Why physicians should care about Amanda Trujillo
From: KevinMD.com - 6:31am - February 25, 2012For the past month, the case of Amanda Trujillo has resonated deeply among nurses, triggering an avalanche of postings on Facebook, Twitter and in the nursing blogosphere. Trujillo is the Arizona nurse who was fired in April 2011 after providing education and making a hospice care consult request for an end-stage liver disease patient. This patient [...]
Saturday, February 25, 2012
Why physicians should care about Amanda Trujillo - Pharma - eWallstreeter @jaydoe #nurseup
Why physicians should care about Amanda Trujillo | News for Dallas, Texas @jaydoe | Dallas Morning News
Kevin, M.D.Why physicians should care about Amanda Trujillo
Many physicians might sympathize with Trujillo’s arbitrary firing, or see in her case a reflection of their own professional concerns about the role of large health corporations in their day-to-day practice. But for me, as a nurse, the issue boils down... Full Article at Kevin, M.D.
Why physicians should care about Amanda Trujillo-KevinMD @jaydoe #rn #nurseup #mdchat #rnchat #s4pm #nursefriendly #amandatrujillo
For the past month, the case of Amanda Trujillo has resonated deeply among nurses, triggering an avalanche of postings on Facebook, Twitter and in the nursing blogosphere. Trujillo is the Arizona nurse who was fired in April 2011 after providing education and making a hospice care consult request for an end-stage liver disease patient. This patient was slotted for pre-transplant evaluation and had poor understanding of the disease process and treatment options. Trujillo filled in the gaps for this patient. Trujillo then requested, at the patient’s own wish, a hospice team consult, documented her actions appropriately, and left a note (it was night shift) for the primary physician.
These actions — the education and the hospice team consult — drew the wrath of both the primary physician, who demanded her dismissal and her license, and also her nursing director, who told Trujillo she had ”messed up all the doctors’ hard work and planning for the surgery.” The patient-requested hospice care consult was cancelled. Trujillo’s employer subsequently fired her, and reported her to the Arizona State Board of Nursing for exceeding nursing scope of practice, though in fact, nurses previously had ordered a hospice care consult without consequence. In short, many nurses believe Trujillo was fired for educating and advocating for her patient.
These are the bare bones of the story. Further details can be found on WhiteCoat’s Call Room and on Nurse Up for Amanda Trujillo. The debate among nurses — sometimes heated — has common themes around the limits of nursing practice, the meaning of nursing advocacy, and how nurses in trouble are left high and dry by the professional organizations that purport to represent them. Well and good. But why should physicians care?
via kevinmd.com
Thank you Jay Doe RN, for the great article.
Thank you Dr. Pho for raising awareness of this issue.
Original url:
http://www.kevinmd.com/blog/2012/02/physicians-care-amanda-trujillo.html
For more information, please visit http://www.nurseup.com
Sincerely,
Andrew Lopez, RN
Nursefriendly, Inc. A New Jersey Corporation.
38 Tattersall Drive, Mantua New Jersey 08051
http://www.nursefriendly.com info@nursefriendly.com ICQ #6116137
856-415-9617, (fax) 415-9618
Wednesday, February 22, 2012
Andrew Lopez, RN, Really is Nurse Friendly | Notes from the Nurses' Station, @rncentral @jolin2 #nursefriendly #nurseup
February 22nd, 2012
By Jennifer Olin, BSN, RN
I first met Andrew Lopez, RN, when the Amanda Trujillo story broke out in Arizona. He was one of the first nurse bloggers to run with the story on Facebook and Twitter. In short order, a group of nurse-writers gathered together on line and adopted Trujillo’s fight as their own. I don’t think anyone in that group would disagree that Lopez is one of the ringleaders of this band of RNs out to right Trujillo’s wrong and hopefully bring some changes to nursing: how we see ourselves, how we are seen and how our professional organizations represent and stand up for us.
Andrew, you have been so passionate about Amanda’s case since the first minute anyone heard about it, and you continue to stay at the forefront of the effort to help her…why is this so important to you?
”With Amanda, I continue to help because I'm in a position where I can. Am I a ringleader because I'm around, because I contribute my time, efforts? If that qualifies me, then yes, I'll accept the role.
