I am looking for some insight into retaliation acts by employers.I am a RN in a ICU setting at a major teaching hospital.I have been a resource to my entire unit.I received a promotion only weeks ago.I received a email from my unit manager only hours before she fired me "thanking me" for my dedication to the new nursing staff. I have never been written up, never a verbal warning.My evaluations have been excellent in all my years at this hospital. Until this past month....
I voiced my concerns over some incompetency acts performed by a coworker-nurse. These were acts that were not merely mistakes...they were acts that could have resulted in patient death. I tried to set a meeting with my nurse manager to discuss this nurses incompetent level of function...and I was met with a date to come in for a termination meeting...mine!
This nurse was the nurse managers best friend and recently was her assistant manager.She had done office work for years and had not taken care of any actual patient in years. When she opted to go back into staffing she "refused " to "accept" any orientation....and so she was left to learn by trial and error.In a ICU setting...thats just wrong!Othernurses had complained to the nurse manager to no avail...but I am a lil different.I have a history of being a strong patient advocate and I had told the nurse who was functioning incompetently that I was left with no choice but to go to our risk management dept re: her unsafe pratices.Hours later....I was "fired" for an alledged documentation error. This same kind of documentation error has resulted in no disciplinary action for other employees.Secondly ...my chart had been altered after I left...so I actually never had a documentation error.I dont know what to do. I have been a model employee for years.I have asked for dispute resolution....but they keep postphoning the dispute resolution hearing. What actually happens in a dispute resolution hearing? Are they a sham?Do you have any advice? I feel like I have been incredibly niave.Like I should have seenit coming...but didnt.
Thanks so much.I knew it was covered under the nurse pratice act ,..but I hadnt actually archived the actual nurse pratice act.Is this the same Nurse Pratice Act that Texas and all states acknowledge or are the individulaized?Is it universal for all RN's ,..or just for Texas? Thank you...I am just devastated.
Thanks so much.I knew it was covered under the nurse pratice act ,..but I hadnt actually archived the actual nurse pratice act.Is this the same Nurse Pratice Act that Tennessee acknowledges?Is it universal for all RN's ,..or just for Texas? Thank you...I am just devastated.
Silly me... I thought you lived/worked in Katy, TX. I don't know if TN has a similar NPA as Texas.
Specializes in Vents, Telemetry, Home Care, Home infusion.
may i make a suggestion here? management folks tend to get very defensive when the work "incompetence" is thrown at them as subjective term. much better to use phrase "nursing practice issues" as that can be described in concrete objective terms using state board of nursing standards, department policies and procedures, nursing textbooks, ana standards of practice and code for nurses, specialty organization standards: aacn standards apply here
i'd recommend printing out those emails with glowing praise and having copy of last evaluation. hr required to allow you access to employee files and for employee make any corrections, add explanatory note-since you've left, lawyer might need to help you gain access.
i'd write down time line of all issues you brought to managers attention, note any documentation supporting your concern, etc and your managers response or lack thereof to each issue.
each state has its own practice act with interpretations by each state board of nursing(sbon). link to all sbon here:
google search "determining competent practice + nursing" came up with these interesting articles
the ana supports the professional obligations of the nurse to safeguard patients.
it is the nurse's responsibility to:
provide competent nursing care to the patient.
safeguard patients and avoid actions that place the interests of the patient(s) in jeopardy. the right to refuse an assignment should be narrowly construed and the nurse must balance such a refusal against the obligation to provide for patient safety and to avoid abandonment. a refusal of an assignment may be justified when the risk of harm to the patient(s) is greater by accepting the assignment than by rejecting it.
exercise informed judgment and use individual competence and qualifications as criteria in giving, accepting or rejecting an assignment. nurses are individually accountable for the care of each patient.
clarify assignments, assess personal capabilities, jointly identify options for patient care assignments when the nurse does not feel personally competent or adequately prepared to carry out a specific function.
determine what will put a patient in immediate, serious danger. the nurse may be held legally responsible for judgments exercised and actions taken in the course of nursing practice. ...
nurses are accountable for judgments made and actions taken in the course of nursing practice. neither physicians' orders nor the employing agency's policies relieve the nurse of accountability for actions taken and judgments made.
section: § 90-171.37. revocation, suspension, or denial of licensure.
