Would you File a Complaint?

[everchangingRN]

My dad was recently in a bad fall. The ambulance picked him up without placing him on a backboard or in a neck brace. Then when at the hospital, they didn't either. Nor did they listen to me when I said he has a head injury and can't move his arm. They didn't do a neurochecks or given him a sling when I asked for one. One particular Nurse was very rude and told me "you don't work here you just can't run the show" because it was at the hospital where I used to work. She then kept kicking us out of the trauma bay, and wouldn't let us in for hours. (ME, my sister and my Mom.) I asked for another nurse to take care of my dad and she ended up calling security on me after cursing at me. My question is - would you file a complaint with the state board of nursing? I have already filed a complaint with the hospital and have heard nothing after 3 months!

Thanks for your opinions.

[Wuzzie]

again, you are assuming.

Nope! Said I wasn't there. Merely described how things went down in our ED and a little commentary on human nature.

[FolksBtrippin, BSN, RN]

Huh? The BON does investigate and make determinations about whether licensed nurses violated the standards, rules, and regs under which they practice, and disciplines people for violations as appropriate. There is a lot more to regulating the practice of nursing in a state, which is what BONs do, than simply determining "whether a nurse has the qualifications to hold a license." That's just one piece of their role.

According to my class on legal issues in nursing, the BON does not deal with malpractice. But my prof (a lawyer and nurse) states that this is a very common misconception about what the BON does, especially among nurses.

The BON deals with licensing issues, not malpractice issues. There could be a situation in which both apply. For example, if the malpractice happened because the nurse was intoxicated, then that is both a licensing issue and a malpractice issue. The intoxicated at work part is the licensing issue.

The BON does not investigate whether or not a clinical decision was the right clinical decision, but instead whether the nurse is qualified to make clinical decisions. A nurse who gets drunk at work is not qualified to make clinical decisions, hence "qualifications."

This situation involves a question of whether or not the nurse made the right clinical decisions-- like whether or not she should have done neurochecks, whether she missed important data, etc. That is a malpractice issue. Not a licensing issue.

[elkpark]

According to my class on legal issues in nursing, the BON does not deal with malpractice. But my prof (a lawyer and nurse) states that this is a very common misconception about what the BON does, especially among nurses.

The BON deals with licensing issues, not malpractice issues. There could be a situation in which both apply. For example, if the malpractice happened because the nurse was intoxicated, then that is both a licensing issue and a malpractice issue. The intoxicated at work part is the licensing issue.

The BON does not investigate whether or not a clinical decision was the right clinical decision, but instead whether the nurse is qualified to make clinical decisions. A nurse who gets drunk at work is not qualified to make clinical decisions, hence "qualifications."

This situation involves a question of whether or not the nurse made the right clinical decisions-- like whether or not she should have done neurochecks, whether she missed important data, etc. That is a malpractice issue. Not a licensing issue.

Your professor is correct that BONs do not deal with "malpractice," which is a civil liability issue. But there is a lot more to nursing practice than whether or not a particular situation meets the legal criteria for "malpractice," and BONs get involved in much more than you describe.

"Whether or not the nurse made the right clinical decisions-- like whether or not she should have done neurochecks, whether she missed important data, etc." -- clinical practice issues like those have licensure ramifications as well as professional liability (malpractice) ramifications. Nurses can get in trouble with the BON for unsafe clinical practice whether or not the practice issues rise to the level of "malpractice," (which only becomes an issue if someone brings a suit charging malpractice), and whether or not something like substance use is involved.

I don't know whether your professor is not doing a good job of explaining the BON role in regulating nursing practice, or you're not getting what s/he is explaining (or maybe it's just early in the course?) There are established standards of what constitutes safe, prudent, responsible nursing practice, as well as an NPA (Nurse Practice Act) in each individual state. Nurses get in trouble with the BON, get disciplined, and sometimes lose their licenses, for failing to meet the standards of safe and appropriate clinical practice, and/or "scope of practice" issues, totally apart from any civil professional liability issues.

