Nevada board: Nurses have duty to report IC breaches
Fear of retaliation may be a factor
A nursing journal published by the state licensing board in Nevada recently urged nurses to report breaches in infection control and other egregious acts in light of the hepatitis C outbreak in Las Vegas linked to improper injection practices. The following is an excerpt from the article, written by Deborah Scott, MSN, RN, APN.1
"I have talked to no one that is not shocked, angered, and confused that patients have been harmed by health care professionals who forgot their values and integrity. This is an opportunity for each of us to take a step back and reevaluate our commitment to our role as patient advocate, identifying what may prevent us from putting our patients safety above all else. Nurses are patient advocates. . . . So, when a nurse sees another health care provider take such actions that jeopardizes the health or safety of her patient — violations of the Nurse Practice Act, the nurse must take the appropriate actions and notify the proper persons to protect the patient and to insure the offending health care provider does not endanger another patient in the future. Reporting violations of the Nurse Practice Act are actions of patient advocacy; in that, we are protecting our patient and, by reporting the offender, protecting future patients from harm.
Who is responsible for reporting violations of the Nurse Practice Act to the Nevada State Board of Nursing? You are — the licensed nurse or the certified nursing assistant. If not you, then who? Who is at the bedside? Who is routinely familiar with the patient's medical record? Who sees the interactions that other health care providers have with the patient and their family? Who has knowledge of what goes on behind the scenes or when patients are unable to advocate for themselves? Who is at the heart of the culture of the practice site — a culture of patient advocacy or one that has forgotten our primary role?
Those are questions of duty that highlight the importance of a nurse's role as advocate due to our being the person most closely connected with the patient and with the patient's care. Therefore, it is the nurse who will most likely be in a position to report changes in a patient's status and any improper actions, by any health care provider, that may affect a patient.
. . . [I] realize that it may be a lack of knowledge, clouded by fear that has prevented nurses from following their mandate to report unprofessional conduct when it confronts them in their practice settings. Specifically, it has been reported that nurses fear retaliation by their employer or being "blackballed" by other employers. . . .
Unfortunately, I cannot completely allay nurses' fears by promising that a nurse won't be disciplined when there are questions about different incidents of misconduct and the possibility that the nurse has some relationship to the facts. I can say, however, that if a nurse is aware of a violation of the Nurse Practice Act, and does not report the violation to the proper persons, then that nurse is herself in violation of the Nurse Practice Act. That is the legal answer. The ethical answer is that if a nurse is aware of a violation of the Nurse Practice Act and does not report the violation to the proper persons, then that nurse is failing to act as a nurse advocate for the patient
. . . . It has been my experience that no nurse who reported a problem has been disciplined by the Board where there was evidence to prove that the actions she took were those that a reasonable and prudent nurse would have taken in a similar situation. The Board wants to work with nurses to protect the public against unsafe nursing practice. We cannot do it alone."
Reference
- Scott D. Blowing the whistle is, in fact, a form of advocacy! Nevada State Board of Nursing News. June 2008; pp. 6-8. Available online at: http://www.nursingboard.state.nv.us.
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