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Do I have recourse after being terminated for pointing out the use of expired medications and medical equipment versus "not being a good fit"?

Wednesday September 11, 2013
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Question:

Dear Nancy,

I took a position in April 2012 in a small private practice women's health OB clinic. I was the first RN on staff. I found out quickly that the practice was dispensing expired sample medicines and using expired LEEP wires, formalin, catheters, etc. I began a campaign to remove these things from being dispensed to patients. On my own time, I documented every single expired item dispensed in emails to my office manager, as the senior MD partner.

I was terminated for "not a good fit in their environment" in July 2012. They simply stated that I was too black and white about things, and this did not fit with their laid-back style. I really thought I was doing my job as it is stated in my job description.

They also have one LPN and a few CMAs and a CNA on staff, who do telephone triage, assess patients, prescribe medicines, etc. This is all done without standing orders and no policies or procedures in place.

I feel that I was unfairly terminated and what they are doing is completely illegal and dangerous. Do I have any recourse? I would not want my job back as it would be very uncomfortable environment, but now I have to find another position and explain a termination.


Judith



Dear Nancy replies:

Dear Judith,

The clinic in which you worked for a short period of time is functioning in a way that puts patients at risk and is breaking established standards of practice. The conduct is also unethical. In addition, there may be false billing for the use of outdated medication samples and re-used equipment, especially if the patients had private insurance or were covered under Medicare/Medicaid.

Your termination needs to be evaluated by a nurse attorney or attorney in your state who can decide whether or not it was a "retaliatory" dismissal rather than one based on you "not being a good fit. Although you weren't a "good fit" because you spoke against practices that are not acceptable, the most likely reason they didn't want you there was because you did not turn your head to their modes of practice. Be sure to take your job description with you when you meet with the attorney.

The attorney you consult also will discuss the scope of practice issues of the LPN and the unlicensed, assistive personnel. As you know, an LPN's practice is a dependent one and must work under the direction of an RN or another healthcare provider. Standing orders for medications are a must for an LPN as well as an RN if the latter is not an advanced practice nurse or prescriptive authority is granted to the LPN or RN. If your attorney so recommends, reporting these individuals to the board of nursing and/or other regulatory agency that enforces their respective practices (many CNAs, for example, are not regulated under the state nurse practice act) will be another option for you.

You should feel good about your attempts to speak out against practices that are unethical and not consistent with good nursing practice.


Cordially,
Nancy




Nancy J. Brent, RN, MS, JD, is an attorney in private practice in Wilmette, Ill. This information is for educational purposes only and is not intended as legal or any other advice. The reader is encouraged to seek the advice of an attorney or other professional when an opinion is needed.