(5) is unfit or incompetent to practice nursing by reason of deliberate or negligent acts or omissions regardless of whether actual injury to the patient is established;
depending on facility, review boards may be helpful. ones i've been involved in as part of grievance task force about 60% sided with management, 40% sided with employee and able to overturn termination decisions. take a look at your facility's process. often employee is able to bring colleague to provide support to you along with lawyer. some allow you to choose members of pannel from those on a list so cross section of departments represented. look carefully at this option, and don"t choose only those in nursing-- maintenance and radiology staff often look at issue as department outside and are able to look objectively at situation, instead of having "department blinders" on.
It is...kinda hard to not call it what it is.It is incompetence. We are not just talking about giving a wrong dose/ route kinda error.these are serious...serious deviations from the Gold Standard ANA guideleines.
I applaud you for taking stand in efforts to ensure safe patient care. But often times, we need to make sure that our message delivery is not overly harsh. Either way though, if you were acting as a patient advocate, they are crazy to fire you. I've been through a similar situation in which our "uppers," when I made an issue of incompetent staff. Sometimes you just have to take the high road though, and that was one of those times. They didn't fire me, but did threaten my license over an unrelated event, in which I was keeping one of their other fav's from having to code a patient. Probably irregardless though, you will have to move on, unless they are going to remove the management staff who've done this to you. And now you probably don't feel you can trust your HR dept, so it certainly is time to move on, but I'd at least want to be reinstated until I could make the decison on where to go next. Good Luck!!!
Just adding here...Since you think that they have tampered with your charting...And I assume that it's computerized charting...If it's ''edited'' by either you or someone else, then you should be able to know who edited it. From the IT department. Though I wouldn't mention that over the phone, it's better if you can print out the info right before the grievance process and you're in front of the board, just to avoid additional tampering from their part. I'm glad you want to clear your name, but for me personally I would not return. But your reputation is what you're basically after.
This just shows how a lose lose situation develops. Even if you win a legal battle the settlement would probably be cash and not reinstatement.
Another point is even if the nurse manager and hospital acted wrongly and possibley illegally, what is there punishment? Not much I bet. Because there is no real legal punishment this type of behavior will continue.
My advice is to get a cash settlement have your records purged of this incident and move to another organization.
may i make a suggestion here? management folks tend to get very defensive when the work "incompetence" is thrown at them as subjective term. much better to use phrase "nursing practice issues" as that can be described in concrete objective terms using state board of nursing standards, department policies and procedures, nursing textbooks, ana standards of practice and code for nurses, specialty organization standards: aacn standards apply here
i'd recommend printing out those emails with glowing praise and having copy of last evaluation. hr required to allow you access to employee files and for employee make any corrections, add explanatory note-since you've left, lawyer might need to help you gain access.
i'd write down time line of all issues you brought to managers attention, note any documentation supporting your concern, etc and your managers response or lack thereof to each issue.
each state has its own practice act with interpretations by each state board of nursing(sbon). link to all sbon here:
google search "determining competent practice + nursing" came up with these interesting articles
the ana supports the professional obligations of the nurse to safeguard patients.
it is the nurse's responsibility to:
provide competent nursing care to the patient.
safeguard patients and avoid actions that place the interests of the patient(s) in jeopardy. the right to refuse an assignment should be narrowly construed and the nurse must balance such a refusal against the obligation to provide for patient safety and to avoid abandonment. a refusal of an assignment may be justified when the risk of harm to the patient(s) is greater by accepting the assignment than by rejecting it.
exercise informed judgment and use individual competence and qualifications as criteria in giving, accepting or rejecting an assignment. nurses are individually accountable for the care of each patient.
clarify assignments, assess personal capabilities, jointly identify options for patient care assignments when the nurse does not feel personally competent or adequately prepared to carry out a specific function.
determine what will put a patient in immediate, serious danger. the nurse may be held legally responsible for judgments exercised and actions taken in the course of nursing practice. ...
nurses are accountable for judgments made and actions taken in the course of nursing practice. neither physicians' orders nor the employing agency's policies relieve the nurse of accountability for actions taken and judgments made.
section: 90-171.37. revocation, suspension, or denial of licensure.