”Amanda is in a difficult spot. She is there because she advocated for a patient and the doctor didn't like it. He decided to destroy her career, he was so upset. Her employer, Banner Del E. Webb Medical Center went right along with it. They even filed the charges with the Arizona State Board of Nursing, as the doctor requested. Amanda, for the first ten months of her ordeal, had no support.
”Her situation is wrong on so many levels. It is something I've seen repeatedly in my Nursing career and often felt powerless to do anything about. It is empowering to be able to act on Amanda's behalf and have a group of like-minded nurses with the same mission. Together we can do some serious damage to the powers that be. It is almost worth the risks that we each take by getting involved.
”Since we received her initial call for help, we've had a consistent stream of dedicated, enthusiastic and supportive nurses willing to help. It is a very good feeling to be fighting for something you believe in. It is one thing to "Save the Whales" it is another to fight a war that can significantly improve not just one nurse’s life, but hundreds, thousands, tens of thousands.”
We’ve established you are a revolutionary, rabble-rouser and ringleader….how did you get here? Tell me about becoming a nurse.
”From the beginning I was attracted to the health sciences. I liked biology, psychology, wanted to be in a helping profession. Went to school to be a laboratory technician, got a four-year degree in it. While doing clinicals I found my favorite part of the day was the patient contact I had at 5 a.m. every day drawing labs. While I was doing phlebotomy, got to see and talk to the nurses on the floors. I saw what they were doing and caught the nursing bug.
”Nursing school was two years including pre-requisites. The hospital where I was working had a school of nursing on site. I could work, go to school, and live in the dorms, it was perfect for me. I signed up for an accelerated program using my laboratory degree credits and was a nurse inside of two years. I’ve been a nurse for 14 years now.”
via rncentral.com
Please click on the "VIA" link to read the full article.
Thank you so much to Jennifer Olin, BSN RN for the opportunity to interview.
I support Amanda Trujillo, RN - For more information, please visit http://www.nurseup.com
Sincerely,
Andrew Lopez, RN
Nursefriendly, Inc. A New Jersey Corporation.
38 Tattersall Drive, Mantua New Jersey 08051
http://www.nursefriendly.com info@nursefriendly.com ICQ #6116137
856-415-9617, (fax) 415-9618
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Monday, February 20, 2012
In the Footsteps of Rosa Parks | Nurse Up! Terri Polick, RN @motherjonesrn, #nurseup #amandatrujillo
In the Footsteps of Rosa Parks
February 20, 2012 in Amanda TrujilloEdit this entry
“You must never be fearful about what you are doing when it is right.” Rosa Parks.
Nurse K, the proprietor of Crass-Pollination: An ER Blog just wrote a post about the Amanda Trujillo case. She and I have very different opinions about Amanda’s case, but I encourage you to read her post because she reflects the opinion of many nurses about Amanda’s situation.
Nurse K gives an accurate blow by blow description on how corporate nurse leaders wage war against their nursing staff. She explains how nurse managers orchestrate the demise of nursing careers. Make management angry and you get the axe, and there isn’t a nurse alive that hasn’t witnessed or experienced the wrath of hospital management.
Nurses scatter and go underground when someone gets in trouble, and conventional wisdom states that a nurse should be contrite and take their punishment when they are abused by those who hold power. Many people are wondering why Amanda didn’t follow the same path. Some, like Nurse K, are suggesting that Amanda is committing career suicide. Other’s have told Amanda to “shut up.” The American Nurses Association and the Arizona Nurses Association won’t support an individual nurse who is “under investigation.” Egregious comments and actions are coming from the Arizona Board of Nursing. Kim McAllister from Emergiblog writes about the board’s actions here.Rosa Parks made history when she refused to move to the back of the bus and she was persecuted for her actions. She wasn’t trying to start a movement when she refused to move. She said that she was tired and just trying to get home. Amanda Trujillo wasn’t trying to start a movement either. All she did was write to fellow nurse Echo Heron about being fired from Banner Del E. Webb Medical Center, and her situation with the Arizona BON. Echo passed the letter on to Vernon Dutton and from there her letter went viral. Now Amanda is being persecuted for her actions. A lot of people have asked me why the Amanda Trujillo case resinates with nurses. It’s because nurses are tired of being treated like second class citizens. Nurses have few rights and little protection in the workplace. We are abused and bullied by nurse executives who cherish corporate profits. Frankly, we’re tired of being told to go to the back of the healthcare bus. And God help the nurse who says no, they aren’t moving. He or she is ridiculed, fired, dragged before the state board of nursing and threatened with the loss of their nursing license. Now, with the support of others, Amanda is fighting back. She’s isn’t doing this for herself, she fighting for our patients and the nursing profession. Great changes begin with one person.
