To tell or not to tell!

TheCommuter, BSN, RN · Apr 1, 2015

Unless consent forms have been signed and the team is aware, taking photos is a breach of confidentiality. Termination is likely.

Upon admission, all of our patients sign a 'consent to photograph' form which addresses this type of issue thoroughly.

joanna73, BSN, RN · Apr 1, 2015

We have the same policy re: photos. However, some families/ residents have refused to sign the consents.

kool-aide, RN · Apr 1, 2015

If you really want to be an advocate, talk to each individual privately and professionally about each of these issues. Don't be a martyr. Also, *HIPAA

NobleLeo · Apr 6, 2015

I know how you feel. When I started on orientation I was amazed at how little compliance there was with standard practices or things I felt had been emphasized in nursing school such as PPE and medication issues. My best advice for you is to practice how you were taught and to stop focusing on what other coworkers are doing. I do my best to follow policies and procedures and my coworkers always make fun of me because I know them so well which is why they always come to me for an answer. I encourage my coworkers to do things properly but even the most dedicated nurse (myself included) will have moments where you can't be perfect. As long as you can go home at the end of each day and say I did my best, you'll be fine.

P.S. I would wait to see what are singular incidents and what ends up being a pattern before saying anything to someone. You never know who might be falling out of bed or vomiting that caused someone to not follow "the right way."

SmilingBluEyes · Apr 6, 2015

A little off-topic, but it's ORIENTING, not "orientating".

chicsurfs, LPN · Apr 6, 2015

I can't believe I'm hearing all this advise, wow.

tyvin, BSN, RN · Apr 6, 2015

Sounds like a bunch of sloppiness and bad habits. Orient, keep your nose clean, and don't copy your co-worker's habits (try correcting them). When you saw someone hanging blood with no gloves why didn't you go ask why they weren't wearing gloves?

If you really feel that what you're seeing is hampering patient care, go to your boss and ask what you should do...that simple. If you're not ready to spill names, don't bother going to the boss IMO. I mean... "Hi boss, you know what; some of those nurses are dong this and that"...'who,' "I can't say"...'hmmmm, did you ask them why or what's going on?'..."uhhhh, no" You are the one that may end up in the hot box. Funny how that happens.

I bet if you check the pecking order of complaints at your facility it will say to go to the nurse first for a conversation before going farther up the ladder.

opdahlamber · Apr 8, 2015

So I could be fired for being a patient advocate? Well I guess this is a small price to pay for looking out for what is best for my patients.

I was terminated for reporting a coworker for abuse for stealing medications. Retaliation is real. While not supposed to happen, it does sometimes. That said, I would do it again in a P-wave. :sneaky:

psu_213, BSN, RN · Apr 8, 2015

I can't believe I'm hearing all this advise, wow.

What the OP describes is definitely sloppy practice on the parts of the nurses on his unit. I certainly do not advocate turing a blind eye to the situation. However, making it in the world of nursing (as in most other professions) involve politics. It would be easy to thing "I will just go tell the nurse manager and the problem will be solve." Unfortunately it's not that simple. I've worked on units where someone was going "anonymously" to the NM, yet, somehow, his/her name always got out. Especially as a new nurse, you don't want to be wearing the label of "snitch." Yes, the motives of the OP are good. He wants to make a positive change. In a perfect world, he should be able to go to the NM, lay out his concerns, and, even if people found out he was the one who went to the NM, every nurse would say "hey, thanks for pointing that out." They would be happy with him and they would change their practices.

Well, this is not a perfect world. Try asking a nurse in a non-threatening way: "On my orientation, I was taught to wear a gown in an isolation room. I've seen many nurses who don't. Which is correct?" If it is still a problem, the OP can try going to infection control and ask the same question.

Again, doing nothing is not the answer. However, as a new nurse, if everyone says about the OP "watch your back around him," the he is going to have a very difficult time on this unit.

**canoehead, BSN, RN** · Apr 8, 2015

The OP didn't say what time frame he observed these behaviors over. If it all happened before lunch, then it sounds like a sloppy unit. If it happened over a week, pretty average. If we're talking a month, and those were the worst things he saw, I'd say those nurses rock! For a new grad, and even a new hire with experience, I'd stay silent and watch the politics on the unit before I'd get involved. Manay have come before you, and somehow those issues remain...I bet there is a reason. Find out the reason.

chicsurfs, LPN · Apr 9, 2015

Wow. Hide the bad stuff and keep your job. No thanks Id rather respect myself, job role and my patients first!

Alnitak7 · Apr 9, 2015

I am orientating on an intermediate care unit and can't believe what I am seeing... 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?

I also worked in a place where some patients had scabies and no one was using gloves or gowns and it was getting spread and I thought it was so insanely stupid I contacted the Board of Nursing. I really did not care if I got in trouble for reporting it or not but still didn't bother telling anyone that I reported them.