(5) is unfit or incompetent to practice nursing by reason of deliberate or negligent acts or omissions regardless of whether actual injury to the patient is established;
depending on facility, review boards may be helpful. ones i've been involved in as part of grievance task force about 60% sided with management, 40% sided with employee and able to overturn termination decisions. take a look at your facility's process. often employee is able to bring colleague to provide support to you along with lawyer. some allow you to choose members of pannel from those on a list so cross section of departments represented. look carefully at this option, and don"t choose only those in nursing-- maintenance and radiology staff often look at issue as department outside and are able to look objectively at situation, instead of having "department blinders" on.
may i make a suggestion here? management folks tend to get very defensive when the work "incompetence" is thrown at them as subjective term. much better to use phrase "nursing practice issues" as that can be described in concrete objective terms using state board of nursing standards, department policies and procedures, nursing textbooks, ana standards of practice and code for nurses, specialty organization standards: aacn standards apply here
i'd recommend printing out those emails with glowing praise and having copy of last evaluation. hr required to allow you access to employee files and for employee make any corrections, add explanatory note-since you've left, lawyer might need to help you gain access.
i'd write down time line of all issues you brought to managers attention, note any documentation supporting your concern, etc and your managers response or lack thereof to each issue.
each state has its own practice act with interpretations by each state board of nursing(sbon). link to all sbon here:
google search "determining competent practice + nursing" came up with these interesting articles
the ana supports the professional obligations of the nurse to safeguard patients.
it is the nurse's responsibility to:
provide competent nursing care to the patient.
safeguard patients and avoid actions that place the interests of the patient(s) in jeopardy. the right to refuse an assignment should be narrowly construed and the nurse must balance such a refusal against the obligation to provide for patient safety and to avoid abandonment. a refusal of an assignment may be justified when the risk of harm to the patient(s) is greater by accepting the assignment than by rejecting it.
exercise informed judgment and use individual competence and qualifications as criteria in giving, accepting or rejecting an assignment. nurses are individually accountable for the care of each patient.
clarify assignments, assess personal capabilities, jointly identify options for patient care assignments when the nurse does not feel personally competent or adequately prepared to carry out a specific function.
determine what will put a patient in immediate, serious danger. the nurse may be held legally responsible for judgments exercised and actions taken in the course of nursing practice. ...
nurses are accountable for judgments made and actions taken in the course of nursing practice. neither physicians' orders nor the employing agency's policies relieve the nurse of accountability for actions taken and judgments made.
section: 90-171.37. revocation, suspension, or denial of licensure.
(5) is unfit or incompetent to practice nursing by reason of deliberate or negligent acts or omissions regardless of whether actual injury to the patient is established;
depending on facility, review boards may be helpful. ones i've been involved in as part of grievance task force about 60% sided with management, 40% sided with employee and able to overturn termination decisions. take a look at your facility's process. often employee is able to bring colleague to provide support to you along with lawyer. some allow you to choose members of pannel from those on a list so cross section of departments represented. look carefully at this option, and don"t choose only those in nursing-- maintenance and radiology staff often look at issue as department outside and are able to look objectively at situation, instead of having "department blinders" on.
I applaud your decision for taking the high road and being a patient advocate.
I have had a similar instance in the past. Although it did not result in my being fired, the manager made my life miserable including unwarranted discliplinary action! (on a previously flawless record). And in this case my documentation was not tampered with but rather the documentation of the instance in question.
I ended up leaving that facility a few months later and wrote a lengthy letter to chief nursing official detailing that and some other concerns with the unit and the manager. I tried to be as professional as possible.
I will never know whether I had anything to do with it but about 2 months later, the manager in question was fired. it didn't give me back all of what I feel that I lost but I do feel that justice was served by getting rid of a horrible manager.
Perhaps voice all of your concerns in a narrative as I did and send them to the chief nursing officer, VP nursing, etc....copy the BON if you feel you need to.
Keysnurse2008
554 Posts
Corvette Guy,
Thanks so much.I knew it was covered under the nurse pratice act ,..but I hadnt actually archived the actual nurse pratice act.Is this the same Nurse Pratice Act that Texas and all states acknowledge or are the individulaized?Is it universal for all RN's ,..or just for Texas? Thank you...I am just devastated.