Don't Handle Nursing Investigation Alone
Seemingly innocent statements may backfire
If an ED nurse is contacted by the state board of nursing about a medication error that harmed a patient, his or her first instinct might be to state, "I told them this would happen because we didn't have enough staff!"
"An opposing attorney will turn that back around into, 'Well, if you knew it was unsafe, what else did you do to prevent it?'" says Karen Jarboe, RN, CEN, CCRN, a legal nurse consultant specializing in emergency medicine and a senior clinical nurse with the adult ED at University of Maryland Medical Center in Baltimore.
Any complaint from a patient or family member could result in an ED nurse becoming the subject of an investigation by the state board of nursing, adds Jarboe, and in this case, the first step should be to contact an attorney.
"Don't let anyone talk you into representing yourself," she warns. "Your license is your livelihood, and trying to represent yourself could backfire." She gives these recommendations:
ED nurses should retain a nurse attorney or one who specializes in administrative law.
"Remember, the role of the state nursing board is to protect the public," she says. "They do not advocate for the best interest of the nurse."
ED nurses should not discuss the issues with anyone except their attorney.
"Refer any phone calls to your attorney, including phone calls from the investigator," says Jarboe. "Speaking or responding in writing on your own can be detrimental to your case."
ED nurses should never post anything about the investigation on a blog or other website, as many nursing boards monitor these sites.
"Be careful with social networking sites they're not as private as you think," says Jarboe. "Many privacy settings can be easily overridden by an IT person."
An opposing attorney will use information about activities outside work to raise doubts about your values, beliefs, and character. "Some of those fun shots from a night of drinking and dancing on the bar end up being very detrimental," she says.
In addition, many ED nurses post comments throughout the day about their shift. "While this may seem innocent at the time, using code words or room numbers to describe your patient, as well as posting pictures from your nursing unit, can easily turn into a [Health Insurance Portability and Accountability Act] violation," says Jarboe.
In one case on which Jarboe consulted, an ED nurse commented on Twitter about a patient's HIV status. "A friend of the family saw the post and filed a claim. The nurse was immediately terminated," she says.
In another case, an ED nurse posted a photograph of a group of staff members while working, with a tracking board listing patient names visible in the background. "A coworker reported it, and was able to enhance the photo so 11 patient names were clearly visible," says Jarboe. "All nurses in the photo received disciplinary action."
ED nurses should be truthful.
It's a mistake to try to lie your way out of the situation during an investigation. "Attorneys are very good at asking the same question 10 different ways. If you lie, you will never have the same response," says Jarboe. "Truthful answers will be consistent no matter how many times the question is asked."
ED nurses should not keep personal notes about an incident or the investigation.
The notes you keep are discoverable, says Jarboe, and you will find yourself trying to explain why you knew a particular incident was going to be a problem.
"Let your attorney do the documenting and keep notes. His or her notes are attorney-client privileged," she says.
ED nurses should never take home medical records or copies of medical records.
Medical records are considered to be hospital property and confidential patient information. "Not only will you be the subject of an internal investigation, you will quickly find yourself facing criminal charges," says Jarboe.
Source
For more information, contact:
Karen Jarboe, RN, CEN, CCRN, Adult Emergency Department, University of Maryland Medical Center, Baltimore. Phone: (717) 993-6872. E-mail: kjarboe65@gmail.com.