Nursing is a challenging profession in general. You are in a tough spot when a doctor, administrator, or co-worker asks you to do something potentially fraudulent or illegal. You want to follow orders, especially from a superior, and you may want to help a co-worker if possible, but some actions can lead to serious trouble.
We all understand that providing quality patient care is our number one priority. However, when a nurse is asked to do something fraudulent or potentially illegal, they could risk losing their job, being subject to administrative discipline, and losing their license to practice as a nurse.
Common Requests Nurses Receive That Can Lead to Trouble
Patient charting is one of the most common tasks nurses handle. Accurate patient charts are important for many reasons, including:
- Protecting the patient by documenting the care and medication they receive
- Tracking the timing of procedures and medication to ensure all services are provided as scheduled and avoid double-dosing or missed doses of meds
- Verifying which medical provider saw the patient and what happened during their time together
- Documenting the patient’s status at a certain time in case their care is questioned later
- Protecting healthcare providers facing accusations who may have to prove their actions to avoid malpractice claims or other legal entanglements
When a supervisor, doctor, or even a co-worker asks a nurse to change a patient’s chart, the nurse is put in a difficult position. Let’s look at a few possible scenarios and how you can handle these requests.
What to Do If You Are Asked to Enter Back-Dated Chart Information
Nurses are human and sometimes make mistakes like forgetting to check a box or make a chart entry. As a nurse, you might be requested to add dated or timed information to a patient’s chart after the fact.
If the details were inadvertently missed earlier, you can back chart the information, but you must clearly indicate that the entry is a back charting entry and state when the services or medications were actually administered but not placed in the chart.
If you add a late entry to a patient chart without admitting it is back charting and noting the correct date and time, it could be considered fraudulent charting. Don’t add a late entry without identifying it as such, and hope no one will notice it. That is fraud and could cause serious problems down the road.
What If Someone Asks You to Falsify a Chart Entry?
When things go wrong, and a patient is harmed, the first people who may be blamed are the healthcare providers. If there was a lapse in care, a doctor or co-worker may ask you to change the chart to cover the error. A hospital might also request actions to help protect the company from legal liability.
With electronic health records, it is possible to track when an entry is made and by whom. Since many electronic entries are date-stamped, it’s possible to see when information is added after the fact.
If someone else forgot to provide the care or meds and asks you to enter the data in the chart, your electronic signature may appear on the entry. Upon investigation, you could be held responsible for the fraudulent action.
The best way to handle this situation is to refuse to make the entry and notify an appropriate supervisor or facility administrator that you were asked to change a patient chart. Keep track of all details surrounding this tricky scenario in case you must defend your actions in the future.
You can also contact a dedicated nursing license defense attorney for more advice about how to protect your rights and your license when you are caught in this complicated situation.
Never Chart Actions You Didn’t Personally Do or Observe
Don’t do it if a superior or co-worker asks you to make a chart entry about a service you didn’t provide or witness. If you witnessed it, document who you saw do it. Although you may want to help a tired co-worker or harried doctor with their paperwork, you could open yourself up to fraud allegations and serious repercussions. The best policy is to only chart things you did or saw, regardless of who is asking for your help with their charting.
Other Professional Requests That Can Get a Nurse in Trouble
Beyond charting issues, a supervisor or co-worker may ask you to do certain things that amount to fraudulent or illegal behavior. While most nurses want to be helpful and easy to work with, they must always put the patient’s safety and sometimes their own career first.
For example, another nurse may forget to give a patient medication as scheduled. When they remember, they might ask you to administer the meds for them. Before agreeing to step in, you should check with a doctor or supervisor and clearly chart your actions.
What Can Happen If You Commit Fraud When Requested By Someone Else?
Committing a crime or acting fraudulently is never part of a job description. If you are fired for refusing to commit fraud, contact a nursing lawyer immediately.
Nurses who follow orders and commit fraud at the request of someone else also face these potential repercussions:
- Your employer may lose trust in you, reducing your chances for a raise or promotion
- Your actions could be grounds for firing, and you will most likely experience difficulty finding a new job
- You could face possible criminal charges
You’ll likely be investigated by the Board of Nursing and penalized. Potential outcomes include formal censure, license suspension, or license revocation, meaning you can’t work as a nurse again.
Turn to Nurse Attorney Lorie Brown if Someone Asks You to Commit Fraud or an Illegal Act as a Nurse
As a licensed registered nurse, Lorie Brown knows that nurses are sometimes placed in difficult situations through no fault of their own. When someone asks you to do something questionable at work, your license to practice nursing is at stake. You need solid legal advice from someone who has been in your shoes.
At the first sign of trouble, reach out to Lorie to learn more about your legal rights and what steps you can take to protect your license and your future. Call (317) 465-1065 or share your story through our confidential online contact form today.
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