Lorie A Brown, R.N., M.N., J.D., Author at Empowered Nurses

Darned if you do, Darned if you don’t!

September 15, 2022 4:07 pm 1 Comment

Beverly Ann Bratcher was an LPN working in Michigan at the Grand Rapids Home for Veterans in December 2020 when she became aware that 2 incorrect medication doses had been administered to one specific patient. Ms. Bratcher failed to report this error to her supervisor and now faces a criminal charge of second degree vulnerable adult abuse. [Story]

I took the opportunity to look up her Michigan license and it is still active despite the outstanding criminal charges. What is interesting is that RaDonda Vaught, who I have mentioned in earlier reports as the Tennessee nurse who mistakenly gave the wrong medication to a patient resulting in the latter’s death and for which she was convicted and sentenced to 3 years of supervised probation, was completely honest and up front about her medical mistake. Yet, she was criminally charged and convicted. However, Ms. Bratcher is facing criminal charges for not reporting the medications mix up in her situation and wound-up facing criminal charges.

This is a sad state we live in where nurses are expected to report medication errors and then get criminal charges and when a nurse does not report, she gets criminal charges. Many healthcare facilities claim to have just culture and the purpose is for full disclosure so that when mistakes are made, the facility can do a root cause analysis to figure out the source. Unfortunately, either way, when medication errors are reported, a nurse could be subject to criminal charges and when a medication error is not reported the nurse can also be subject to criminal charges.

This is unfortunate and scary for every nurse because who knew that you could go to jail for just for doing your job. Things need to change in nursing. It is no wonder that there is a nursing shortage. Hopefully, things will change.

I soundly suggest that facilities that really believe in just culture will let their nursing staff know that they will not be reported for telling the truth and doing the right thing.

What Is Crisis Staffing In Nursing?

September 8, 2022 11:42 am Leave a Comment

During the pandemic, several institutions had to resort to what is called “crisis staffing.”
This is when facilities find themselves operating under extreme circumstances such as emergencies, disasters or overburdening situations such as pandemics and they are required to change circumstances.

A number of hospitals have experienced examples of crisis staffing including Penn Medicine.

At Penn, when there is a crisis level 1, nurses go from 1:1 or 1:2 to team-based nursing which is, “1 ICU nurse and 2 non-ICU nurses caring for 4 to 6 patients with documentation by non-ICU nurses.”

With crisis level 2, “1 ICU nurse and 2 non-ICU nurses can care for 8 to 12 patients with documentation by non-ICU nurses.” Can you imagine taking care of 8 to 12 ICU patients with 2 non-ICU nurses?

As a medical malpractice attorney and professional licensing defense attorney, this is extremely concerning to me because there needs to be notation of who provided the actual care. If it is not documented, it was not done!

By changing the standards during a crisis is a recipe for poor patient care and outcomes.

Certainly, in a crisis, there needs to be flexibility but who determines when the crisis occurs. Is it just because there isn’t enough staff or is it because of something else? [more information]

During COVID, legislation was passed saying that nursing homes could not be sued. However, the Indiana law was applied retroactively, and nurses were still being reported to the Board. So, even if medical malpractice claims were not allowed, claims against licenses of individual nurses could still be brought forth.

With crisis staffing, the same thing could be true except that there will be malpractice cases and, of course, a nurse can still get reported to the Board.

Does your facility have a policy for crisis staffing and, if so, what are your thoughts about this topic?

Is Your Business Worth It?

August 30, 2022 5:55 pm Leave a Comment

I have had the privilege to study with some of the best coaches on the planet including Tony Robbins. Tony told the story of a man named Mel Fisher. In 1969, Mel thought that he knew where the wreck of the Nuestra Señora de Atocha, a Spanish galleon, could be found. The ship had carried a treasure worth an estimated half-billion dollars when it sunk during a hurricane off the Florida Keys in 1622.

The crazy part of this story is that it took this man 16 years to locate this missing treasure. He never gave up!

What would you have to believe to keep at that quest for so long?

His first belief was that the treasure was there. Do you believe that the “treasures” in your business are there?