Nurses can also face criminal charges (potentially, although that's rare) for failure to practice safely and responsibly. There are three areas of law that affect nursing practice, criminal law (e.g, stealing from an employer or a client, assaulting a client, things that would be criminal for anyone to do), civil or "tort" law (this includes "malpractice," in which professionals can be sued by individuals for having caused an individual to suffer an injury/loss by neglecting/violating their professional responsibilities), and administrative law (that's the BON piece, in which you are responsible to the relevant licensing body for meeting the established standards of safe and appropriate practice). That's a lot of responsibility, but that's what comes with choosing to enter a licensed occupation/profession. I understand that nursing schools don't always do a good job of explaining this to students, and lots of students graduate and enter practice without fully understanding how their licenses "work" and to whom and for what they are professionally and legally accountable. Kudos to your school for offering a course.

[Accolay]

I'm sorry about your father's fall.

Your story is confusing to me and it is hard to follow what has actually happened. The general tone I gather is anger. And now you sound like you're out to make someone else's life miserable.

I will say that as a fellow nurse, and one who worked at this hospital in some capacity, you probably already know that usually an amazing amount of behaviors are required before family is actually kicked out. Could there be any chance that you didn't know what the ED staff was doing? I'll say it like this:

Some hospitals do a lot of stuff. Nurses can work in the same hospital and not know about the amount of stuff that happens in their hospital. Other nurses work at places that have little interaction with a lot of stuff and are completely out of their depth of knowledge to what is or what isn't normal when they come to a hospital that does a lot of stuff.

What are you angry about? What was missed? Was there malpractice? Or are you just angry that staff didn't do what you thought was supposed to be done?

How's your dad?

[morte, LPN, LVN]

Nope! Said I wasn't there. Merely described how things went down in our ED and a little commentary on human nature.

perhaps projecting would have been the better term. you were certainly accusatory towards OP, by projecting your experience on them.

[morte, LPN, LVN]

OP, that is a lot of damage for a ground level fall. is it possible the ED though he had been attacked?

[FolksBtrippin, BSN, RN]

Your professor is correct that BONs do not deal with "malpractice," which is a civil liability issue. But there is a lot more to nursing practice than whether or not a particular situation meets the legal criteria for "malpractice," and BONs get involved in much more than you describe.

"Whether or not the nurse made the right clinical decisions-- like whether or not she should have done neurochecks, whether she missed important data, etc." -- clinical practice issues like those have licensure ramifications as well as professional liability (malpractice) ramifications. Nurses can get in trouble with the BON for unsafe clinical practice whether or not the practice issues rise to the level of "malpractice," (which only becomes an issue if someone brings a suit charging malpractice), and whether or not something like substance use is involved.

I don't know whether your professor is not doing a good job of explaining the BON role in regulating nursing practice, or you're not getting what s/he is explaining (or maybe it's just early in the course?) There are established standards of what constitutes safe, prudent, responsible nursing practice, as well as an NPA (Nurse Practice Act) in each individual state. Nurses get in trouble with the BON, get disciplined, and sometimes lose their licenses, for failing to meet the standards of safe and appropriate clinical practice, and/or "scope of practice" issues, totally apart from any civil professional liability issues.

Nurses can also face criminal charges (potentially, although that's rare) for failure to practice safely and responsibly. There are three areas of law that affect nursing practice, criminal law (e.g, stealing from an employer or a client, assaulting a client, things that would be criminal for anyone to do), civil or "tort" law (this includes "malpractice," in which professionals can be sued by individuals for having caused an individual to suffer an injury/loss by neglecting/violating their professional responsibilities), and administrative law (that's the BON piece, in which you are responsible to the relevant licensing body for meeting the established standards of safe and appropriate practice). That's a lot of responsibility, but that's what comes with choosing to enter a licensed occupation/profession. I understand that nursing schools don't always do a good job of explaining this to students, and lots of students graduate and enter practice without fully understanding how their licenses "work" and to whom and for what they are professionally and legally accountable. Kudos to your school for offering a course.

It's possible that I didn't get it or that we didn't go into enough detail. It was not a full course taught for credit, it was a one day class and it was optional. My school was really excellent about constantly offering these types of lectures and seminars to students. I didn't mean to imply that the class was a full semester course.

