To tell or not to tell!

cheezwizz90 · Mar 24, 2015

I AM in a position to judge the practice of other nurses when they write about what those practices are in these comments. Thanks.

"If the computer is at the nurses station & the public has no access to the computers then the patient is never harmed." That's a BIG "if." I'm used to computers being in alcoves and hallways, encouraging nurses to spend less time chatting in the nursing station and ignoring call lights. The computers are certainly visible to the public.

It's even more loving to save strangers!!! Think of the Titanic's men shoving women and children THAT THEY DIDN'T KNOW onto lifeboats first. America's unwritten social contract is called SELFISHNESS. And I'm NOT signing that contract.

OrganizedChaos, LVN · Mar 24, 2015

I AM in a position to judge the practice of other nurses when they write about what those practices are in these comments. Thanks.
"If the computer is at the nurses station & the public has no access to the computers then the patient is never harmed." That's a BIG "if." I'm used to computers being in alcoves and hallways, encouraging nurses to spend less time chatting in the nursing station and ignoring call lights. The computers are certainly visible to the public.
It's even more loving to save strangers!!! Think of the Titanic's men shoving women and children THAT THEY DIDN'T KNOW onto lifeboats first. America's unwritten social contract is called SELFISHNESS. And I'm NOT signing that contract.

It's NOT a big if, the OP didn't state where the computers are. That is YOUR experience. NOT the OPs. My experience has been everything was at the nurses station.

And unless you work with all of us you can't judge us as complete nurses, you can only judge our comments.

Jessica2015 · Mar 24, 2015

Or, snitches end up in ditches, or the unemployment line.

imintrouble, BSN, RN · Mar 24, 2015

Trust me they'll know.[/quote']
They always know. Always. Do not ever report your fellow worker with the illusion that you'll be anonymous. Don't think that if you report your fellow nurses that your job will be salvageable, because it won't.
Don't believe for one minute reporting those you work with makes you a better person, a better nurse, or a better patient advocate.
Consider all the above, then decide if you can live with the transgressions you've observed.
I've fought the campaign the OP is complaining about. Not exactly, but close.
It sounds from the responses, like most of us have been there done that. I suspect the OP will have to fight his own battle, and live with the scars like the rest of us.

cheezwizz90 · Mar 24, 2015

Let's say that the computer is only located in the nursing station, not patient rooms, hallways, alcoves, etc etc since this is 2015 and computers are now beyond the nurse's station in any reputable, updated hospital setting. Let's not forget that iPads and tablets are coming into use and those defintely go out of the nurse's station. OK, so let's say ALL computers are ONLY in the nurse's station because its 1999. Are nurses the only people in that area? NO!! Housekeeping, maintenance and others are in the area and have NO business reading patient medical records. Actually, other nurses have NO BUSINESS reading the medical records of patients that they are not caring for.

In short, it is a big violation of the information security agreements of many hospitals, not to mention HIPAA, to leave the EMR open and walk away. I usually log out the careless nurse and have a discussion with him/her about it. They've always appreciated it and so do I. We all make mistakes, let's not minimize our impact as a guardian of a patient's privacy.

OrganizedChaos, LVN · Mar 24, 2015

Let's say that the computer is only located in the nursing station, not patient rooms, hallways, alcoves, etc etc since this is 2015 and computers are now beyond the nurse's station in any reputable, updated hospital setting. Let's not forget that iPads and tablets are coming into use and those defintely go out of the nurse's station. OK, so let's say ALL computers are ONLY in the nurse's station because its 1999. Are nurses the only people in that area? NO!! Housekeeping, maintenance and others are in the area and have NO business reading patient medical records. Actually, other nurses have NO BUSINESS reading the medical records of patients that they are not caring for.
In short, it is a big violation of the information security agreements of many hospitals, not to mention HIPAA, to leave the EMR open and walk away. I usually log out the careless nurse and have a discussion with him/her about it. They've always appreciated it and so do I. We all make mistakes, let's not minimize our impact as a guardian of a patient's privacy.