Rosa Parks said that you must never be fearful about what you are doing when it is right. Amanda is doing the right thing and she will win, and by doing so, we will all win in the end.
via nurseup.com
Thank you Terri Polick, RN @motherjonesrn for your support and moving post regarding Amanda Trujllo :)
For more information, please visit:
http://www.nurseup.com
--
Sincerely,
Andrew Lopez, RN
Nursefriendly, Inc. A New Jersey Corporation.
38 Tattersall Drive, Mantua New Jersey 08051
http://www.nursefriendly.com info@nursefriendly.com ICQ #6116137
856-415-9617, (fax) 415-9618
Sunday, February 19, 2012
Nurse Abused by Banner Health | Flickr - Photo Sharing! @nursingpins #nurseup #amandatrujillo #nursefriendly
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Nurse Abused by Banner Health
Nurse Up for Amanda Trujillo (Support for Amanda on Facebook)
www.facebook.com/NurseUpforAmandaTrujillo(Amanda's Story) vdutton.posterous.com/94287821
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Thank you Vernon for all your support in the Amanda Trujillo case :)
Andrew Lopez, RN
www.nurseup.com
via flickr.com
The Nurse and The Golden Goose - Guest Post by Carol Gino RN, @icoachnurses @hopefulhealer
The Nurse and The Golden Goose
- Guest Post by Carol Gino, Nurse and #1 New York Times Bestselling Author
When I was working the night shift, one of my patients- a 44 year old man, had just gone for an angiogram. He had been brought back to the floor afterwards, but began hemorrhaging from his femoral artery. I’d added pressure dressings, laid on heavier sandbags, and then called the intern.
The intern took a while to get to the floor and all the while the patient kept bleeding heavily. When the intern just shook his head and did nothing, I called his resident. When the resident didn’t respond, I called the attending. Now I knew I was in big trouble. It didn’t matter that the patient’s blood pressure was 60/40 by the time I called, it mattered that I had broken protocol.
Because I knew this Directress of Nursing was good and fair, when she called me into her office, I decided to try to listen to her with an open mind, even though the whole thing made no sense to me.
She was sitting at her big oak desk and she hardly looked up as she waved her hand, indicating that I should sit in the chair across from her.
“You’re a good nurse,” she said, “that’s not the problem.” She smiled just a bit when she added, “I’m even beginning to believe that you’re a good person.” She looked straight at me when she added, “But you’re difficult to deal with. You’re headstrong – a lot for a supervisor to handle. Though you’re supposed to be part of a team, you often make independent decisions that I have to be responsible for.”
“No one else was available. That patient almost bled out and not one of those doctors paid any real attention,” I said. “And how often have I been wrong?” I asked.
“That’s not the point,” she said, her voice soft, patient. “So far you’ve been right. But what if we let every smart young nurse make independent decisions-how well would that work for the organization, for the business of medicine? Who will be liable?”
“So what am I supposed to do?” I asked defensively. “Stand by and let the patient die until I get an okay?”
She stiffened. Her voice was steely when she spoke now. “That’s one alternative,” she said. “The other is to go back to school and get more education. Get enough degrees that you can run your own show and take your own responsibility.”
When she saw I was really listening, she added, “You’re not going to do anybody much good if you behave in a way that gets you fired.”
So I went back to school and got more degrees, as many other women and men have done, based on the promise of nursing in an evolving health care system. We, as nurses, understood the value of education for autonomy, and knew what we needed to do as professionals. In other words, we grew up.
But today, thirty years later with many more nurses with degrees, have any of the organizations, who are supposed to back us, grown into “professional organizations” that can support us?
Are we paid as independent professionals who’ve been trained to think, consider treatments, help patients and their family through the difficulties of life and death, if necessary?
Have doctors suddenly begun to treat us like colleagues, with any real understanding of what a better education has done to change our role and the way we can work together?