At the time my school was developing a masters program in conjunction with the law school to offer a Juris Doctorate/ MSN. She was the head of that effort and I absolutely do trust everything she taught us.

[FolksBtrippin, BSN, RN]

cursing would go to the morals clause of the nurse practice act.

Oh please.

If I can lose my license for cursing, then take that **** right now.

[Wuzzie]

OP, that is a lot of damage for a ground level fall. is it possible the ED though he had been attacked?

Agreed and that may be part of what's making people question the entire situation.

[Kooky Korky, BSN, RN]

Oh I get that. And of course I think using profanity in this manner (and possibly some of the other described behavior) is egregious.

Reporting to a BON for something like that is egregious in its own right; it is upping the ante significantly. It, too, is unprofessional. It is nothing more than, "You have offended me and I will be *sure* to make you pay."

I have seen at least a couple of posts lately where there was interpersonal difficulty and BON reporting was being considered. Neither post mentioned any harm to a patient whatsoever.

This is not okay. Is there nothing out of bounds any more? I just can't wrap my mind around such a disturbing reaction. My opinion is that completely losing sight of any bigger picture and becoming hell-bent on a vindictive action involves serious emotional instability.

The nurse was absolutely wrong to curse. Perhaps OP should talk to HR and the Manager of the ED. Maybe she should contact the nurse directly before reporting anything other than what she has already done. Maybe the nurse won't even remember her, or maybe she will be completely dismissive or contrary, or perhaps she will apologize.

Whatever path OP chooses, the nurse cannot be allowed to curse at work. It's just something no one needs to hear. And we know that we are not at our best when our loved ones are hurt or sick, so maybe the OP's perceptions were off. Still no cursing allowed.

I'd say nix on BON reporting unless the hospital doesn't resolve this.

Can you update us, OP? Is your Dad getting better? How are you?

[JKL33]

I guess in order to report someone "for cursing" it would have to be some sort of enraged lunatic (inherently dangerous) situation in my book.

As it is, the OP lists a mix of care concerns (which I personally believe are mostly unfounded based on the little information given) and personal insult. I also believe the situation escalated to what it did mostly because of the OP's unfounded concerns.

If there are serious care concerns, fine, report it. Also make sure to report (to the full extent humanly possible) every other entity that supposedly delivered unsafe/imprudent care - - since that's the assertion. What's up with supposedly believing that multilple entities/systems provided ridiculously negligent care but then deciding to only report the person who was involved in a situation of personal offense?

No. There are either serious care concerns, or there aren't. If so, report everyone through every possible channel. If not, take responsibility for your own involvement in how things played out, and drop it.

There were a lot of injuries sustained in the original incident, whatever it was. That seems to be clouding the issues here. The ribs that were broken, the brachial plexus injury, the head injury - none of those were caused by the people providing care. I find the knowledge deficits and lack of objectivity completely disappointing as a story told by an RN who is charged with instructing students.

[Wuzzie]

If there are serious care concerns, fine, report it. Also make sure to report (to the full extent humanly possible) every other entity that supposedly delivered unsafe/imprudent care - - since that's the assertion. What's up with supposedly believing that multilple entities/systems provided ridiculously negligent care but then deciding to only report the person who was involved in a situation of personal offense?

There were a lot of injuries sustained in the original incident, whatever it was. That seems to be clouding the issues here. The ribs that were broken, the brachial plexus injury, the head injury - none of those were caused by the people providing care. I find the knowledge deficits and lack of objectivity completely disappointing as a story told by an RN who is charged with instructing students.

I'm with you on this. The OP has issues with the care provided by everybody involved, literally everybody, yet she has focused her anger on just one person and is willing to attempt to ruin her career over it. The level of vindictiveness makes me think there's way more back story to this especially since she apparently used to work at the offending hospital. And yes Morte, I'm making assumptions but the OP did not do a great job presenting herself well and has not bothered to come back and clarify anything beyond her second post so all we are left with is speculation. And regarding making assumptions, Morte, aren't you are doing the same by assuming that the OP was completely truthful in her retelling all of this. I'm pretty sure the truth actually lies somewhere in the middle. I think the offending nurse should be given the same benefit of the doubt as you seem to want to give the OP.