The second belief is that “I will” or “I must follow this.” No one else is going to find it but you. Do you have that faith and that belief that you are going to find it?

The third belief is “is it worth it?” To Mr. Fisher, the 16 years he devoted to find the sunken treasure was worth it.

One of the drawbacks to Fisher’s search was that for eight years he was tied up in litigation. It goes without saying that once a treasure is found, everybody wants at least a part of it, if not all of it.

First it was the state of Florida and then it was the U.S. government, but the matter was settled when a judge ruled for Fisher by saying, “finders keepers!”

It took me 5 long years to build my business! (Fortunately, not 16!)

At first, I thought it would be easy. I knew everyone in my legal community, either working as co-counsel or opposing them in matters, plus I had a great service to offer assisting attorneys with medical issues in their cases.

But building my business was not so simple, it took me 5 long years. However, it was definitely worth it!

During that half-decade, I had to take uncomfortable actions to grow my business. I had to look at new ways to market to attorneys because the traditional ways were just not working.

For me, my big why was my children and then as I became more successful, my big why was my freedom. I want to work when I want to work, I want to go on vacation when I want to go on vacation, and I want to afford the lifestyle to which I have grown accustomed. I wanted to live where I want. Even though my law practice is in Indianapolis, I choose to live in San Diego.

What is your big WHY? What is it that gets you out of bed in the morning to do the hard work you need to do?

What treasures are you searching for? What treasures are you are determined to find no matter what? You’re not going to quit and will devote your life to the search.

What difference are you going to make in this world?

I had the good fortune to discover the Mel Fisher Museum containing countless artifacts from the sunken ship. It was so interesting to see these beautiful assets which had been encrusted over centuries by the sea’s salt water.

Again, what is your big WHY to start your business and make it grow? Are you worth it to have the business of your dreams? Let me know in the comments below.

In addition, if you would like to have a 15-minute strategy talk to discover your treasure, feel free to schedule a CallWithLorie.com.

DÉJÀ VU ALL OVER AGAIN

August 29, 2022 7:26 pm Leave a Comment

Well, it happened with RaDonda Vaught and now, there is another nurse who has been charged with murder.

This past May, a Lexington, Kentucky nurse, 52-year-old Eyvette Hunter, was charged with the murder of James Morris, a 97-year-old World War II and Korean veteran and patient at Baptist Health. Nurse Hunter allegedly administered Ativan that she reportedly had taken from another patient.

Sometime later, Mr. Morris was found experiencing labored breathing and the oxygen saturation equipment had been turned off! Nurse Hunter never called for the rapid response team! The veteran had aspirated on either food or medication, developed pneumonia, and died 2 days later in hospice.

Nurse Hunter was seen walking out of the patient’s room when she was asked “What’s going on?” She reportedly tersely replied, “None of your business!” There is evidence that Nurse Hunter took Ativan for another patient and allegedly gave it to Mr. Morris without an order.

It was found later that Nurse Hunter had edited her documentation of administering the Ativan stating that the pharmaceutical was NOT given.

Ms. Hunter’s license has been suspended by the Kentucky Board of Nursing and now she must deal with this criminal matter.

Even if the Ativan had been ordered for this patient, it is forbidden to “borrow” someone else’s medication if that ordered medication is not available for your patient. Such a determined act is considered theft.

There are proper channels to get the appropriate medication in such a situation and calling the supervisor is absolutely necessary.

Making an insurance company pay for a medication that was used for a different patient is a crime: insurance fraud.

This case is virtually indistinguishable from that of RaDonda Vaught in 2017 in that Ms. Hunter allegedly administrated the stolen medication to ease Mr. Morris’ suffering after which she purposely decided not to call for the needed life-saving services of a rapid response team.

I do not know whether Mr. Morris was a code; nurses cannot take it upon themselves to generate such a situation and then fail to perform required life-saving services.

Your Nursing Mindset

August 25, 2022 6:58 pm Leave a Comment

What are your biggest concerns about being a nurse? I bet it’s the feeling that there’s not enough time, not enough resources, not enough staff, not enough support, etc.

