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?
I would speak to the coworker RN first that the doc wanted his signature on the slip and that you had to replace the slip that was signed by the RN with the Dr's slip that he signed. Additionally, the doctor should be the one who is going to bring up the issue with management if he/she cares that people are signing his name on slips without his permission. It is up to your discretion if you want to bring management into it.
I would suggest not confronting him. If you speak to the nurse don't do it alone. You never know how he may react and if he gets in REAL trouble(like reported to the board for practicing medicine without a license) or fired. He may target you as the cause of his woes. See what happens and talk to your manager. People like this often minimize their mistakes and blame others when things go wrong.
At our hospital, we have standing orders. For example, we order morphine and nitro plus ekg for pt with chest pain. We write the doctor's name (even tho he doesnt know about the chest pain and orders yet). Then we sign it too. But we have to inform the doctor within an hour per protocol. Do u know if it was your favility's protocol to order that without the physicians actual signature?
One thing that's always bugged me about nurses is how willingly we 'see' the behavior of other nurses in it's WORST possible context and how quickly we conclude we've witness BAD NURSING and then roll around in it like a dog in horse pee. Everyone of us has been on the wrong end of THAT, and it sucks, so why do it to someone else?
People are quick to shoot down their colleagues... its quite sad...
People are quick to shoot down their colleagues... its quite sad...
As a seasoned nurse I am quick to not be dragged down by a coworkers mistakes. They would not do the same for you. Every tub needs to sit on its own bottom.
Because sometimes our eyes ARE wide open to wrong-doing and we choose not to take the "meh" approach to our life's work. Perhaps those so "bugged" are too often finding themselves on the receiving end of scrutiny. Go back and consider the tone of your post. Then think about how you would feel if you truly witnessed something wrong and subsequently received the reply you provided. Think about how unbelievably pompous your "... reach inside your brain and change things around in there..." comment might read.
OP hasn't clarified what signature this nurse put on the slip, only that md signature is required (for billing no doubt).
And OP didn't say that the nurse made a medical decision, OP said he sent off the path slip to possibly prevent a delay in care. The same RN who is permitted by law to receive/write/implement much more complex orders.
I've always taken myself for a black and white thinker but context does matter sometimes.
OP hasn't clarified what signature this nurse put on the slip, only that md signature is required (for billing no doubt).
And OP didn't say that the nurse made a medical decision, OP said he sent off the path slip to possibly prevent a delay in care. The same RN who is permitted by law to receive/write/implement much more complex orders.
I've always taken myself for a black and white thinker but context does matter sometimes.
I think the OP needs to clarify the hospital policy in regards to this. I mentioned this earlier, but at my old job we had standing orders and could write and sign our own pathology forms. At my currently job this would be considered well outside my scope of practice and I would expect to get into very serious trouble for doing it. I don't see why the RN couldn't have chased up the doctor and asked them to sign the form, it sounds like they were only a couple of minutes away.
this has happened at facility I work for as well with face/face forms. 1 RN with 30+ yrs experience actually photo shopped every MD's signature that had privileges at our facility on these medicare forms. Her latest stunt was pulling DC'd narcs out of destruction and writing up bogus order instead of calling on call. This bit her in butt though because patient then saw MD of which she had forged order and he saw his name ordering oxycodone and he wrote I did not order this on the order form. Why this facility has allowed her to continue in practice is beyond me. But it happens. Amazing but true. -
In a specialized clinic but part of our Out-Patient Surgery , we sometimes filled in for staffing. There is a 5 page Med form, on page 4 it requires the Docs signature before discharge--no ifs, ands or butts about the policy. When I was staffing for the day it was of course not signed for my particular patient, I informed another RN co-worker just to double check the policy cause I had not worked in this area for awhile and this particular Hospital loved to change the working rules and paper work daily--NOT KIDDING-- She said and I quote" well WE just sign their name cause its a lot of time wasted trying to get a verbal order." I chose NOT to follow her Idea and of course got my Butt chewed on furiously by the Doctor, DID NOT CARE. My license, Follow the rules. This was a Fabulous RN of excellent long standing.
A short time later she approached me and very quietly said "Maybe signing the Doctors names isn't such a good idea." YA THINK ??
Never told anyone, I left this area sometime later as did she, moving out of the city but it is always in the back of my mind as I think it is in hers. Do I regret Not saying anything to the Supervisor, yes but timing is everything and this was NOT the proper time for a variety of reasons--the place was in a huge flux of change. I followed the policy for 1 patient. She and few other RN's who worked in this clinic more frequently had been doing this for over a 6 months to a year. A timeline I found out about much much later. It will always be a regret.
joe007
88 Posts
I would speak to the coworker RN first that the doc wanted his signature on the slip and that you had to replace the slip that was signed by the RN with the Dr's slip that he signed. Additionally, the doctor should be the one who is going to bring up the issue with management if he/she cares that people are signing his name on slips without his permission. It is up to your discretion if you want to bring management into it.