Has the business of medicine stopped stacking us with the bedpans and the gauze pads as part of their budget so that we can’t be “cut” whenever they have a budget shortage?
And while– for budgetary reasons –they are even considering putting us in the place of primary caregivers because there are fewer doctors who are willing to work for the wages the corporations (that we now call healthcare) are willing to pay, who has our back?
Nurses have gotten better educations, they’ve grown up. They’ve done their part.
But what about the rest of Healthcare?
Are they going to grow up too and let the patients know how important nurses are to their well-being? Are they going to pay us and treat us with the respect we deserve?
Or is the business of medicine going to watch the mass exodus of the smartest and best nurses as they hit the road for a profession that offers respect for work well done, autonomy to go with responsibility, decent pay without intimidation, and most of all for caring for what happens to another?
If not, if they stay stuck, what happens to the patients? All those mothers, fathers, husbands and wives, all the sick children and new babies to whom life deals a tragic blow and who depend on us to keep them safe and advocate for them? Who will be there to observe, educate, nurture, comfort, call, soothe and help them through the hardest times? Who?
To Congress and to the Business of Healthcare I say:
“This is not the Golden Goose, it is the Golden Calf. Beware.”
aRead More
via icoachnurses.com
To visit Anna Morrison's site, please click on the via link.
--
Sincerely,
Andrew Lopez, RN
Nursefriendly, Inc. A New Jersey Corporation.
38 Tattersall Drive, Mantua New Jersey 08051
http://www.nursefriendly.com info@nursefriendly.com ICQ #6116137
856-415-9617, (fax) 415-9618
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Saturday, February 18, 2012
The Winkler County Nurse Trial, An Alleged Massive Conflict of Interest, and Morgellons : The Questionable Authority #nurseup
The Winkler County Nurse Trial, An Alleged Massive Conflict of Interest, and Morgellons
Category: Medicine
Posted on: February 9, 2010 10:32 PM, by Mike DunfordAs some of you might know, there is a very scary criminal case currently underway out in West Texas. A registered nurse named Anne Mitchell is currently standing trial. She's been charged with misuse of official information, which is a felony carrying a 10-year maximum sentence. She allegedly committed this crime by sending a complaint to the State Medical Board, because she was concerned about what she believed to be a pattern of sub-standard care and ethics on the part of Dr. Rolando Arafiles, a physician at the hospital where she worked.
Dr. Arafiles, according to the complaint filed by Mitchell and a colleague, engaged in a wide range of questionable activities. Even though he did not have surgical privileges at the hospital, he performed a skin graft in the emergency room. (The graft failed.) He sutured a rubber cap to a patients crushed finger to help protect it (yes, that's about as nutty as it sounds). He also repeatedly attempted to get patients to purchase - from him - various herbal remedies.
If you want to see the good Doctor at his questionable best, I just found (via a comment at another blog) some YouTube clips of an appearance that he did for something called "God's Learning Channel", which appears to be some kind of local access program. In this program, Arafiles is discussing Morgellon's - a condition which most physicians believe is nothing more than delusional parasitosis. Dr. Arafiles does not seem to share their view:
via scienceblogs.com
--
Sincerely,
Andrew Lopez, RN
Nursefriendly, Inc. A New Jersey Corporation.
38 Tattersall Drive, Mantua New Jersey 08051
http://www.nursefriendly.com info@nursefriendly.com ICQ #6116137
856-415-9617, (fax) 415-9618
Visit our network of sites. Over 150,000 + Nurse Selected, Approved Nursing & Healthcare Resources:
For Health Information you can use, Follow, Connect, Like us on Facebook, Google +, LinkedIN, Twitter, StumbleUpon (Most Invites Accepted):
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http://www.4nursing.com
InspirationalNursing.com:"InspirationalNursing.com. Touching Poems, and Inspiring stories that touch the heart and occasionally bring a tear to your eye. Affection, Ambition, Angels In Our Lives, Animals, Babies, Bereavement, Caring, Caring, Children, Christian Stories, Christmas, Computers & The Internet, Death, Dependability, Determination, Dying, Easter, Emergency Medical Services (EMS), End of Life, Etc., Friendship, God's Creatures, Grief, Holiday Thoughts, Honesty, Hospice Poems, etc."
