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?

[rn/writer, RN]

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.

management (including the charge rn) makes decisions based on information, not just on having power. with this kind of logic, if the tech saw smoke coming out of a closet, he should just keep his mouth shut. it's the rn's job to discover the situation and the fire department's job to put out any fires.

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.

aides do not have the same kind of responsibility, but that doesn't mean they don't have an obligation. we all have a duty to report unsafe conditions or patient distress or smoke coming out of a closet. no, you don't want people narking out every little detail, but leaving early without prior permission is huge and has the potential to be harmful in many ways.

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.

the med tech knew the cna left. the op had a reasonable expectation for staff to call her attention to any dangerous situations. not wanting to get involved doesn't cut it when you have a responsibility toward vulnerable patients, even if it's a responsibility that is delegated downward from another level.

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 med tech overstepped bounds if he gave permission for the cna to leave. he didn't have the authority to do that.

the fact that he/she wouldn't perform the charge position of making the aide stay?

how can the charge nurse intervene if she doesn't even know there is a problem? it isn't a charge nurse's duty to shadow everyone. she should be able to trust that she will be alerted if anything unusual comes up. the tech shouldn't be the one to investigate or discipline, but we all have a duty to report something serious like this.

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.

when you are responsible for the lives and well-being of others and you see a serious lapse, "minding your own business" is just not an option.

with 80 patients to care for, the rn can't be everywhere at once. she needs to be able to rely on her staff to alert her to problems, from lousy vitals to skin tears to disappearing staff. ancillary staff members are not inanimate objects like blood pressure machines. they are the eyes and ears of the rn. if they don't communicate, they aren't doing the whole job.

[j621d]

Both the CNA and the Med Tech should be disciplined. The CNA for leaving without proper permission, and the Med Tech for not notifying the RN about the CNA leaving. When the CNA left, it created a potentially dangerous situation by the lack of coverage.

The more serious offense was the CNA leaving without proper authority. Is there a P&P for staff leaving early (who to notify, reasons for leaving, etc.). There must be a chain of command....

[Mrs. Sparkle Pants]

You are putting patient safety 1st and your license 2nd, sounds like you have your priorities in check and you most definitely did the right thing. So nothing happened this time, but what about the next time she leaves? She and management need to know this is NOT okay!

[NocturneNrse]

I agree totally with your decision to write this up! I would have guilt feelings too, but you put the patient first in this.. and that's what we do!

[nanacarol]

Hi,

I really disagree with the comment that the Med Tech had no responsibility to "report, mention" to the charge nurse that a peer had left the building for several reasons. The first is that the charge nurse is responsible for the work flow related to patient care. If that charge person does not know that he/she is down a person, the potential for serious patient mishandling can occur. No the med tech does not have supervisory authority but is responsible to notify the individual who has either supervisory responsibility or delegated authority to manage the facility in the absence of the supervisory authority. As I see it as long as we nurses make excuses for individual employees (ourselves included) not stepping up and holding our peers accountable for our team performance, team members such as the CNA will continue to get paid for not doing her/his job, for leaving the rest of the team in a bind that could cause poor care to our patients.

The initial writer did the right thing, she is responsible for invoking her code of ethics in the work place. The old adage "if you don't stand for something, you will fall anything" rings true here. Whether the organization followed through or not is really irrelevant from my perspective, the real deal is the "nurse remained true to her/his code of ethics. nanacarol

[indigonurse]

First of all this aide knows that legally she is working under the supervision of a licensed nurse, not a med tech. Leaving your shift after you have clocked in before the shift is over can be considered patient abandonment and grounds for serious disciplinary action by the CNA board. If it were me I would report the incident to them and to the health department because the facility has to maintain a certain CNA/pt. ratio and can never have pts. with no CNA taking care of them even when they go on break their are supposed to be other CNA's responsible for their patients.

[Batman25]

The aide not only should have been written up but fired immediately. Inmates don't get to run the asylum where I work. The med tech was also wrong but it sounds like they understand and get it now. You handled things appropriately. Good for you.

[Nurse Cathy Foley]

You did exactly what I would have!