Unbelievable

Specialties School

Published

Hi all, just need to get this out there. Would a principal that instructs you to do things against Scope of Practice ---- or one that tells you to look the "other way" when you see things that could potentially harm a very medically fragile child -- cause you to resign?

I have a situation that, despite trying to state the facts, the direction I've been given is not ethically sound for an RN -- I was told to "get over it". I've shared other such situations with administration. I will not ever compromise my license, or more importantly, the safety of a child in my care.

I would appreciate feedback.

Specializes in school nursing, ortho, trauma.

if it was a do this or else type of situation, then yes... i'd start looking for another job and i'd give my notice. if the principal can listen to reason, then try to make them understand that doing X will risk your license and that is why you will not do it. If you've already barked up that tree - then move on.

This is hard to answer without specifics, though I understand why you wouldn't want to be too detailed on a public internet forum.

I've noticed in the school that many coworkers/administrators are don't like hearing privacy laws as a reason not to do something or refusal to shortcuts. It's frustrating. I would maintain my ground that I need to work within my scope of practice. I am not putting my license (read: my livelihood, my passion, my blood/sweat/tears, my grueling education, my only way to feed my family) on the line.

if it was a do this or else type of situation, then yes... i'd start looking for another job and i'd give my notice. if the principal can listen to reason, then try to make them understand that doing X will risk your license and that is why you will not do it. If you've already barked up that tree - then move on.

YES!

Also, pull up your scope of practice. Print and highlight the portion you would be in violation of if you follow through with what they are asking you to do. If that doesn't help, take it up the chain to the next person in charge. While you are doing all of this, dust off the resume and start looking in case it cannot be resolved amicably.

Sometimes it is just ignorance and/or laziness. They cannot ignore it though if you hand it to them in black and white.

Specializes in Community Health/School Nursing.

Go to the Board of Education with your concerns if it is that serious. I don't let administration tell me how to do my job. That is what policies are for and my nursing judgement. Hope all turns out in your favor.

Holding strong on ethics and advocating for the safety of a child trumps a principal's comfort!

Sorry you are in such a difficult situation. Be strong!

Unfortunately, I do think you need to go up a chain of command, whether you resign or not. If you have direct knowledge of wrongdoing, say nothing to the people who need to know about it, and then something does happen to that child...then what?

If there were to be a court case against the school or the District, and previous records were called in to play to establish a pattern of neglect or wrongdoing, will you be pulled in as a witness? Will your documentation be scrutinized?

At the end of the day, your job is to protect your patient. That will always come first in the Great Big Book Of Nursing. But you are also protecting the District (who likely currently know nothing about what their Principal is doing) from liability.

So if your concerns are legitimate, driven by fact, and presented in a way that keeps your own personal emotion out of it, you should have no problem reporting them to the proper responsible party. Make a log of the dates/times/occurrences to the best of your knowledge. For example "On March 12, 2014 at 1400, Mr. X informed me that I was to do ABC to child Z. I refused to do ABC on the grounds that the current clinical practice act/law/rule/school policy does not permit me to do such". "On March 27, 2014, Mr. X informed me that I was to not address ABC on child Y. The current clinical practice act/law/rule/school policy states otherwise".

Mr. X can always dispute your account (and he most surely will). If you have any other documentation that supports your account, use it to your advantage. The only thing that can hurt your integrity is if you have followed Mr. X's direction and falsified documentation or neglected to provide reasonable care.

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