http://www.inspirationalnursing.com
Jocularity.com (Former home to the Journal of Nursing Jocularity (JNJ)):"Nursing & Medical Humor. Find hundreds of jokes and links to sites that will make you smile. Therapeutic Humor Associations, Battle of the Sexes, Bedside Nursing Humor, Brain Teasers, Clowning, Clowns, Therapeutic Humor & Comedy Links, Dental Humor, Emergency Department Humor, General Nursing Humor, Geriatrics, Senior Citizen, etc."
http://www.jocularity.com
Legalnursingconsultant.com:"This website is intended to be a resource for Legal Nurse Consultants, Attorneys looking to use their services, and nurses looking to enter the field of Legal Nurse Consulting. On our site you'll find a directory of LNCs by state and specialty."
http://www.legalnursingconsultant.com
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Nursinga2z.com:"It is our intent for this Alphabetical, A to Z index to be a comprehensive listing (In Progress) of Nursing-related resources on the Internet. It is indexed by Google and fully searchable."
http://www.nursinga2z.com
Nursingdiabetics.com:"Welcome to NursingDiabetics.com. Here you will find information on all aspects of Diabetes, a disease that afflicts millions of people world wide. I'll be adding pages as fast as I can research the information so remember to bookmark this page and return."
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http://www.nursingdiscussions.com
Nursingentrepreneurs.com:"Nationwide Nursing resource to nurse entrepreneurs looking to nework and start home based businesses. On it you will find links to small and large business related resources."
http://www.nursingentrepreneurs.com
Nursinghumor.com:"Nursing & Medical Humor. Find hundreds of jokes and links to sites that will make you smile. Therapeutic Humor Associations, Battle of the Sexes, Bedside Nursing Humor, Brain Teasers, Clowning, Clowns, Therapeutic Humor & Comedy Links, Dental Humor, Emergency Department Humor, General Nursing Humor, Geriatrics, Senior Citizen, etc."
http://www.nursinghumor.com
Friday, February 17, 2012
When Nurses Attack At the Highest Levels: A Blatant Abuse of Power // Emergiblog
When Nurses Attack At the Highest Levels: A Blatant Abuse of Power
I am not a conspiracy theorist.
I am not militant.
I am not a bleeding heart, I don’t embrace every cause du jour, nor do I hop on what someone termed a “clown car of supporters” for whatever happens to run across the blogosphere on a given day.
I am as straight-arrow, by-the-book, trust-the-Establishment as you will find in this world.
So when I say that I am reeling; when I say that I would take to the streets about something that has happened…when I say that I am questioning everything I thought I knew about authority, power…and nursing…
I’m not bluffing, over-reacting or being hysterical.
Pardon my unprofessional language, but there is some bad s*** going down in Arizona.
**********
The Arizona Board of Nursing has gone from ridiculous to abusive in the Amanda Trujillo case.
It wasn’t bad enough that they felt clicking a box on a computer that would order a case management hospice consult should mean enduring:
(a) a detailed interrogation about every facet of your entire career,
(b) or that talking about your situation should lead to a psychiatric evaluation, including obtaining signed releases from all your physicians for the last six years and seeing a board appointed PhD. Yep, clicking that box meant giving up all your protected HIPAA information! I can’t repeat that enough, it’s that appalling.
But that’s old news, isn’t it?
Here’s the new stuff.
********
Amanda received a letter from her university stating they were informed by the AZBoN that her license was under investigation.
Still, old news, you say? But wait!
A Board staff member wrote a letter denying it!
via emergiblog.com
Please click on the "VIA" link to read the full article.
Thank you Kim, for calling attention to Amanda's situation.
For more information on Amanda Trujillo, please visit: http://www.nurseup.com
Wednesday, February 15, 2012
Sealed "Rape Kit" Reopened By Nurse. Evidence Inadmissible?
Sealed "Rape Kit" Reopened By Nurse. Evidence Inadmissible?
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Summary: Documentation of observations and findings are basic to nursing practice. Our practice is governed by standards of practice and "protocols" to be followed. In this case, a nurse admitting a rape victim collected and placed in a "rape kit" DNA samples, evidence to be submitted for laboratory analysis. The evidence submission protocol would inadvertently be broken by the nurse. The defense for the rapist would argue this breach made the evidence inadmissible.
