professionals would consider correct.

I. believe you could qualify to go to that officer training school thing and come out as an officer. I looking into this when I considered joining the military, I know there is some kind of program for people who have bachelor or higher degrees.

You can work anywhere regardless of your personality. Certain personalities are more common on specific units, and maybe there are some pairing that work well, but you can work anywhere you want regardless of your personality.

Honestly, I think moving is way to extreme of a reaction. I'm not judging you, I actually respect your commitment to something you believe in, but I think moving is too extreme. Have you considered the value of staying where you are and actively working to change the direction the hospital is going? Educate your patients on the (medically valid) benefits of breastfeeding, convince you co workers, even consider something big like organizing a petition, letter writing, campaign, or preparing a presentation to give to a higher up. Putting aside what I think of the moving idea, I think staying and working to change things would benefit your cause much more.

As long as you either get the flu shot or wear an appropriate mask all the time, its ok with me! I don't think its right for an organization to require everyone gets the shot (although I do think we all should get the shot), assuming my impression that the mask prevents transmission as effectively or more so than the shot is correct. IMO its embarrassing to be a RN and not get the shot (unless of course you are allergic or something). The research clearly demonstrates that its safe and RNs are supposed to know how to evaluate medical claims and do research properly.

@Randomnurse Your are always supposed to disclose medications you take before taking a drug screen, especially if its something they are testing for (like Xanax). That info remains HIPAA protected, but you need to bring the required proof of having a prescription before being tested for, especially when its the official drug screen you take when you are hired because if you don't they are required to report a positive result even if you bring proof right away. Once the sample is collected and processed, any positive result without proof of prescription is reported as a positive drug screen. If you bring valid proof before hand, its HIPAA protected and they just report that your drug screen was negative. No institution is going to require that you disclose the meds you take unless its something that you would get in trouble for taking without a valid prescription.

RELAX AND READ THIS! 1. They just need to document your side of the story since the incident probably triggered some policy. 2. Your boss said something about the Xanax and they need proof of a valid prescription. 3. You looked up your own medical record and are in pretty serious trouble, although if it was this it would most likely be dealt with immediately. 4. You actually tested positive on your drug screen. If you took any Xanax 14 days or sooner before the test, it could show up and all hospitals test for benzos in a standard drug screen. But again, this would be dealt with immediately 5. The incident triggered some other minor thing. If they are allowing you to continue working and haven't taken any immediate action, it can't be anything too serious. If they thought you were using drugs illegally they would immediately suspend you until proven otherwise. If you did anything that could get you fired, you would know by now. My advice is to submit proof that you are prescribed Xanax ASAP (call HR and ask what they require for proof) because you should have done so when hired. Forget about hiring a lawyer, if it were anything that a lawyer could help with you with then would already have been fired (also a lawyer would only help if you were charged criminally or wanted to sue the hospital). Also, ask your boss is she can tell you anything about the meeting and if its mandatory for you to go. Again, relax! If you were getting fired you would know by now.

If she has a valid prescription she will most likely be able to continue to work. The only problem is you are supposed to bring proof when you are first hired.

Most hospitals (and I believe state boards as well) require you to disclose any medications you take that could be impairing, especially ones that show up on a drug screen (like xanax, weird it didnt come back positive) because they need to have proof you have a valid prescription You are probably going to get in a bit of trouble but I highly doubt they would suspend or fire you unless its a mandatory policy thing. Unless your taking methadone or suboxone for addition treatment, most if not all hospitals will allow you to work provided you disclose the meds you take and take them as prescribed. To be prepared, I would ask the doc who prescribes you the Xanax to write a letter, get a copy of your current prescription, and get a printout of the pharmacy record. Get as much of that as you can before the meeting, it might lessen the blow! P.S. Not to scare you but did you physically look at the test results? If not, its possible it actually came back positive. I can't imagine them not testing for benzos because they are common in abuse and overdose and almost all standard drug tests include benzos like Xanax.

That funny, the fact that its planned/required is the thing I hate the most about it! Don't you think making it mandatory can make it insincere? My other issue with it is if family is present, you don't know if this pause thing is going to help them or make it worse, IMO its better to tailor your response to the family as best as you can (be especially mindful of cultural preferences). I'd like to see some study done on this, it might be a good thing I can only guess!

I don't think this has much value. First of all, the idea of it being mandatory makes it insincere to start with, and people deal with patient deaths differently, while some people might like the pause it might make others feel worse. Personally I would not like it. Working in the ICU we have more deaths that other units, and pausing to be more aware of the patient's passing would make death seem more common and that would not be good! Nurses should not be forced to do this, they should be allowed to handle it in the way they prefer so long as they fulfill their obligation to give the family emotional support (and their method of dealing is healthy!).

I agree that it a complete suicide/mental health assessment is not necessary unless there is some indication for it, but every patient should get a quick mental health assessment (we ask 4 questions to screen for depression and suicide/violence). Other than that, we should really just be trying to establish trusting relationships with our patients and paying attention to their moods, document significant things, etc. The fact is, most depressed patients are not going to admit they are depressed to you when you first meet them. That said, I work in a SICU. Most of my patients are sedated, unable to answer questions, or able to answer questions but are too critical to be worrying about mental health at this point. Sometimes I get a medical patient when I'm working a 5 day stretch and get them back every day, and thats when I'll dive deeper into their mental health. They won't tell you much unless they trust you.

I used to be very shy, but nursing has made me very outgoing. I'm also better at time management.

Only in when no patients can see you. For example, I used to play music on a low volume while bathing patients that were sedated (mostly vents). It unprofessional to listen to music in view of patients. Your patients want you to be listening for alarms and paying attention in general. Its just a bad image!

Your medical history is private and protected by HIPAA law. Only those directly involved in your medical care, your medical insurance company, and a few exempt entities (i.e. UNOS) and law enforcement agencies with a warrant are legally entitled to require disclosure.

Issues related to harassment or other workplace misconduct are handled by HR. Issues related to violations of nurse practice acts or one's nursing liscense are handled by the BON. Finally, issues related to threats or assault are handled by the police.

If they did indeed look up your EMR, then yes it was a HIPAA violation (unless they were involved in your care). Medical information can only be shared when its necessary for the medical care of an individual, with additional exceptions for educational purposes (which is why it is okay for students to discuss patients they collectively know provided its in an educational context). You should be able to contact the hospital and verify if this was the case as electronic charting software keeps automatic logs of who views what.

I'm not an expert in HIPAA law but since no personally identifiable health information was released, I think you might be okay but this seems like a bit of a gray area and I'd recommend paying for an hour with a HIPAA attorney to discuss the situation.

Typically when an organization is associated with a union, all workers must be invited to join. Usually all they do is mention that there is a union and you are welcome to sign up but if you are not a member and management thinks you might be on a path to termination, they will make sure to explicitly offer you membership because most unions offer certain protections from termination.