To write up or not???

[sasha2lady]

I work nights 12 hrs with just one other nurse for almost 80 residents. We wrote up an aide who left the shift hours early without permission The only one she told was a med tech on the floor she was supposed to be on. I had a talk with the med tech and told him he was not authorized to let cnas leave early. We wrote the other one up for leaving without authorization. Anything couldve happened up there, a code another fall a masssive med tech med error . I am not willing to stand idly by and let a med tech or a cna or anybody else endanger my license. Me and the other nurse r responsible for everybody in the building.

The boss apparently talked to the aide who then proceeded to rant and rave about me behind my back saying her leaving wasn't my business etc. I disagree. It became my business when the other aides had to pick up her slack and couldn't take their breaks and those residents did without care they needed because it was a weekend and she had a party to go to.

She said she didn't get wrote up so if she's not lying then the boss didn't show her the writeup. That is a hard call since mgmt never ever follows thru with things. I spoke to both supervisors and told them I refuse to b put at risk like that. I keep very detailed records of events like this. For my own protection. I've been to court once and don't plan on being pulled back!

Was I wrong to write her up? I don't feel like I was but I know the dirty looks and attitude that I'll get in return. I honestly don't care about that at this point but as nurses do we not have a right to protect our licenses ????even if it means ******* a few people off in the name of what's right?

[Zookeeper3]

I think you did excellent! I do worry about hurting others feelings when I aproach them about behavior that needs adjustment or an experience to learn from so I'm careful with what I say. I do not care to the point that I would let any patient issues prevent me from writing anyone up.

I agree with you 100%, now quit worrying about it!

[Davey Do]

You did what you needed to do, sasha2lady. You don't work to win a popularity contest. You're there to do a job to the best of your ability.

I applaud your integrity.

Dave

[Orange Tree]

I would have talked to the manager and asked what the proper procedure for an aide leaving early was. If it involved my permission, I would have asked the manager to make sure that this was clear to the aide. I also would have spoken to the aide myself to clarify my own expectations. If it didn't involve my permission or at least notification, I would try to get things changed.

[BabyLady, BSN, RN]

The only disagreement that I had, is that you said anything AT ALL to the Med Tech.

The Med Tech...is not a manager and as a human being, he/she has no control whatsoever of what someone tells him/her. They are not under any obligation to try to stop the aid from leaving either or to play tattletale...that isn't their job.

That would be like some other RN ie. "Candy" coming up to me and saying, "Oh...Susie is coming in to split my shift with me today, just wanted to let you know I was taking off!"

You know what I would have done? Nothing...absolutely nothing...I have no control over another nurse and it is Candy's job and Candy's license, not mine, if she leaves without authorization...not for me to police.

However, if the aide left without permission, that aide needs to be written up because no one should be leaving without clearing it with a manager first if they are leaving eary..but the Med Tech probably deserves an apology...as they were simply, a bystander and had no control over the decisions of the aide.

[nurse2033, MSN, RN]

Write up!

[sasha2lady]

Thanks for the input. I truly appreciate it. I talked to the highest power that be that night..the don and she said to write her up. I went to this particular med tech for overstepping bounds. He was the only person aware that the aide had left and didn't bother to let us nurses know. Only nurses on duty or mgmt can say if someone leaves early when it's not sickness related. She most def wasn't sick. She's been a slack employee for a long time along with alot more but somehow they are kept around.

I like rules and I follow them. I'm a structured organized worker....very type A as my former instructor put it . If one of us nurses had pulled that we wouldve been raked over the coals. ...trust me. I was threatened with a writeup myself over a huge overstepping of bounds by that same med tech on my day off...wasn't there an had no idea what had went on buy somehow I got the heat.

That's also another reason I directly adressed that particular problem with him. I explained how unsafe it was to give her the ok to go while doing meds for 20 residents. Don't think he will be doing that again anytime soon @ least not if I'm there.

Even if it's well deserved a writeup is one thing I hate doing. I like to resolve issues before it has to get to that point.

[catshowlady]

You absolutely should have written her up. What lousy behavior, she has no business being in a position to care for vulnerable people. It might be different if she were sick or had a family emergency. Do you have a corporate office above your DON that you could report her to as well?

It sounds like you are in LTC? In my state, aides have to be state-tested/certified to work LTC. I'd be sorely tempted to report her to the state for pt abandonment. Even if she gets fired from your facility, what would stop her from going somewhere else and treating that facility's pts the same way?

@BabyLady: I'd say this would be more like another RN approaching me and saying, "I'm leaving," with no one left to care for his/her pts. I'd be reporting that to my supervisor, if I thought there were pts being left with no one to care for them. I guess we don't really know what she told the med tech; for all we know, she could have lied and told the MT she had permission to leave. I don't think the med tech should necessarily be written up, but a discussion of how to best handle any similar future situations would be warranted.

