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Is The Handwriting On The Wall?

October 10, 2019 by LORIE A BROWN, R.N., M.N., J.D. 2 Comments

I frequently have nurses come to me because they have been fired from their jobs and are afraid that they will be reported to the Board.  What’s interesting about these nurses is that almost all have said, “I knew I should have been looking for another job.”  If you feel the handwriting is on the wall, it is better to resign than get terminated.  On every job application, you will have to include that job on the application and include that you were terminated. You cannot simply omit a job because you were terminated.  And you must tell the truth.  If you do not put these jobs on an application or do not tell the truth about being terminated, its considered fraud and material misrepresentation in obtaining a position.

I always say you can get another job, but you can’t get another license.  Many nurses stay in the job because they feel a loyalty to their patients.  I can assure you, when there is a problem or complaint, your employer will have not have loyalty to you.

Many nurses stay in a position rather than leave because it is comfortable for them.  It is so much more difficult to go out and find another job.

I’ve represented 2 nurses around the same proximity in time.  One nurse worked at Hospital A and got terminated and went to Hospital B and said, “If I knew Hospital B was so much better, I would have left a long time ago.”  The other nurse said, who worked at Hospital B, got terminated from Hospital B and went to Hospital A, said the exact same thing.  “If I had known Hospital A was better, I would have left a long time ago.” It’s so interesting that 2 nurses each had very different experiences at the hospitals.

There is a place out that there which you love, you will fit, you will say “I wish I had come here a long time ago.”  If you’re struggling and see the handwriting on the wall, I am not telling you to quit your job but just think about it and make a decision.  Are you staying out of loyalty or comfort?  Could there be a better fit out there?  You won’t know until you try.

I would love to hear your comments below about how you handle difficult situations at work and what you would do if the handwriting is one the wall.

 

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Filed Under: Employment, License Protection, Newsletter, Workplace Issues Tagged With: board of nursing, find another job, fired, Fraud, job, license defense, license protection, Lorie Brown, material misrepresentation, nurse, nursing board, nursing license, patients, terminated

25 Nurses in Trouble with Ohio Board Due to Physician Overprescribing

July 25, 2019 by LORIE A BROWN, R.N., M.N., J.D. 2 Comments

In an Ohio hospital system, a physician, William Husel, D.O, is on trial for ordering excessive and fatal doses of fentanyl.  He has criminal charges pending against him and he recently pleaded not guilty to murder in 25 deaths.  This is the biggest case against an American healthcare professional.  (Story and Timeline).  The physician ordered potentially fatal doses for 29 patients who died over the past few years.  5 might have had a chance to improve their condition with proper treatment.  The defense claims that William Husel, D.O., was alleviating pain and providing comfort for dying patients.  However, the fentanyl was 20 times the normal dose which is excessive.  And no one questioned them.

Dr. Husel was working a critical, care intensivist at the hospital and he completed a fellowship in critical care but did not complete a required residency in internal medicine according to one source. 

Five (5) managers along with 18 nurses and pharmacists were fired while the CEO of this health system stepped down.  (Story).  No one ever questioned the excessive doses. 

Every nurse has a duty to question doses.  Twenty five (25) of these nurses were reported to the Board as well.  (Story).

What happened to Hippocratic Oath, physicians do no harm?

There have been several wrongful death lawsuits filed that have reached nearly $4,500,000 in settlement.  It is so sad that these families trusted their loved ones to receive appropriate health care but through this doctor’s actions, they were denied.

This case is just an example of the importance of speaking up due to medical malpractice concerns, loss of your job and being reported to the Board. It is now even more important than ever that nurses speak up when the care is not appropriate. 

Have you encountered any doctor like this?  What would you do?  I would love to hear your comments below.

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Filed Under: Employment, Newsletter, Workplace Issues Tagged With: board of nursing, criminal charges, fentanyl, murder, nurses, nursing board, Ohio, pharmacists, terminated, William Husel

Does Your Facility Have Your Back?

May 30, 2019 by LORIE A BROWN, R.N., M.N., J.D. 2 Comments

I’m sure you’ve read in the media or on my blog about Nurse RaDonda Vaught who has been charged with reckless homicide for an inadvertent medication error.

In a news article released by hospitalwatchdog.org, they described what Vanderbilt University Medical Center (VUMC) did not do that could have prevented this tragic incident.

Whenever the Centers for Medicare & Medicaid Services investigates, they prepare a deficiency report.  When a deficiency report is received by a facility, they must respond to the deficiencies and offer a plan of correction to remedy the deficiencies.

“The real issue in this case is that there were no effective systems in place to prevent or detect the accidental selection, removal, and administration of a neuromuscular blocker that had been obtained via override.”

As in the past, I am in no way saying that Nurse Vaught’s actions were proper.  My position is that this is a medical malpractice rather than a criminal matter!  However, VUMC did not have her back and fired her rather than fix the system issues that contributed to this error.

Once CMS investigated, VUMC had to put systems in place to prevent these types of problems.  In VUMC’s Plan of Correction, the facility has agreed to:

1.         Take vecuronium off override.  Had vecuronium been taken off override, Nurse Vaught would never have been able to access this medication.

2.         Implement bar coding verification in the radiology department.  Like most areas, if one takes a medication out of the Pyxis or the med cart and gives it to a patient, the medication’s barcode is scanned.  This ensures that the patient is receiving the correct medication.  In this situation, if Nurse Vaught would have been able to scan the patient’s wrist band, it would have alerted her that this was not an ordered medication for this patient.

3.         Implement the second nurse verification in the radiology department.  Having a second nurse review and verify the accuracy of the order and the medication, this would have prevented the death of Charlene Murphy.

4.         Require a nurse to enter “PARA” in the automatic dispensing cabinet (ADC).  In order to obtain a paralytic drug from the ADC, a nurse must first type in the letters P-A-R-A.  This too would have prevented Ms. Murphy’s death.

5.         Implement policies that did not previously exist for monitoring high risk medications such as versed or vecuronium.  It is surprising that prior to the incident with Ms. Murphy, VUMC did not have policies and procedures to monitor such dangerous medicines.  They now do.

The article goes on to question whether the District Attorney (DA) has a conflict of interest because the DA, Glenn Funk, has multiple, personal and professional relationships with Vanderbilt University.  He is an Adjunct Professor at the Vanderbilt School of Law, served on the Vanderbilt Kennedy Center Leadership Council and he and his wife are members of the Next Step Advisory Council at the Special Education Department at Vanderbilt’s Peabody College.

Criminal prosecution will not provide safer medicine.  It is a system issue that needs to be addressed.

It should go without saying that Vanderbilt and VUMC attempted to cover up this tragedy and the Murphy family did not even know of the situation for almost a year after the incident.  My heart goes out to Ms. Murphy’s family, to RaDonda Vaught and to all of the nurses who everyday put their health, their lives, their well-being on the line in the service of others.

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Filed Under: Employment, License Protection, Newsletter, Workplace Issues Tagged With: criminal charges, medical malpractice, medication error, nurse, nursing, RaDonda Vaught, reckless homicide, terminated

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