What did I get myself into?

[Hpy_Vly_RNBSN]

After Graduating in Sept 13 with my BSN and passing the NCLEX, It took 6 months of job searching to get 3 offers in one week. After a lot of soul searching and asking for advice I chose a position on a Med Surge floor at a acute care hospital in an inner city. I turned down an OR position and a Cardiology Office job. I really thought that with the training that came with this job and the patient population I would learn a lot and be able to move on after my contract ends. I was very happy with my decision until my first "real" day on the floor. We had 3 weeks of class orientation prior.

My first day on the floor, everyone was deceptively nice. As soon as I rounded with my preceptor (who is a foreign immigrant) I kinda got the feeling that things were off. Most of the report that I was included in was in a foreign language with other nurses from the same homeland as my preceptor. And almost immediately after report the nurse disappeared for almost an hour "getting coffee" So I did a full head to toe assessment on my patient, bathed him and changed his sheets. Then I charted the assessment in the computer, on my own. We then rounded together and gave late meds to several of the patients. I noticed that not once did this nurse do an assessment. She didnt even carry a stethoscope. But sure as anything she charted that she did complete assessments including lung sounds. Which doesnt surprise me because after a few hours I used the staff restroom and there is a sign up on the door that says " Real Nurses carry their stethoscope. You cant document clear breath sounds with out listening to them"

At this point I am really wondering what I got myself into. I knew that an inner city hospital was bound to have some kinks but false charting. That makes me nervous. I continued to round on her patients and eventually bathed another patient who looked like she hadnt had a bath in a few days let alone, turned.

I have a very principled work ethic. I do things because A.) Thats what being a nurse is all about and B.) I like to follow the rules.

I am wondering if I made a mistake. I am terrified to say anything being the "new" person and I have heard of other nurses being bullied out after trying to change things.

Any Advice

[schnookimz]

I would definitely say something about them speaking a different language in front of you. That's just rude. How can you understand what's going on?

[HouTx, BSN, MSN, EdD]

Most organizations have very clear policies on communication - which include use of alternative languages. Suggest you familiarize yourself and refer to them in order to address the blatantly risky behavior... not speaking English when giving report. If the majority of nurses speak that language, they probably have just drifted into this practice without consideration of the risky involved.

As for falsification of patient records - this is extremely serious. As an RN, if you know that fraud is being committed, you are legally and professionally required to take appropriate corrective actions. If you do not, you may be considered complicit - and when (not if) it is discovered, you will be caught up along with the guilty parties. This would be a career-ender, because commission of fraud will land you on the OIG exclusion list.

There are several ways to address these issues. Hopefully, you have already addressed your concerns directly with the people involved. If that does not work, following the chain of command is always preferred, but if it has been going on for some time with your supervisor turning a blind eye, you may need to choose a different pathway. Refer the communication issues to HR. Use your organization's 'whistleblower' process to report the suspected fraud.... Every organization that receives Federal funding is required to have one of these. It is usually a toll-free phone number and you can make complaints anonymously if you wish to. These complaints are normally reported directly to the Compliance department &/or Executive Suite - so they are not ignored. The organization is forbidden (Federal law) from retaliation against anyone who makes a 'good faith' report.

Be ready to deal with the fallout. Doing the right thing is seldom the easiest route - it takes courage to act with integrity rather than simply take the path of least resistance.