I live in a small city, with one hospital & I don't see them getting iPads. Where I've worked everything was ALWAYS at the nurses station, so sorry to pop your bubble. Not everything is updated to your standards. And according to the OP's post he was going to go to the NM with a list of complaints about a nurse while he is on orientation.

Not to mention you are starting to sound like you are just Miss Perfect & never make a mistake. I find that just hard to believe. People make mistakes, are in a hurry or just forget. It's not live or death things we're talking about. I've come up on things like that, logged the person out & life went on.

Conqueror+, BSN, RN · Mar 24, 2015

Well if you don't get fired for getting on the NM's nerves by upsetting the unit then those slacker nurses who obviously don't advocate for their patients will make your work life so miserable that you won't stay anyway. You can believe that you will be an island unto yourself, caring for your patients as only Supernurse can and that you won't need "those nurses" that you think so lowly of but the reality is that even a semi busy unit becomes hellish without your team members. Good luck and God speed newbie. I'm singing to you in my head.

You've only just begun to work, white scrubs and promises, a kiss for luck and you're on your way.....

imintrouble, BSN, RN · Mar 24, 2015

Well if you don't get fired for getting on the NM's nerves by upsetting the unit then those slacker nurses who obviously don't advocate for their patients will make your work life so miserable that you won't stay anyway. You can believe that you will be an island unto yourself, caring for your patients as only Supernurse can and that you won't need "those nurses" that you think so lowly of but the reality is that even a semi busy unit becomes hellish without your team members. Good luck and God speed newbie. I'm singing to you in my head.
You've only just begun to work, white scrubs and promises, a kiss for luck and you're on your way.....

Funny, but snarky.

I gave your post a like because it made me laugh. And if I were honest, I thought most of what you posted, but kept it to myself.

macawake, MSN · Mar 24, 2015

I am actually a bit saddened and dismayed by some of the responses in this thread. The consensus seems to be; keep a low profile, don't rock the boat and choose your battles wisely.

While I agree that I wouldn't report my co-workers to management because of the "violations" listed I would certainly take some kind of action. In the case of the unattended computer (screen) with the patient data clearly visible I would simply log out the user if there was any risk that someone not allowed access to it, could read it. The meds left unattended, I'd put away out of plain sight and if possible inform the nurse.

There's no reason other than emergencies to provide direct care to a patient who's on contact precautions without proper gowning (and other appropriate PPE). If you have to do it due to a an emergency than you should wash and change into a clean set of scrubs before caring for another patient. Our hands are a vector for spreading crap between our patients but so are our clothes. My opinion is that unless you'd be entirely comfortable for yourself or a loved one lying in a hospital bed with a fresh post-op incision or immunocompromised and being cared for by a nurse with a bit (or a lot) of MRSA, C. difficile and VRE on his/her scrubs you owe it to your patients to remind your co-workers to adhere to hygiene precautions.

Nursing isn't a darn popularity contest. There are definitely some ways of tackling the problem that I wouldn't recommend (such as running straight to your manager), but the problems needs to be addressed and we should in my opinion never be afraid of talking to and pointing out to our co-workers, when we see actions that are less than ideal from a patient outcome and/or privacy perspective.

I don't know if it's a cultural difference but I've been encouraged since day one of nursing school to always point out mistakes or oversights if I observe them. I haven't been a nurse for a very long time but it's approaching eight years so I'm no longer a new nurse. However I still remember a clinical placement (OR) during my forth semester when I told a visiting bigwig visiting surgeon from a prestigious hospital in a country much more authoritarian and "respect-thy-(professional)-elder"-culture, that s/he came very close to contaminating the sterile field during surgery. The bigwig had a minor conniption (about 240/130..) but my preceptor, the OR nurse, sided with me and gave me excellent scores on integrity and courage when my four OR weeks were done (part of the assessment for each clinical).

