All Entries Tagged With: "disruptive behavior"
Nurses targeted after anonymous complaint about physician
Two registered nurses from Winkler County Memorial Hospital in Kermit, TX are being prosecuted for reporting complaints to the Texas Medical board about a physician’s standard of practice, according to the local CBS affiliate.
The American Nurses Association (ANA) has joined the Texas Nurses Association (TNA) to criticize the state’s response. Both associations worry about the precedent the action sets for future nurse whistle blowers who advocate for patient safety. An initial hearing on the nurses’ motions to dismiss the case was held July 15 but no ruling was made.
The nurses sent an anonymous letter to the Texas Medical Board. The Winkler County Sheriff’s Department then received a harassment complaint from the physician, and initiated the investigation that resulted in criminal charges. The Texas Medical Board has notified the sheriff’s department that the complaints were confidential and not subject to subpoena. TNA has set up a fund for the nurses’ legal fees.
What do you think of this case, will it hold?
Physician buy-in can work wonders for EHR implementation
If your hospital is struggling to get its electronic health record (EHR) off the ground, you might want to take a look at the role your physicians are playing in its success (or lack thereof). This article from my colleague Lisa Eramo from HealthLeaders Media explains how physician participation with and support of an electronic health record can really make or break a hospital’s foray into health information technology.
However, with new government requirements, EHR is no longer a nice to have, but a must have in the coming years. Those hospitals without some sort of EHR are losing out on incentive money from the American Recovery and Reimbursement Act. Whether they like it or not, physicians are going to have to be using some form of EHR in the near future.
The Health Information Management and Systems Society created its HIMSS EMR Analytics Model in 2005 to delineate the stages of EHR adoption. Eramo says in her article that many hospitals struggle with step #5, which says the EHR will have an effect on patient safety, and more specifically by closing the loop on medication administration. This is most likely because it involves communication from various caregivers- physicians, pharmacists, and nurses.
Culture of safety issue apparent with sleepy surgeon
The Massachusetts Department of Public Health has reported that a surgeon at Beth Israel Deaconess Medical Center in Boston, MA nodded off during surgery in June 2008. The patient involved sued the team of doctors working on him, as well as some nurses, and has already settled out of court. You can read the details of the day in this Boston Globe article, but what struck me most about the story was how many times the nurse involved in the case tried to get the surgeon’s attention and suggest that he take a break; she even called the plastic surgery department (the department in which the doctor worked). However, according to the report, the surgeon left inexplicably later on that day, without the influence of a more senior staff member.
Sine the incident, the hospital has educated all nurse managers about the proper protocol for handling staff members who might not be performing at the top level (as was the case in this instance). The vice president for quality at the hospital says that protocol for handling a disruptive and/or impaired staff member is to call a supervisor for resolution.
What has been your own experience in this area? Have you ever felt that you needed to speak to a fellow staff member’s supervisor to ensure that patients received the safest care available during their hospital stay? This incident is certainly not isolated and represents how difficult it can be to speak up about a disruptive staff member, an impaired staff member, or perhaps a sleepy staff member. Have you received training or education on this topic? Building a solid culture of safety takes time and support from the highest levels of the hospital. This instance shows that even for a hospital that is actively addressing culture of safety issues, there is still room for improvement.