All of these are based in lack. Unfortunately, hospitals want you to be in lack. They want to keep you in fear so you will stay. They want you to be afraid to leave.

This is a ploy by hospital administrators to keep nurses where they’re at and to disempower them. However, to be empowered and to have choices in our profession, we need to change our mindset to one of abundance.

What if you went to work and felt you had all the time to get everything you needed to get done for your patients? What if you felt like you had all the support you want to do everything for your patients? How different would your day be?

As nurses, I suggest we change our mindset from one of “lack” to one of “abundance.”

I have heard nurses say things like, “I can’t work elsewhere because the next closest hospital is hours from my home.”

You always have a choice!

When you live in lack, you will always be in lack! Something outside of you has your power. When one has lack thinking, they frequently accumulate debt because there is never enough money. So why not focus on abundance so you have choices to make more money.

I really hope that you and other nurses will rethink your mindset and make the necessary changes in nursing to create the abundance so that patients get the best care.

Nurses’ Whistleblower Protection

August 18, 2022 11:32 am 1 Comment

Many states have statutes to protect whistleblowers in the medical field. However, there was an interesting matter where a hospital nurse, licensed and working in a Texas hospital reported a situation to CPS (Child Protective Services), she was terminated 2 weeks later.

The hospital nurse was assigned to work with a pediatric neurologist. One young patient, whose divorced parents shared custody, was suffering from seizures. The father brought the child in for his/her appointments.

The hospital nurse received a call from the child’s mother who claimed that both parents were seeking treatment for the child from their individually selected neurologists. The recommended treatments were different from each other.

The greatest concern for the hospital nurse was that the child was receiving different medications depending on which parent had custody at the time.

The hospital nurse called the child’s middle school nurse to discuss her concerns. The school nurse said that there had been some increased behavioral issues and the child had since been placed at an inpatient psychiatric center in response to these issues.

The school nurse warned the hospital nurse to be on the lookout for worsening behavior or increased incidences of seizures. When the hospital nurse contacted her supervisor to provide advisement of the circumstances, she was told that if she believed that the child was in danger, she needed to report that issue.

The next day, the hospital nurse followed her supervisor’s suggestion and issued a report to CPS that the child was being treated by 2 separate neurologists resulting in 2 different sets of medications being provided to the child.

The hospital nurse was terminated 2 weeks later. The nurse sued for wrongful termination.

The trial court dismissed the hospital nurse’s claim, but the appeals court overturned that decision, sending the case back for trial.

The statute required a professional to make a report within 48 hours upon discovery of suspected child abuse or neglect. Texas code says should an employee be suspended within 60 days of making a report, it is assumed that the employer was discriminated against for making the report.

To overcome this presumption, the employer must show that there is no connection. The report from CPS was included in the hospital nurse’s termination documents, thus preventing her from challenging that the CPS report had no bearing on her being fired. Here, the employer clearly put the CPS reports in her termination papers.

I hope this matter can be resolved. Nurses need to feel that they are protected and, when suspected, able to report abuse or other wrongdoings without fear of retaliation.

What are your thoughts? Please let me know in the comments below.

Hospital At Home

August 11, 2022 4:04 pm Leave a Comment

I have written previously about the concept of “hospital at home.” I read in a recent issue of Becker’s Hospital Review an interview with Michelle Mahon who is the Assistant Director of Nursing Practice at National Nurses United.

Ms. Mahon expressed concerns, as have I, about hospitals at home.

Did you ever have a patient who you knew, by the feeling in your gut, had something seriously wrong with them even though when you took their vitals, everything looked fine?

I had one such patient, a young woman, who I sensed was experiencing something that was wrong and shortly thereafter, she started screaming at the top of her lungs as she was having a stroke.

In a hospital nowadays, a Rapid Response team is available to help this patient. At home, nothing is available.

If a patient is sick enough to be hospitalized and requires nursing care, a private home cannot deal with a complication such as pulmonary embolus, a blood clot, or a heart attack, it means that the patient is at risk by treating them at home.

When they are at home, there are untrained personnel who rely solely on the monitors and an untrained person’s assessments. They may send out an EMT or a home health aide, but these caregivers cannot take the place of nurses.

