Part One of this series covered the issue of when to blow the whistle. This post will cover how you might go about exposing a problem. (Click here to read part one.)
As nurses, we may be faced with situations in which a coworker or a superior is doing something that is wrong, unethical, or unsafe. These situations can make us feel helpless especially when we do not want to cause trouble for other people. So what do we do? How do we intervene to protect our patients, other coworkers, our facility, even ourselves?
Is it a reportable problem?
As nurses, we sometimes see things that we may not agree with. Just because we don’t agree with a work policy doesn’t mean it’s wrong. You may need to do some research to find out what other facilities do, or speak with someone from your licensing board, to see how your situation compares.
If you feel that the situation is serious and should be taken care of, then – unless it is an extreme emergency – there are certain steps that should be followed to resolve the issue early and fast.
Just as charting is your best friend in protecting you against any legal action regarding patient care, you must have an accurate record of issues you feel are dangerous or unethical. These records should include dates and as many details as possible, including names of other people who were present and who may have heard or seen the reported event. Ask yourself, is this information verifiable?
Safety in numbers
There is safety in numbers. Hospital Administration may be more likely to respond to an issue if other coworkers feel the same way you do. Compare notes with your coworkers, discuss what the problem is and present the concern as a group.
Speak to a superior
Although this may bring back feelings of “tattling” if the issue is with a coworker, speaking to a charge nurse, head nurse, or supervisor brings the problem to someone else’s attention. It may be an uncomfortable feeling to do this, but if no one brings bad behavior to the attention of a superior, how will it ever be discovered and corrected?
If the issue is with a colleague, such as a physician or allied health care professional, and they have not been responsive to your concerns, then your superior is the next person who should be contacted.
Consult your licensing board
Nurses who observe issues that negatively affect patient care are required to intervene. This is often written into state law and is part of each state’s Nursing Act and can be called “good faith” reporting. Your nursing board or association is there to help you. In 2009, the Texas Nurses Association did just that. They provided support for two nurses who had been unjustly fired after speaking out about unsafe practices.
Call your nursing board to speak to someone about your concerns and ask them to advise you. You may be surprised to learn that you are not the only nurse calling with that particular concern. If you are worried about retribution, you should request to speak your nursing board representative confidentially. The New York State Nurses Association has a brochure that discusses various types of complaints and contact information to make reports.
Check your facility for an anonymous reporting program
Understanding that it can be difficult to file a report against a coworker or superior, the administration at your facility may have set up an anonymous reporting line. Although you may only have observed one incident, it may not have been an isolated case. If everyone who reports dangerous or unethical incidents, the administrators may see a pattern with a particular individual or department.
Anonymous reports can be more difficult to investigate than named reports. If you go this route, the more information you can provide, the better the administration will be able to address the problem.
Go up the chain
Standing up and speaking out, being a whistle blower, can be difficult professionally and personally. If you feel that the other options discussed here are not open to you, you may need to go up the chain, so to speak. If your superior does not act on your complaints, you may need to go to the next level of administration, and so on until you get to the top.
Many states have instituted whistle-blowing protection policies for people who are speaking out and trying to help make things right. Your best protection is to ensure you have your facts straight and that your records are as accurate as possible. Unfortunately, you may need to be prepared to look for other work if you feel you have been placed in a difficult situation.
As nurses, we are in a unique position. We see things that no one else may see and we have the legal and ethical responsibility to make sure our patients are safe and cared for in the best possible manner. Sometimes, this means we have to speak out. And the more of us who speak out, the better the health care environment will become, because unsafe or unethical behavior will not be tolerated.
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