The nurse was caring for a sexual assault (rape) victim on the night in question. Herpatientwas one of a number of patients in for the same reason.
Rape is a "reportable" crime in most states. This means when a healthcare worker suspects in the course of their duties that an individual has been a victim of sexual assault, it must be reported. Procedures are in place in hospitals and other facilities for the reporting of rape victims.
"The facts about sexual violence are:
Victims of sexual violence do not invite or cause the assault to happen. Only the person initiating the sexually violent act is responsible.
Sexual assaults are committed primarily out of anger and/or a need to feel powerful, to control and dominate another person.
Victims of sexual violence are forced, coerced or manipulated to participate in unwanted sexual activity.
Victims are usually traumatized by the assault. Friends and family members may also experience trauma reaction.
Sexual assault is a reportable crime. It is important for adult victim/survivors to consider reporting so sexual offenders can be identified by the system and the community.
In Colorado, professionals are mandated to report the crime if the victim:
Is a child. Goes to the emergency room. Was assaulted by someone in a position of authority or trust. (i.e. coaches, psychotherapists, scout leaders, teachers, priests, etc.) Is physically, emotionally or mentally disadvantaged."1
In the process of her examination protocol, she collected several specimens that would be submitted for DNA analysis. These specimens could later be used as "evidence" in the event of a trial.
"a party seeking to introduce an item of physical evidence must prove that the item was that which was taken from a particular person or place which makes the item relevant as evidence in the trial. Such proof is provided by testimony identifying the item as having been taken from that person or place, and by evidence tracing custody of the item from the time it was taken until it is offered in evidence. This latter evidence is necessary to avoid any
claim of substitution or tampering."2
The collection of specimens by a nurse in a
hospital must be treated as a strictly legal process. Often nurses are called upon to draw blood alcohol specimens from suspected drunk drivers, blood or urine drug screens from prospected employees to suspected drug abusers or as in this case semen and skin scrapings for later use in a rape trial.
Any such specimen must be handled with extreme care and with attention paid to established procedures.
After collecting the samples and preparing the documentation, the nurse sealed the package. Per policy, the "kit" once sealed could not be reopened except by the laboratory personnel receiving it for analysis. The nurse was unsure whether the documentation had been prepared properly. Unsure, the nurse broke the tamper evident seal and double checked the paperwork. Satisfied that it was in order, the package was resealed and sent for analysis.
"Specimens are sealed in packages and any tampering with a sealed specimen would be noticed by the laboratory and documented on the specimen chain of custody. In addition, as a practical matter, couriers, express couriers, and postal service personnel do not have access to the specimen chain of custody form since the form is inside the sealed package. Section 2.2(i) of the Mandatory Guidelines that discusses the transportation of a specimen to a laboratory has been revised to clarify this point."3
The defendant in this case was being charged with not one, but several counts of violent crimes.
"Blain Southern, who was charged with several counts of kidnapping, burglary, theft and "sexual intercourse without consent," went to trial on the charges filed against him"4
During the trial the defense would argue against the admissibility of the evidence contained in the kit. They stated that the samples may have been "tampered with," when the seal was broken.
The court disagreed. The defendant was convicted of all charges against him.
The defendant appealed.
Questions to be answered:
1. Did the reopening of the rape kit, constituting a breach of protocol, raise the possibility of evidence tampering?
2. Was the nurse negligent for her breach of procedure in handling the kit containing the DNA specimens?
The defense presented expert witnesses who testified that any "tampering" of the kit could potentially violate the integrity of the samples within.
The court ruled that because the kit was opened to "check the paperwork" that a claim of "tampering" could not be supported. It was noted that none of the specimen boxes themselves, containing the DNA samples, had been re-opened.
"The court stated that "tamper" means to interfere with something improperly, meddle with it, or make unwarranted alterations in its existing condition"4
The nurse in her testimony had clearly stated that her purpose in re-opening the kit was to check the "documents" inside. She did not disturb or re-open the actual sample containers. This satisfied the court.
The defense could produce no clear evidence that the integrity of the "specimens" as opposed to the kit had been violated. The court of appeals affirmed the ruling of the lower court.
