RN forging doc's signature

[Student Mom to Three]

Yep, that's right. Today an RN I work with forged a pathology requisition slip. I don't know why he did it, but if I had to hazard a guess it would be that he didn't want to wait for the doc to sign it. Immediately after, that particular RN left for the evening.

About the same time the doc returned the procedure room asking where the slip was because he hadn't completed and signed it yet. The specimen and path request were already gone- picked up by the lab.

So....what could I do when the doc asked me about it? I told him the other nurse signed it. I don't know how upset the doc was because he simply completed a new slip and asked me to make sure the correct path request made it to the lab and replaced the forged one.

I am furious with the RN. I had to fix what he did wrong, and it felt awful explaining to the doc what happened. What should I do now? Do I inform our manager about what happened? I don't know if the doc will talk to the manager. I do not want to work with this nurse ever again as he clearly can be way out of line.

If this were your situation how would you follow up with the doc, the RN and the manager?

[Rose_Queen, BSN, MSN, RN]

Medicare requires a physical signature on a path sheet for payment; at least, that's what we've been told and it's now the requirement for all surgical pathology at my facility. Used to be we signed off the path sheet as a verbal order. Now, if the physician doesn't sign and has left the OR, I just send it to the lab and let them deal with the physician. I would definitely bring this up to the manager- if they're forging signatures on this, what else are they forging signatures on? And if you don't report and it comes out anyway, now you're guilty by association. This is something that is most likely illegal.

[NicuGal, MSN, RN]

You also should say something to the nurse. Tell him the doc came looking for the req and you told him what went down.

[RN403, BSN, RN]

I agree. Inform the nurse and then make your nurse manager aware of what happened.

[AJJKRN]

In my facility you would make a factual occurrence report, alerting the right powers that be to talk to everyone involved and take it from there.

[meanmaryjean, DNP, RN]

Are you sure it is 'forging' and not just co-signing?

[Nurse SMS, MSN, RN]

For certain things, the scope of my job allows for me to sign for the physician with a /ndy at the end of it (initials). Some of those things the physician then comes along behind me and signs as well. This is not a forgery, it is a co-signature, it is legal and it is appropriate. I send lab test specimens all the time and enter in an order for this in the electronic record. It flags the physician to cosign on it when he or she next logs in. Not sure how doing this on paper would be any different. Also not sure it is your place as a student to be "furious" with the RN.

[Student Mom to Three]

Thanks for the replies!

Actually I'm not a student- been an RN for about three years and the RN in question is my coworker.

At my hospital we don't co-sign for the docs....it was a forgery.

I know it is not the crime of the century- but I think it was pretty bad and it put me and the new RN I am precepting into a difficult position.

Will take care of it today. Not a huge thing- just very frustrating.

[Libby1987]

I don't think you should do anything unless you know whose signature he signed.

[Libby1987]

You're precepting him? He's on orientation? That's an important detail and changes your responsibility.

[Nurse SMS, MSN, RN]

Sorry about the student thing....obviously I needed that second cup of coffee when I read your post. I went back to re-read it and I think I just assumed you were a student due to your user name. Sorry!

[WookieeRN, BSN, MSN, RN]

CYA CYA CYA

That's what you need to do. wrote up a report, inform the NM, whatever your facility protocol is just do it. Then the ball is out of your court and you avoid becoming guilty by association and letting this nurse's mistake haunt you.