Nurses’ assessments are valuable, and patients deserve quality care! We all know that complications can happen at any time.

Before rolling out the hospital at home, there should have been peer reviewed clinical trials to ensure that it is safe. Yet, none were done, and the patients now are the “guinea pigs” of these new care models.

While my preference is to recuperate at home rather than in a hospital, I know that I trust the nurses in the hospital and that would be the best place for me.

Please leave a comment below to let me know your thoughts on the “hospital at home” concept.

How To Become A Nurse Business Owner

July 30, 2022 8:36 pm Leave a Comment

The Risk Of Travel Nursing

July 28, 2022 7:12 pm Leave a Comment

Since the onset of the pandemic, the pay rates for travel nurses have doubled. However, federal money for COVID-19 has dried up because there are far fewer hospitalizations for the disease. As a result, the need for travel nurses has decreased by one third.

In addition, some travel nurses are starting new contracts to only find out that the arrangement has been cancelled. Some are finding that in the middle of their contract, their fees have been reduced. As a result, I am frequently called about these problems.

I want to see nurses sticking together in these matters, particularly in negotiating contracts to be in your favor in the area of fees and cancellations. I suggest focusing on language that the traveling nurse agencies can neither cancel contracts nor unilaterally decrease their fees for the travel nurse’s work.

There is still a future for travel nurses, but I think it will not be such a large portion of the marketplace as it has been except for another, heaven forbid, disastrous pandemic. [Story] Hospitals are looking into ways to hire their own staffs and to compensate them properly. They also are adapting to methods to retain staff and to decrease the need for outside help. However, despite their efforts, there remains the issue of a huge nursing shortage.

I would love to hear your comments below.

Nurses’ No-Complaining Challenge

July 7, 2022 5:25 pm 1 Comment

“There is no way to happiness – happiness is the way.”

– Thich Nhat Hanh

A couple of years ago I conducted an Empowered Nurses Boot Camp. One of the challenges we undertook in that camp was to avoid any complaining. When we complain, we attract more complaints. How can you possibly be happy if you are complaining or in an environment where the people around you are complaining?

I was not surprised to hear that when nurses became conscious of the amount of complaining going on in their environment as well as how much they, themselves, do, they were stunned.

Therefore, I now throw down a gauntlet to challenge you and other nurses to a 7-day period of no complaining! I learned of this from T. Harv Eker. I would like to offer you the same task and to take it day-by-day.

DAY 1 – Focus on no complaining, blaming, or justifying at all today. Every time you find yourself starting to complain about something, just stop yourself. Get really conscious when you are complaining, blaming, or justifying. When you hear others doing any of those three things, remove yourself from the situation.

DAY 2 – Observe others complaining. You will be surprised how rampant complaining is in nursing activities. Take note of about what they are complaining. Many times, there is actually nothing that can be done about a situation. One can simply accept the circumstances and move on or choose to come up with solutions.

DAY 3 – Be aware of any negative thoughts that come up throughout the day. When you are harboring negative thoughts, that leads to unhappiness. Remember, you have a right to be happy. It is a way of being and it’s an inside job. Things outside of you should not affect your level of happiness.

DAY 4 – Watch what you say in the form of complaints, note how many times you have that thought and actually verbalize it. If you complain, what do you think you are creating in your life?

DAY 5 – Turn any negatives you are experiencing during the day into positives. This way you get to focus on what you want rather than on what you don’t want.

DAY 6 – For the entire day, use only positive words. When you use positive words, you feel positive. It affects your happiness and things happen for a reason to support you when you are positive and optimistic.

DAY 7 – Express gratitude for all the blessings in your life. I start every day B.I.G.! Begin In Gratitude! Gratitude sets how I feel each day and when I begin in gratitude, my feelings are affected (but it comes from inside), setting my day on the right course.

So, it’s up to you on what you decide to make yourself feel better. What do you believe makes you feel better about yourself? Complaining all day or being happy and grateful? The choice is all up to you.

Author Archives: Lorie A Brown, R.N., M.N., J.D.