Reportable to state?

Why NOT tell the DON? Is the med nurse somebody's friend/relative??? You're only protecting the offender from internal scrutiny and in effect, you are allowing the bad situation to continue. How long before a pt has negative results from missing meds that YOU believe are being omitted.

In any situation like this, you go up the chain-of-command. That is standard SOP in any business or school. If you by-pass the DON (by going to the State), you will be doing to her a major disrespectful discourtesy. You will have blindsided her and that diminishes her trust of her staff. And you have delayed the first steps in the investigative process that must begin to PROVE guilt.

So who have you protected? Yourself and the med nurse. Who has been potentially hurt? Pts and DON, none of whom deserve that.

Go to the DON with some proven evidence. Let her take the next steps. If nothing gets done, then you SHOULD go to alternative routes. Just know that you may not be privy to all the information & actions as they play out, so be cautious if the pace/outcome of things don't seem to go the way you think they should.

Totally agree with Amolucia.

What are the reasons no one wants to tell the DON? I can tell you it might be scary to go to the DON, but if you were to go behind everyones back and go to state with this you will be opening a whole can of worms that you will be sorry you did it. State will not just investigate the nurse, but also the DON and others in the facility that have nothing to do with this nor even know about it. State will asume that the DON has already been informed about the situation because they will think you went through the chain of compand. and you would not just be blindsiding her, but put her job in jepardy.

Talk to the DON and I agree with Amolucia again about getting proof to go to her with. If she does not do anything go to someone higher up then her at the facility. State should be the very last thing you do to try to resolve the situation. Also how long have you known this information? You could be in just as much trouble holding this info and not reporting it. I Remember my CNA classes. If you saw a fellow CNA abusing a resident and do not say anything you are just as guilty of the abuse as they are. That probably is the same for nurses too I would asume. You say you are a charge nurse. well you better start to take that job seriously and take on the responsibility that that position requires of you.

You are the charge nurse so you are responsible for reporting this but you have to conform your suspicions. Count some pills on her day off and then recheck them when she leaves after her next shift. That's easy.

Count the pills? Really?? No one has time for that. Report your suspicions to the DON. Let her investigate and report to the proper authorities if necessary. Skipping over the DON and reporting to the state isn't a good idea.

You need to report her to the DON NOT the state. If you are concerned the DON may not investigate tell your administrator as well. The state will investigate the whole facility not just the nurse;and it could well take months before they get around to it. You owe it to the administration to tell them so they can investigate and fix the problem. As a mandatory reporter you must report this ASAP; if it is true the nurse is guilty of neglect.

BTW---if you report to administration and they do not do anything about it in a timely manner (3 days to investigate in my state) and you are sure there is not another explanation-that is when you should report to the state.

Count the pills? Really?? No one has time for that. Report your suspicions to the DON. Let her investigate and report to the proper authorities if necessary. Skipping over the DON and reporting to the state isn't a good idea.

Yes ,really-count the pills. How else can you prove that someone is not administering them? You had better have proof of that allegation before you take action I've seen it done.

I would suggest that if you have time to count the pills, you have far too much free time on your hands and, perhaps, you should pass the meds you think your co-worker isn't.

There IS a problem with counting pills - if that med nurses feels her back is against the wall, she can easily lie about it. "Oh, I couldn't find the cards so I borrowed." Now if there's an individual system or some automated pyxis ...

You now have a 'he said, she said' situation (really she/she). Hard to prove or disprove.

Maybe that med nurse needs to have 'a supervised med pass' with the SDC or UM or supervisor. We can all guess WHICH pts are being skipped. But it has to be PROVEN. And that step should be with the knowledge of the DON and her approval.

You've opened the 'Pandora's Box". Now you are obligated to see it through but thru the right process.