peggy101

Thank you Duckie - I have been on the phone all weekend - as you read the other e-post about the Ativan - you are aware of the issue - I have been utilizing all of my resources (including all of you which is new for me - and wonderful)- I am clear about what I need to do - again - just hoped to save this nurse as she is/was a good practitioner until now. I hate to see this happen to one of us. My obligation is to the patients - and I will do what the regulations say I should. She is VERY angry with me for taking her off the schedule and that concerns me a bit - but I am trying to be proactive and not allow further harm to come to the patients. She is threatening to sue me etc. It eats at my gut. I know she must be ill. She has always been a bit "hot", negative and never likes to be told what to do - but usually it was "manageable" until now. Never had such negative outcomes related to patient care. I wish she had accepted the offers of help. I do intend to contact the BORN on Monday. I keep thinking there must be a reason why she did what she did. but no reason is good enough I know.

Thanks again everyone for your input - I clearly see there is an issue here with this nurse - Just wanted to hope that maybe it was isolated. regardless of her medication use. I always feel distressed when I see a fellow nurse in crisis. Just wanted to hear I was not "jumping the gun" - the errors and this degree of neglect is serious. Sorry I was not clear from the get go. I think the patient neglect is heartbreaking and there is no way to ever change the fact that all those residents did not get treatments or medications in those 12 hours of work. There were several supervisors on duty who asked her on several occassions if she needed help - she said no I am fine. I know she is not safe to practice - especially due to the phone calls to the facility the next day at that hour with those demands and threats. She is obviously unstable. Very sad that she came to this. I think I was hoping the ativan use was the cause of her poor performance because that would make more sense than just pure neglect by choice. Further research has shown she passed 56 meds to 18 patients in 12 hours. error total was: 35 medication omissions and 88 treatment omissions in 12 hours. Has anyone ever seen such a magnificent dereliction of duty? I did research "hostile workers" and unfortunalty she fits the bill. Many nurses who work with her are afraid at this time. They are stressed and they are receiving support by management. So difficult to watch this happen to another nurse. I was hoping we could help her - as it is our nature to do so as nurses. But we have to remember that at some point it is out of our hands and the patients have to be our first priority...FYI - the board of registration does state that "practice of nursing while impaired by substance abuse is grounds for discipline" obviously there needs to be evidence of "abuse" of the substance - or impairment from use of any substance. They define a "substance as "Any drug that requires a prescription." And further state it to mean a drug, substance, or immediate precursor in any schedule or class listed in the regs. Obviously people can take meds as ordered without it impairing their ability to function - others can not. Rumor has it that this nurse is, sadly, an alcoholic as well - but I never noticed it on the job. I just never heard of a nurse admitting to something like that while working. I know that this is bad - but again - just wanted to share and hoped I was wrong somehow. Our job is so hard as it is - adding additional stress only makes it worse. I am warmed by all of the patient-centered support from you all. Nice to see so many nurses who put the Patient first. That's the bottom line - yes!!

Thank you everyone for the response - unfortunate thing is she made many medications and treatment errors on the day she admitted to co-workers that she takes this drug at work - I understand that many people require treatment for depression, enxiety and stress - I am worried that she will do more serious harm - although omissions of her magnitutde are serious enough for me - put it this way fellow nurses - in a 12 hour shift this nurse omitted 83 treatments and 14 meds - and did nothing but pass about 70 meds to 23 residents - thats under 2 hours of med pass time - she did not do anything else for resident care that day. YIKES!! she is defensive and non-responsive when asked if we could help her in any way - denies stress or job related stress. She was asked if we could change her assignment and whatever we could do - she refused and now wants to put in a harassment complaint. She was removed from the schedule due to the errors and called the facility at 12 am and 12:30 am that night to demand phone numbers of administration - threatening to report to work if they did not call her before 7 am even though she had been removed from the schedule by her supvsr. That is scary behavior - yes??

What do you do if you are aware a nurse is taking Ativan (her own) at work to function

I have an LPN charge nurse under my direction who admits to taking ATIVAN at work - her own script to my knowledge - she states she takes it in order to function - she has said this to two of my supervisors. She has performance issues for the last week and I suspended her - she called my facility at 1 am demanding my phone number and that of the Administrator - threatening to report to work if we did not call her at 1 am even though she had been notified she was removed from the schedule.. she did not come to the facility however I feel as though she is highly unstable. She has filed a harassment grievance against me and is a union steward which is irrelevant to the performance issue but complicates the matter of course. I am concerned this nurse is unsafe to practice - I can not find details about standards of practice or conduct to guide me as to whether I have a solid case for terminationa and reporting her to the board of registration - anyone ever experience this?

Can anyone help me determine how to prevent an insubordinate, unstable nurse from practicing -and where can I find standards of practice and conduct - I treied BORN for MA and they do not list specifics - wondering if I have enough info on this nurse to report her - anyone with experience in this area? I am the Director of Nursing