It is important to note that most nurses are not specifically trained to recognize and deal with "chain of custody" issues. It is likely that the nurse on duty that night was unfamiliar with the process.
It is important to recognize as well that if the "kits" directions had been followed properly, the issue of "evidence tampering" might never have been raised.
Commonly, attorneys (plaintiff or defense) will "latch on" to any deficiency present in submitted evidence. If a single error or omission or breach of protocol is present, it is their hope that others will be found as well. It raises the possibility of additional error and damages the credibility of the evidence and witnesses involved.
"Opposing counsel will often attack the admissibility of evidence in terms of its relevancy and chain of custody. Especially in the early stages of an investigation, the relevance of a piece of evidence may not be evident. As a result, every item recovered should be treated as though it is relevant."5
This can be applied to sloppy charting just as easily as to "chain of custody" in evidence submission. A chart with incomplete documentation of patient care raises the possibility that care was not given. Regardless of what really happened, it only takes a single discrepancy to raise issues of doubt.
Related Link Sections:
Abuse: Domestic, Physical, Verbal Links:
http://www.nursefriendly.com/nursing/directpatientcare/abuse.htm
Clinical Charting and Documentation, Nurses Notes:
http://www.nursefriendly.com/nursing/linksections/directpatientcarelinks.htm
Chain of Custody, Medical Legal & Law Enforcement Resources on: The Nurse Friendly:
http://www.legalnursingconsultant.org/legal.nurse.consultants.lnc/chain.of.custody.htm
Direct Patient Care Links on: The Nurse Friendly
http://www.nursefriendly.com/nursing/linksections/directpatientcarelinks.htm
Drug Testing, Medical Legal & Law Enforcement Resources on: The Nurse Friendly:
http://www.nursefriendly.com/nursing/directpatientcare/drug.testing.htm
Ethics:
http://www.nursefriendly.com/nursing/directpatientcare/ethics.htm
Emergency Department Nurses on the Nurse Friendly
http://www.nursefriendly.com/nursing/directory/spec/ed.html
Medical Legal Consulting Nurse Entrepreneurs:
http://www.nursefriendly.com/nursing/ymedlegal.htm
Related Malpractice Cases:
June 13, 1999: Felony Child Abuse Conviction, Made Possible Thanks to Nurse's Documentation.
Child abuse is a "reportable" crime. This means when a healthcare worker suspects in the course of their duties that a child has been abused, it must be reported. Procedures are in place in hospitals and other facilities for the reporting of abused children. In this case, it was the expert documentation of a child's statements by a nurse, physician and field agent that made the conviction of an abuser possible.
State v. Gillard, 936 S.W. 2d 194 - MO (1999).
http://www.nursefriendly.com/nursing/clinical.cases/061399.htm
June 6, 1999: Emergency Department Nurse Verbally Abused, Physician History Well Documented
Official tolerance for verbal abuse and sexual harassment is approaching zero. It is clear that both are still prevalent in healthcare settings today. Enforcing and reporting instances of abuse are critical to an end being put to the situation. In this case, a physician had a "history" of verbal abuse in the facility involved. It was the documentation of previous events that made formal action and administration of a suspension feasible.
Gordon v. Lewiston Hospital, 714 A.2d 539 - PA (1998)
http://www.nursefriendly.com/nursing/clinical.cases/060699.htm
Sources:
1. FortNet - The Community Information Network. No date given. "Information about Sexual Violence and Sexual Assault." Retrieved September 7, 1999 from the World Wide Web: http://www.fortnet.org/sava/info.html
2. Vercammen, Kenneth A. No date given. "Proof Of Chain of Custody In A Criminal Case." Retrieved September 7, 1999 from the World Wide Web: http://www.njlaws.com/chain.htm
3. Substance Abuse and Mental Health Services Administration. September 1, 1994. Mandatory Guidelines for Federal Workplace Drug Testing Programs. ." Retrieved September 7, 1999 from the World Wide Web: http://www.health.org/GDLNS-94.htm
4. 40 RRNL 3 (August 1999)
5. Zulawski, David E. and Wicklander, Douglas E. February 26, 1996. "Evidence." Bank Fraud Newsletter. Retrieved September 7, 1999 from the World Wide Web: http://www.w-z.com/evidence.htm
http://www.nursefriendly.com/nursing/090599.htm
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