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I'm having problems with an RN who refuses to follow hospital policy regarding charting and patient orders. What should I do?

Wednesday December 12, 2012
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Dear Donna,

Many times I follow an RN at my facility, who refuses to give a full report. She will say "they are all still alive". She refuses to do a bedside report, which is required by our facility. We just transitioned to a free-standing facility and are utilizing computer charting. Policy states the incoming nurse must login to Protouch and check outstanding orders before authorizing the hand off tool. All outstanding orders from the prior shift must be addressed prior to the handoff tool being signed. Yesterday this nurse yelled at me and told me she would not do this (while we were in and then outside a patient's room). This is not the first altercation with this nurse and I have reported her to administration several times. I requested the shift supervisors intervene, and she was spoken to and advised of the protocol for handoff reports. After supervisors left, I decided to confront her in a professional manner and requested she join me in the medication room. She loudly voiced her opinion on this. I told her she needs to stop talking to me the way she does, but she just said she didn’t have time for this and had things to do. She left the floor without handing me the keys to the patient drawers. I basically received no report on three ventilator patients who I had not cared for previously. I do not always agree with the hospital’s policies, but I follow them. I have reported her several times, as have others. My next course of action should be to call the corporate compliance hotline, but I am reluctant as I am not represented by a union and I work in a right-to-work state. What should I do?


Dear Donna replies:

Dear Reluctant,

What a frustrating situation! The allegations you make are serious and can compromise patient care and safety. If you are having this challenge, I have to assume other nurses are also. Therefore you might join forces and speak as a group to your immediate supervisor or unit/department director. You could be ready with some written documentation about specific incidents. You should keep detailed notes about what is happening, when and to whom you report the situation and what the response is.

Before using the corporate compliance hotline, and after having a serious heart-to-heart with your immediate supervisor with no progress, check with human resources to see if there is a procedure for mediation or resolution of an unresolved complaint. All employers should have this in place, and most do. This would likely be your next course of action.

Best wishes,

Donna Cardillo, RN, MA, well-known career guru, is Nurse.com’s “Dear Donna” and author of “Your First Year as a Nurse: Making the Transition from Total Novice to Successful Professional” and “The ULTIMATE Career Guide for Nurses: Practical Advice for Thriving at Every Stage of Your Career.” Information about the books is available at www.Nurse.com/CE/7010 and www.Nurse.com/CE/7250, respectively. To ask Donna your question, go to www.Nurse.com/Asktheexperts/Deardonna. Find a “Dear Donna” seminar near you: Call 800-866-0919 or visit http://Events.nursingspectrum.com/Seminar.