What would you do???

Nurses Safety

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:flamesonb I have an ethical issue to address...I am a nursing student and work as a CNA while going to school. I work in a nursing home with several people who I also attend school with.

Recently one of the nurses I work with was suspended w/o pay because she had been caught not passing her meds. She was signing off on all meds, but only passing her narcs. At this time it seems as though our DON has NOT reported her to the state board of nursing. I am furious because she is coming back to work tomorrow. I feel like she shouldn't be doing ANY nursing at all because even though no one was 'harmed' the potential was there to do great harm!

I am now considering filing a formal complaint myself. I have checked it out and know that I can remain annonymous. I have spoke with several other CNA's and nurses at the facility and we are all pretty much on the same page... :madface: :madface: pissered off that nothing seems to be happening.

So...what would you do?

I sure am sorry if this has started a battle here! So not my intention!

I just thought that I would let everyone know what I have witnessed myself and not just heard through the grapevine.

Usually this nurse works on our Alzheimers unit...usually,but not always. On several occassions I have worked with her in different areas. On two such occassions I witnessed her 'passing her meds' or rather giving the impression of such. I KNOW of 3 residents who didn't receive their neb treatments. I KNOW of 1 resident who didn't receive his sup. I KNOW of another resident who didn't get OTC PRN meds.

I saw her charting for each patient. I don't know what she charted. But she was charting. I asked her how come X doesn't get a neb...the reply was because they don't need it. The next night I worked with a different nurse...they gave the neb.

I spend more time minute for minute with these residents. Our nurses are not allowed enough time to do that. I LOVE my residents. The reason I am questioning this now is because I lost my mom some years ago in a nursing home. (TOTALLY UNRELATED...She went there under hospice for cancer) I have always tried to treat my residents the way I would have wanted my mom treated. If this was going on with MY mom, I would at the very least want it investigated.

I know our DON has a habit of turning the other cheek. I personally experienced this in another area. (She kept on an employee who had been accused of sexual harassment 3x's...then she let him go.There was plenty of 'proof' there to have let him go though) At any rate, I am now questioning if I should say anything.

It may not seem like much ... M.O.M., Nebs, sups., but these are just what I witnessed. What about what I didn't? And I am not out to ruin anyone's life...I just am thinking of the lives of my residents. They have lost so much already...homes, spouses, freedom...they shouldn't lose their right to have medications.

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Specializes in Utilization Management.
I sure am sorry if this has started a battle here! So not my intention!

I just thought that I would let everyone know what I have witnessed myself and not just heard through the grapevine.

Usually this nurse works on our Alzheimers unit...usually,but not always. On several occassions I have worked with her in different areas. On two such occassions I witnessed her 'passing her meds' or rather giving the impression of such. I KNOW of 3 residents who didn't receive their neb treatments. I KNOW of 1 resident who didn't receive his sup. I KNOW of another resident who didn't get OTC PRN meds.

I saw her charting for each patient. I don't know what she charted. But she was charting. I asked her how come X doesn't get a neb...the reply was because they don't need it. The next night I worked with a different nurse...they gave the neb.

I spend more time minute for minute with these residents. Our nurses are not allowed enough time to do that. I LOVE my residents. The reason I am questioning this now is because I lost my mom some years ago in a nursing home. (TOTALLY UNRELATED...She went there under hospice for cancer) I have always tried to treat my residents the way I would have wanted my mom treated. If this was going on with MY mom, I would at the very least want it investigated.

I know our DON has a habit of turning the other cheek. I personally experienced this in another area. (She kept on an employee who had been accused of sexual harassment 3x's...then she let him go.There was plenty of 'proof' there to have let him go though) At any rate, I am now questioning if I should say anything.

It may not seem like much ... M.O.M., Nebs, sups., but these are just what I witnessed. What about what I didn't? And I am not out to ruin anyone's life...I just am thinking of the lives of my residents. They have lost so much already...homes, spouses, freedom...they shouldn't lose their right to have medications.

I'm certainly not out to start a battle. You must do what your conscience dictates. If you feel that these are reportable, report.

I only urge caution for you because the meds you mention could've been prn meds and could've been given depending on the nurse's judgement of the patient's condition at that time. Next night, different nurse, different conditions. See what I'm saying?

Also, having been in a Charge position and having had to report employees for various problems, please don't assume that nothing has been done at the administrative level. Nursing homes are required to report certain situations to the State or they're risking their own license.

I can think of at least a dozen different situations in which there were extenuating circumstances to an employee's disciplinary process, and I had to make some unpopular--but fair--decisions.

I guess my point is that yes, the situation as you've told it here, looks pretty bad. If you're sure it's true, and it'll help you feel that reporting will increase your patients' safety, by all means, do report.

