when to report to the bne?

[pkmom]

There is a nurse I work with who just about everyone considers to be unsafe. 3 big time offenses I can think of right away are: dc'ing a central line and starting a peripheral IV for TPN, feeding a patient who just had a heart cath, still had a sheath in place and wasn't supposed to be fed, and pulling an rn who was sitting in a room with patient who was a very high need for a sitter to do admission assessments and "cover the desk" while she was at lunch. the nurse she pulled to cover the desk also had absolutely zero training at the desk. The manager has made her a full time charge nurse and everyone is furious, most have left or are looking elsewhere for employment. Somewhere along the line, it occured to me that maybe she should be reported to the bne before something really bad happens. the occurrances listed above all occured in the last month with other less serious concerns added. Our administrators are aware of the big occurrances, but nothing has happened. I need some advice please, what would you do.

on a differet note, one of our nurses requested a schedule change because she was having oral surgery and didn't want to work while still taking lortab. our manager told her she could work while taking the lortab as long as she had a prescription, but she refused. Is that really safe? I'm too cautious to drive while taking lortab after surgery, I certainly wouldn't want to risk anything at work.

[nickola]

I'm assuming the BNE is the same as the BON? Anyway, I would be very careful about taking this on. Unless this is affecting you in some way, I would mind my own business. Have you spoken privately to your charge nurse w/your concerns? If the DON & management are aware of her errors, etc. it's really none of your concern, IMO. Furthermore, I'm not even sure anything you listed is a reportable offense. Reporting someone to the BON should not be done lightly. As far as giving another RN report so she could go to lunch- it is up to THAT RN to speak up if it is something she is unfamiliar or uncomfortable with. It sounds to me like you need to MYOB & concentrate on your own work & your own patients. (and BTW, yes, I have known nurses who had Rx's for Lortab & were OK'd to work while on it.)

[pkmom]

Yes, I mean the BON.

iti s my business because she is our new charge nurse and could be making decisions that effect my patients. in the instance where she fed the pt that should not have been fed, she was charge, she knew the pt had the sheath in place and placed the pt in potential danger by feeding him.

the npa states "conduct subject to reporting" section D "indicates that the nurse lacks knowledge, skill, judgement or conscientiousness to such an extent that the nurse's continued practice of nursing could reasonably be expected to pose a risk of harm to a ptient."

I feel that her judgement falls into that discription, but I'm not sure if it is enough.

I don't want to report anyone, but I also don't want her wandering into my patients rooms and and causing harm.

[anononurse]

I'm not sure you can report something "before it happens" !?!? If almost everyone considers this nurse so unsafe, why don't you all meet w/the charge nurse & DON privately & address these concerns? You should have specific documentation of incidents, otherwise it may sound like a personality conflict.

[penguin2]

I agree that everyone who shares your concerns should meet privately & confidentially w/management, DON, etc. I don't think anything you listed is reportable, however, addressing your concerns to management might help, esp. since it sounds like your whole unit is concerned- maybe they would reconsider their decision to have her do charge. BTW, just to clarify-- even if she 'wanders' into your patient's room and causes harm- it is HER LICENSE -- not yours, each person is working under their OWN license and w/in their scope of practice- never do anything you think is unsafe. As long as you're doing what you should, I wouldn't worry about things that haven't happened yet. It's always a good idea to carefully document everything- in a personal journal of your own, to be accessed if problems do arise. Good Luck!

[pkmom]

People who have talked to the manager about this have been shut down, the manager has backed this nurse. (Our manager is new and many of our staff don't trust her yet).

Right now, we are asking everyone to document incidences of bad judgement and violations of our policy and proceedures and give to to one person so that we can take everything into the manager and once to prove our point. this nurse was written up 2 x in 2 weeks, but there are other incidences that have been caught but not written up because nmany of the staff feel the the process is worthless because nothing happens.

[Dixielee, BSN, RN]

People who have talked to the manager about this have been shut down, the manager has backed this nurse. (Our manager is new and many of our staff don't trust her yet).

Right now, we are asking everyone to document incidences of bad judgement and violations of our policy and proceedures and give to to one person so that we can take everything into the manager and once to prove our point. this nurse was written up 2 x in 2 weeks, but there are other incidences that have been caught but not written up because nmany of the staff feel the the process is worthless because nothing happens.

Didn't mean to thank you, meant to quote you. It sounds like you have already tried and convicted this RN and are not trying to listen to what anyone here has to say, but I will still add my .02 worth.

Everything you have said about this nurse may be true, but before you decide to ruin this womans career, have her possible lose her home, not be able to work as a nurse again, etc. sit back and think about it. Being brought before the BON can cost her thousands of dollars in attorney fees is she choses a lawyer (and she would be a fool not to), and potentially black list her from other jobs EVEN if she is cleared of wrong doing.

No, I am not there, but in my 35 years of nursing, it has never, ever even crossed my mind to report someone to the BON.

If you chose to follow any one of us around long enough and documented every little thing that you did not think conformed to your way of doing things, then you might be the only RN left on the planet.

Just be very careful before you cast the first stone.

[pkmom]

wow, I forgot how heated discussions get around here.

perhaps I didn't make myself clear..I DON't want to report anyone. But I don't want my patients harmed. I have carefully considered everything that has been written here. I am NOT planning on reporting anyone, just wanted some other opinions.

We're not following her around keeping tabs on every tiny little thing. believe me I have way too much stuff to do to even consider that. Her big errors make themselves evident daily. All we are doing is keeping track of things as evidence for why she shouldn't be in charge. She does not have enough judgement to left unsupervised, but they have put her in a position to be advising others.

[Nightcrawler, BSN, RN]

I have to say that while some of the examples that you give may show poor judgement, that the only example that actually could have directly caused harm was the instance where she started TPN through a peripheral.

It may be against your hospital policy to feed patients with sheaths in place, but it is not necessarily dangerous to do so. We routinely give our patients an "angio tray' with a sandwich and finger food for the patient to eat while on bedrest, and before the sheath is pulled.

As far as pulling the nurse to the desk- I am not sure that we really have enough information on that situation.

What this sounds like is that you-and the others on your unit that you have been gossiping with- are upset that she was promoted to permanent charge, and that you are looking for things to hold against her.

If we were to look at your practice, might we be able to find oversights, situations where you violated hospital policy, perhaps a med error or two? If being regular charge is a new role for her, it would be kinder to let her have some time to settle into the role than to gossip about her and look for reasons to report her to the BON

[Jolie, BSN]

If you believe you have legitimate concerns about the safety of the patients under this nurse's care, I would suggest scheduling a meeting with your hospital's risk manager. Perhaps that would be a reasonable step toward addressing your concerns without getting the BON involved.

[tencat]

Hmmm....this all kind of sounds like a VERY toxic work environment that you are contributing to Pkmom.....honestly you haven't shared any info about her that points toward her being dangerously incompetent. Work environments such as this are a big reason people leave nursing. Just something to think about.

[mpccrn, BSN, RN]

it's been my experience that people like her HAVE been reported and it's felt safer to get her away from direct patient care by giving her a management position.