:paw:

[rn/writer, RN]

the only disagreement that i had, is that you said anything at all to the med tech.

the med tech...is not a manager and as a human being, he/she has no control whatsoever of what someone tells him/her. they are not under any obligation to try to stop the aid from leaving either or to play tattletale...that isn't their job.

if a cna or other employee decides to walk out before the end of the shift, the tech can't very well strong-arm her into staying, but he shouldn't be giving her permission or looking the other way either.

as for not reporting her leaving, it most certainly is his job to report the unsafe/irregular condition her absence creates. that isn't "tattling." it's looking out for the residents.

keeping silent makes him an accessory.

that would be like some other rn ie. "candy" coming up to me and saying, "oh...susie is coming in to split my shift with me today, just wanted to let you know i was taking off!"

you know what i would have done? nothing...absolutely nothing...i have no control over another nurse and it is candy's job and candy's license, not mine, if she leaves without authorization...not for me to police.

if you are the rn in charge or the person with the highest license in the building, it is most definitely your job to take action. i think you are confusing "control" with authority and responsibility. no, you may not be the one to discipline or fire candy, but you absolutely are the one who needs to convey her actions to the higher ups. that's part of being in charge and having the higher license.

you don't just look the other way because you aren't able to "police" her. if you do and something bad happens, you are partly to blame. even if there are no disasters, you still say something because residents are not getting the care they deserve.

when you are the rn in this equation, silence equals complicity.

however, if the aide left without permission, that aide needs to be written up because no one should be leaving without clearing it with a manager first if they are leaving eary..but the med tech probably deserves an apology...as they were simply, a bystander and had no control over the decisions of the aide.

the med tech deserves an apology? for either granting permission that wasn't his to give or keeping quiet about someone ducking out on their job? no, no, no! whether this is a first time event or the cna and the tech have some kind of deal worked out to take turns letting each other leave early, he needs to be informed that turning a blind eye to another employee's unexcused absence is unacceptable.

i'm not saying no one should ever work short. things happen. someone gets an emergency call and has to fly. or a cna takes ill and can't complete her duties. but communication with the one in charge is paramount. knowing what is happening, she can try to get someone else to come in early or table some non-essential matters so she can step in herself.

the idea that this is going on without her knowledge (and that the cna feels entitled to do such a thing for apparently frivolous reasons) is disturbing.

op, whether it changes anything for the better or not, you took the correct action by writing this person up.

the sad part is that many ltc facilities have, more or less, made a deal with the devil. they retain irresponsible employees with terrible attitudes in order to keep wages low. but that's another thread.

[INLPN93]

You most certainly have the right to write her up!

And what's with her not being fired????

I would make it understood under no uncertain terms to my med techs & CNAs that you may not get wrote up or fired for leaving at this facility but this nurse will report you to SBON immediately and I have zero tolerence for abandonment of the res.

Because that is what she did.

[BabyLady, BSN, RN]

the med tech deserves an apology? for either granting permission that wasn't his to give or keeping quiet about someone ducking out on their job? no, no, no! whether this is a first time event or the cna and the tech have some kind of deal worked out to take turns letting each other leave early, he needs to be informed that turning a blind eye to another employee's unexcused absence is unacceptable.

i'm not saying no one should ever work short. things happen. someone gets an emergency call and has to fly. or a cna takes ill and can't complete her duties. but communication with the one in charge is paramount. knowing what is happening, she can try to get someone else to come in early or table some non-essential matters so she can step in herself.

it's the idea that this is going on without her knowledge (and that the cna feels entitled to do such a thing for apparently frivolous reasons) that is disturbing.

op, whether it changes anything for the better or not, you took the correct action by writing this person up.

the sad part is that many ltc facilities have, more or less, made a deal with the devil. they retain irresponsible employees with terrible attitudes in order to keep wages low. but that's another thread.

sorry, i completely disagree.

that is what management is for and if someone cannot manage a unit, then they probaby shouldn't be running a charge shift or be in management.

an aide is not directly responsible for patients, the nurses are, so there is no "patient abandonment" like there is for a nurse...the nurses should be following up on the aide to make sure he/she is doing their job, because they are ultimately responsible for that patient, not the aide.

the op gave the aide the power to drag the med tech into something that he/she had zero control over...the med tech did not witness abuse, therefore, there was nothing to report.

if the med tech didn't tell anyone that the aide was leaving...again, the op stated that the med tech "overstepped bounds"...what freaking bounds? the fact that he/she wouldn't perform the charge position of making the aide stay?

sorry..i am 100% all for accountability and the op should put the blame clearly where it lays...on the aide and leave the med tech, that did nothing wrong other than mind their own business.

[INLPN93]

Sorry, I completely disagree.

An aide is not directly responsible for patients, the nurses are, so there is no "patient abandonment" like there is for a nurse...the nurses should be following up on the aide to make sure he/she is doing their job, because they are ultimately responsible for that patient, not the aide.

Possibly not in your state, but in mine (IN) there is.

Thank the lord.

You leave without proper policy & procedure protocol while on shift and on a resident assignment you are reportable to our state for a 'certification review judgement'.

I know a board member of this commitee and it does most certainly include leaving the job without proper notice. Or abandonment. It doesn't lead to criminal or civil litigation but a review by your certification board for reprimand or revocation of the certification standing.

I would hope all states have something to protect the patient or resident from a dangerous aid or tech.