RE: medication blanks

[Brenda Chance]

We keep detailed staffing sheets and have the sustaniation to prove that they worked.  No one can argue with that, especially when that nurse has signed mar’s out on the hall she was working on for that day.  I am not saying that you make them go back and fix but you can certainly counsel.  I would not argue the point with them, the information speaks for itself.  Every nurse has the obligation to the responsible for their own actions and take the initiative to give quality care.  Leaving blanks on the MAR is not quality care, in a court of law it is negligence.  In another facility, I had one nurse that left so many blanks that did not improve with counseling.  So, I had no other alternative to report her to the board when I terminated her.  Another way to look at this issue, if you are a DON or in nursing management, they work under your license.  Do you want to be on a witness stand explaining their mistakes?  Take action and stand firm, but fair.  This is the only way to get control of the situation.   Brenda W. Chance, RN, RAC-C MDS Coordinator     CONFIDENTIALITY NOTICE: This e-mail message, including any attachments, is for the sole use of the intended recipient(s) and may contain confidential and privileged information. Any unauthorized review, use, disclosure or distribution is prohibited. If you are not the intended recipient, please contact the sender by reply e-mail and destroy all copies of the original message. -----Original Message----- From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED]] Sent: Monday, November 24, 2003 4:54 PM To: [EMAIL PROTECTED] Subject: Re: medication blanks   Brenda, My experience is that no disciplinary action is taken, in fact nurses become very argumentative when audit reports are presented.  No one ever worked the day the blanks occurred. I could never figure out why nurses do not include medication and treatment blanks in the change of shift report.  Don't you think we should be auditing eachother?  By the time an audit is completed it is technically illegal to go back and 'fill-in' the blanks. I could not figure this out until I worked ICU, if I mentioned documentation gaps I was considered "a complainer."  And other nurses worked very hard to find my documentation issues.  I always thanked the reporter but it made no difference.  If they worked as hard on their own documentation it would have been perfect Delores First of all, nursing shortage or not, nurses need to be accountable for signing off their medications.  This is a standard that is taught in nursing school and, if they were to ever go on a witness stand or do a disposition, then they would think again about leaving a blank.  Sure, we are all human and leave one every now and then, but, if I worked the floor, that is the last thing I do at the end of my shift, is check my mar’s and tar’s for blanks.  Here are a lot of corrective actions out there.  One is to audit mar’s and tar’s every day until the situation becomes under control and HOLD EVERYONE ACCOUNTABLE.  If they find out you are looking, they will make more of an effort to do what they should.  Follow your own facility policy for disciplinary action regarding this occurrence.  It in a court of law, it would be negligence by omission.  Our nurse consultant has a law degree and is going to hold a mock trial for us.  We are going to use some medication and treatment blanks for some of the trial.  I think they will think again before they will leave blanks after they have sat through this.  Delores L. Galias, RN, RHIT STATEMENT OF CONFIDENTIALITY: The information contained in this electronic message and any attachments to this message are intended for the exclusive use of the addressee(s) and may contain confidential or privileged information. If you are not the intended recipient, please notify D. Galias, RN, RHIT immediately at [EMAIL PROTECTED] and destroy all copies of this message and any attachments.  Thank you for your cooperation