None of us are perfect. I know that I'm not. We sometimes work understaffed and/or under very stressful conditions and that makes us both more prone to make mistakes and liable to cut corners. That doesn't mean that we shouldn't do our best to follow rules that are in place to protect the patients and remind each other when the rules aren't followed. I personally think that this is a responsibility shared by old and new nurses alike.

DeeAngel · Mar 24, 2015

Nothing good is going to come out of telling on these people. They will find out who did it and can make your work life miserable. If you were going to tell you needed to do so when the incident occurred. Do you have photo proof, patient name and admission number, name of the nurse, room number, date and time, and witnesses present? Are you prepared to explain the delay in reporting which made it impossible to correct the actions at the time they occurred? If you do not have those thing then keep quiet and concentrate on perfecting your own skill set. You are not responsible for what others do, only yourself.

OrganizedChaos, LVN · Mar 24, 2015

I am actually a bit saddened and dismayed by some of the responses in this thread. The consensus seems to be; keep a low profile, don't rock the boat and choose your battles wisely.
While I agree that I wouldn't report my co-workers to management because of the "violations" listed I would certainly take some kind of action. In the case of the unattended computer (screen) with the patient data clearly visible I would simply log out the user if there was any risk that someone not allowed access to it, could read it. The meds left unattended, I'd put away out of plain sight and if possible inform the nurse.
There's no reason other than emergencies to provide direct care to a patient who's on contact precautions without proper gowning (and other appropriate PPE). If you have to do it due to a an emergency than you should wash and change into a clean set of scrubs before caring for another patient. Our hands are a vector for spreading crap between our patients but so are our clothes. My opinion is that unless you'd be entirely comfortable for yourself or a loved one lying in a hospital bed with a fresh post-op incision or immunocompromised and being cared for by a nurse with a bit (or a lot) of MRSA, C. difficile and VRE on his/her scrubs you owe it to your patients to remind your co-workers to adhere to hygiene precautions.
Nursing isn't a darn popularity contest. There are definitely some ways of tackling the problem that I wouldn't recommend (such as running straight to your manager), but the problems needs to be addressed and we should in my opinion never be afraid of talking to and pointing out to our co-workers, when we see actions that are less than ideal from a patient outcome and/or privacy perspective.
I don't know if it's a cultural difference but I've been encouraged since day one of nursing school to always point out mistakes or oversights if I observe them. I haven't been a nurse for a very long time but it's approaching eight years so I'm no longer a new nurse. However I still remember a clinical placement (OR) during my forth semester when I told a visiting bigwig visiting surgeon from a prestigious hospital in a country much more authoritarian and "respect-thy-(professional)-elder"-culture, that s/he came very close to contaminating the sterile field during surgery. The bigwig had a minor conniption (about 240/130..) but my preceptor, the OR nurse, sided with me and gave me excellent scores on integrity and courage when my four OR weeks were done (part of the assessment for each clinical).
None of us are perfect. I know that I'm not. We sometimes work understaffed and/or under very stressful conditions and that makes us both more prone to make mistakes and liable to cut corners. That doesn't mean that we shouldn't do our best to follow rules that are in place to protect the patients and remind each other when the rules aren't followed. I personally think that this is a responsibility shared by old and new nurses alike.

I agree with everything you said, while work shouldn't be a popularity contest we can make it easier or difficult on ourselves to get along with our coworkers. If we keep bringing up to them every time they leave meds out or a screen up, accidentally, it might rub them the wrong way. I don't expect anyone to be perfect, I know I'm not. I do expect to get along professionally at work though, but if someone took a list of violations about me to the NM, it would be hard to work with & trust them.

OrganizedChaos, LVN · Mar 24, 2015

Oh, I have to add. I was orienting on a PDN case & the nurse orienting me didn't like what I did. But instead of correcting me or talking to me, she went to our DON. Let me tell you I didn't stay at that case very long.

If you can't talk to me about anything but feel the need to go to the boss about everything, I don't want to work with you. I couldn't trust her after that & I was glad I left.