Justin Tyme - a registered nurse - joins the unit after successfully completing new employee and unit orientation. He had worked for 10 years in a similar unit at St. Elsewhere but grew tired of the 2 hour daily commute. He is thrilled to be working closer to home. The staff is ecstatic as the unit has been short-handed and the census high.
The staff likes working with Justin. He is a friendly fellow and frequently brings hot donuts and a huge thermos of Peets coffee for the staff. He is always willing to help with lifting and turning patients and often is the first one to respond to patient lights.
Justin does not always follow through on his observations and physician orders; he often misses giving routine meds. The staff has taken to routinely double-checking Justin's orders and the following shift often dispenses the missed meds.
One morning, Dr. Tauk comes in to review the speech consult he ordered the day before on his patient, Mrs. Dee Phagia, prior to ordering her a diet. Dr. Tauk cannot find the consult asks Charity N. Able, RN, to locate it and call him. Charity discovers that the order had never been placed. On follow-up, Charity discovers - not to her surprise - that Justin was the nurse who noted the order. Charity does not talk to the manager but does point out the error to Justin who feels terrible about it.
Over the next month, Justin continues to make intermittent "small" mistakes which cause no harm to patients; and the staff continues to cover.
Today, Dr. L. Ovin comes in and notices that her patient, Mr. Hart, is in atrial fibrilliation. She orders stat IV digoxin and cancels scheduled diagnostic procedures. Mr. Hart remains in atrial fib and, as you review his chart, you discover that Justin missed the last two routine digoxin doses.
What do you do now?
Found at: http://www.scu.edu/ethics/dialogue/candc/cases/covered.html
At this point, I believe that Justin should be reported to the state. There have been too many careless mistakes that have caused problems for other health professionals and/or patients. Justin may be a nice person and he may be very willing to help, but because he is constantly forgetting to do routine tasks I believe the he needs some sort or remedial training so that he can provide the adequate care to patients. Reporting him to the state will notify the proper authorities and will make sure that he gets the appropriate punishment.
ReplyDeleteReporting Justin seems like the best option at this point. I just wonder if maybe some extra training could help Justin and maybe he could continue his job here after he completes that training. Because Justin is such a good person, does he deserve less punishment than maybe someone who did the same stuff but was a mean person?
DeleteI would report Justin's mistake first to Dr. Ovin so that his patient may receive the treatment and procedures needed. Next, I will report Justin to the hospital's legal/HR department(s). I then will report him to the state. I have to believe that by now, after over ten years as an RN, his forgetfulness has turned into a habit, and he needs to be re-trained. The state also needs to know so that they can investigate and make sure that his negligence hasn't caused further harm to anyone.
ReplyDeleteI agree with this because his mistakes should be reported to all levels of power which this pertains to. I also would speak to Justin himself because simply bringing coffee and doughnuts to work everyday doesn't make up for having to keep rechecking his work to make sure everything was done correctly.
DeleteAs a doctor who has had issues with Justin before, I would report him to the committee or board of directors that is ultimately in charge. Even though his past mistakes haven't affected the patients' health, who knows what will happen next. Before reporting him, I would sit down and have a talk with Justin about what has been going on. It seems that everyone likes him, but I bet most everybody is getting tired of picking up his slack.
ReplyDeleteI am not sure how harsh the punishment should be, is the board of directors the people who should be informed first when the heads of the department haven't been told? I am not sure if this is as serious of a situation. At the same time, I do not know that this is not the first time that Justin had missed or make a mistake so something should happen but maybe some thought should be made into the severity of the punishment.
Deleteat this time, I believe they he should be reported and placed under review. however, in reading this it only stated once that he was confronted about the situation, maybe if he was frequently reminded that he is making mistakes, he could change. though, he should be able to hold his own in the office.
ReplyDeleteI do agree with he should be reported. But, I do believe that they should start by going to Dr. Ovin. Then if Justin still keeps forgetting they could go to the higher authorities. I also agree that Justin could've been reminded more than just once.
DeleteIt seems that Justin has been making consistent mistakes with his work, and so far it has been swept under the carpet with no consequences for Justin. Because it seems that Justin feels terribly about his mistakes, I do not think he is doing anything on purpose, but in the end, these mistakes need reported. Even though he is the most well-liked person, that doesn't cover the fact that he is bad at his job. I feel that Justin should have to go back and do more training and receive some sort of punishment for these mistakes. While it might be hard for the staff to turn him in, it needs to be done. Especially after that last mistake, that one definitely cannot go unnoticed.
ReplyDeleteJustin really needs to be given some kind of training on writting orders and maybe that will help to make him stop forgetting. At this point I think a boss or head person should forsure be told because it has gotten to the point where he is putting patients in danger. I believe that the double check was a way to make sure that each patient is taken care of but I aslo think it was a way to make sure that Justin's work was double checked. When it should have been adressed earlier to completely bypass this point and energy to punish him now after so long.
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