I'm just asking that you bear in mind that you need to report only facts--things you have witnessed--and not rumors. Your report itself is evidence that you suspect abuse or neglect has happened.

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I'm certainly not out to start a battle. You must do what your conscience dictates. If you feel that these are reportable, report.

I only urge caution for you because the meds you mention could've been prn meds and could've been given depending on the nurse's judgement of the patient's condition at that time. Next night, different nurse, different conditions. See what I'm saying?

Also, having been in a Charge position and having had to report employees for various problems, please don't assume that nothing has been done at the administrative level. Nursing homes are required to report certain situations to the State or they're risking their own license.

I can think of at least a dozen different situations in which there were extenuating circumstances to an employee's disciplinary process, and I had to make some unpopular--but fair--decisions.

I guess my point is that yes, the situation as you've told it here, looks pretty bad. If you're sure it's true, and it'll help you feel that reporting will increase your patients' safety, by all means, do report.

I'm just asking that you bear in mind that you need to report only facts--things you have witnessed--and not rumors. Your report itself is evidence that you suspect abuse or neglect has happened.

This is a very good post. Good points.

I too have had employees getting very angry about perceived situations where they did not have all the facts.

steph

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That is partly why I am so torn. I do understand the circumstances of the meds I listed. All PRN...those are just the ones I know...my problem lies within the ones I don't know.

Rumors are a dime a dozen...and believe me, this has created a rumor mill like no other. I am trying to weed between the rumors and hear facts. I have even considered going to our DON and talking to her. However, I know that she can't tell me anything in regards to specifics.

:uhoh3: :uhoh3: My head is spinning! I just keep thinking that if nothing was wrong, why was she suspended in the first place? ( I seen the note to the scheduler from the DON saying to NOT schedule her as she was on unpaid suspension)

I don't know...everyone here has brought up some very valid points...I think I am more confused now than before! :confused: :confused:

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Specializes in Utilization Management.
I have even considered going to our DON and talking to her. However, I know that she can't tell me anything in regards to specifics.

Since you say that you're "torn," I suggest that a talk with your DON might be helpful. You might ask about the situation and explain your concern for your patients. It might help to mention that these rumors are certainly disturbing. Have you told your DON what you saw? She would be able to see if the nurse hadn't given a med or signed it off, or even if she had charted that she didn't give it and why.

I hope I haven't confused you. My intention was to help you make an intelligent decision that you--and especially your patients--could live with.

I see that you care a great deal for your patients, and I just want to add that you could take care of me any day! :icon_hug: Whatever your decision may be, bless you for caring.

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Specializes in Inpatient Acute Rehab.

This is the way it is in the eyes of the legal system... If you know of it happening, and you chose to do nothing about it, then you are just as guilty as the one who actually did it.

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This is the way it is in the eyes of the legal system... If you know of it happening, and you chose to do nothing about it, then you are just as guilty as the one who actually did it.

I agree, I know it is a hard decision but i'm sure you will make the right choice, I dont see any harm in just talking to your DON, maybe after that you will feel more confident in making that decision. However if patients are truly suffering or being mistreated then that should take presedence over all else. If a nurse withholds medication (if that is truly what she was doing) then there is no excuse and you should definetly take action, just be careful how you do it, if you go about it the wrong way it could potentially do more harm than good...good luck...keep us posted

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Just wanted to let you all know...I am meeting with my DON tomorrow to discuss this. I will let you know the outcome!

Thanks so much for your advice and comments. It made me see things from more than just my own perspective. :)

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:flamesonb I have an ethical issue to address...I am a nursing student and work as a CNA while going to school. I work in a nursing home with several people who I also attend school with.

Recently one of the nurses I work with was suspended w/o pay because she had been caught not passing her meds. She was signing off on all meds, but only passing her narcs. At this time it seems as though our DON has NOT reported her t wowo the state board of nursing. I am furious because she is coming back to work tomorrow. I feel like she shouldn't be doing ANY nursing at all because even though no one was 'harmed' the potential was there to do great harm!

I am now considering filing a formal complaint myself. I have checked it out and know that I can remain annonymous. I have spoke with several other CNA's and nurses at the facility and we are all pretty much on the same page... :madface: :madface: pissered off that nothing seems to be happening.

So...what would you do?

wow, this is horrible. these meds were ordered for a reason and they should have gotten them. be aware though if the don finds out you reported her, you could be let go, after awhile. You will make a mistake and you will be out of there. not only will this worker be involved but also the don. I don't blame you for being upset, but think before you act. will the others also go along with you. I sure wouldn't want this person working for me.
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I find it strange that (if all this is true) that she would only be "passing" narcotics. Maybe she passed nothing and pocketed narcotics.

My thoughts EXACTLY. If she really was not passing their meds, it is very likely that she was pocketing the narcs! Maybe your DON should begin with a drug screening... :uhoh21:

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