To tell or not to tell!

caliotter3 · Mar 24, 2015

The entire idea with taking a laundry list to any supervisor, much less the DPCS of a home health agency, is to get rid of the person you are complaining about. As long as no one else can successfully work at your case or place of employment, your superior position is solidified. As the notches on your belt increase, it becomes more difficult to find anyone willing to try to work in your aura. At least one person in such a position bragged to me about how wrapped around their finger they had the client, and how wrapped around the finger of the client, they had the agency management.

Raviepoo · Mar 24, 2015

Leave. It sounds like it's not a good environment for you to be in. It's doubtful that one person can change the existing culture. Leave and find a place with a culture that doesn't give you the heebie jeebies. They exist.

OrganizedChaos, LVN · Mar 24, 2015

Leave. It sounds like it's not a good environment for you to be in. It's doubtful that one person can change the existing culture. Leave and find a place with a culture that doesn't give you the heebie jeebies. They exist.

Well no work place & no one is perfect.

NurseSpeedy, ADN, LPN, RN · Mar 24, 2015

I read the first five pages of this thread and would say that if you are going to report your concerns that you should do it anonymously. I'm not saying that these concerns are not valid, I'm just saying what many other people are saying, being the newbie on the unit pointing out what is being done wrong is most likely not going to end well for you. Most likely your nurse manager knows what is going on and will address it (or not) based on the culture of the organization. I have worked for some facilities that have shown some pretty cruddy practices. Usually it was due to equally cruddy staffing and not uneducated nurses. Unfortunately, you will see people perform short cuts and all you can do is make sure that your own practice does not incorporate these short cuts that you have witnessed.

If the practices are really bad and you see a lot of them posing a risk to the patients, then you should probably also look for another place of employment. If the system at a facility is that broken then it is going to be a long time before you see any real positive change, if ever. I have only left a facility once due to the situation being this bad, because I did not want to be a part of a company that didn't care about their residents and repeatedly provided staffing numbers that were way below state regulations (one nurse and one aide for 110 residents, many of which were two assist). It was pure neglect for the residents and an unsafe situation for both the the residents and the nursing staff. Management knew the situations going on and would repeatedly turn a blind eye to it as they were more concerned about the bottom line than patient safety to call in outside resources to staff at a required minimum by law. If what's going on at your facility is bad enough to disgust you with what you are witnessing, it would be wise to get a different position elsewhere as eventually you are going to be miserable going to work each day.

workinmomRN2012, BSN · Mar 25, 2015

I was going to go to the Nurse Manager and just tell him/her what I saw, NO names or times. My point in all this is I believe more training is needed and NOT to get someone fired. It could be something as easy as putting a training module for ALL employees to complete.

Really???? I've done most of these "offenses" at one time or another and the reason for it is.....lack of time. It's easy to do everything perfectly when you only have one patient, but when you come on shift and start with 5 patients, have 3 dc's home one transfer to another unit and 4 new admissions it'd not so easy. Training module would just take up more precious time, we know how its suppose to be done- we just don't have the time.

SunriseDay · Mar 25, 2015

I am orientating on an intermediate care unit and can't believe what I am seeing. I have seen blood transfusions started without gloves, meds being pulled and set on top of the cart and left unattended, computer screen left on with patient data clearly visible and left unattended, no gowns being used in patients rooms that are on contact precautions. I can go on and on. I am a strong patient advocate and feel the need to tell someone so that these things do NOT continue. What do I do?

You could mention to your manager that you noticed these things happening, and from your previous training/experiences that you didn't do that. If you do it right, it might say that you were trained well previously and just notice things which are amiss. But don't do it, as others are saying, to get other workers in trouble.

Sometimes supervisors and managers like it when their workers tell them they were trained well in their previous job or clinicals. The manager might just see it is fine and okay, however, to do that. If they are okay with it, laugh it off and just do your job as you see fit. They might be a laid-back manager. However, as you see things occurring which you disagree with, say it right away instead of waiting. I've done this in a life science lab I worked in and when doing research - wearing gloves, counting to make sure labels were on correctly.. these things look good and noticed the supervisor/professor started doing it too. Sometimes it's good to be careful and thorough and your employer will often like that.

But it all depends on HOW you say it. If it's a casual observation, with them clearly being the most knowledgeable, it should be fine. You might see these things improve if you tell them about it, or mention to your co-workers you are used to XYZ in a non-critical way, like just a casual aside. You might see the nudging could improve things and remind people. :) Just a thought.

allnurses Guide · Mar 25, 2015

If a new person notices that their new job environment includes practices that are not optimum, and decides a training module will fix the situation I don't think they have enough experience to successfully pull off the whistleblower role.

Someone who wants to affect workplace culture needs to understand why the situation exists, first and to assume it is because people don't know any better is the wrong approach right out of the gate.

Making waves is pretty easy but connecting the waves to actual change is very difficult even when your goals are admirable. You will most likely lose your job in the process and then you won't have any patients to advocate for there.

joanna73, BSN, RN · Mar 26, 2015

If a new employee, in particular a new grad comes to me with these observations, I will take note. However, I will refer them to the policy and procedures manual in addition to signing them up for education, usual practice for all recent hires. Why? To ensure that they have been taught the needed theory.

When the same person (s) are reporting often, they will be guided re: conflict management and probably given a learning plan.

You're not doing the manager any favours. We already know where the issues are and who to watch.

nurse4ever08 · Mar 26, 2015

Starting blood without gloves is just as a big risk to the nurse for exposure purposes. Hippa is huge but that could have been an accident. This is not worth starting a battle. Choose wisely

SassyRN_972 · Mar 26, 2015

Do it the right way and the way you were taught. You can't change peoples bad habits but you sure can make yourself a target real quick. Get some experience under your belt and then you'll have some standing to air out the dirty laundry.

NurseSpeedy, ADN, LPN, RN · Mar 26, 2015

Why can't we all get the HIPAA acronym right? It's been drilled into our brains so much but it's still looking like a hippo in so many posts (not just this thread)...

TheNGTKingRN · Mar 26, 2015

Why can't we all get the HIPAA acronym right? It's been drilled into our brains so much but it's still looking like a hippo in so many posts (not just this thread)...

I honestly feel it must be the way verbal English translates to written. HIPAA. Idk. That's my best guess. I've always known it as HIPAA.