[Corrected]
Four nurses and a supervisor, who nearly six weeks ago were placed on administrative leave without cause from Eureka’s St. Joseph Hospital, have been accused by hospital administrators of over-sedating patients, disregarding medication schedules and spending too much time on the Internet — all while maintaining a “party-like atmosphere” during night shifts, according to Wesley Thornton, one of the accused nurses. A potentially criminal charge of patient abuse has also been leveled at one of the nurses, Thornton said. He denies any wrongdoing.
In a phone conversation earlier today, Thornton told the Journal that the four nurses and their non-union supervisor met separately Friday with hospital administrators, who presented them with evidence (scant, said Thornton) of unprofessional behavior. The nurses were informed that Dr. W. Scott Sageman was having trouble waking patients during the day, leading him to suspect they were being over-sedated, Thornton said.
St. Joseph spokesperson Courtney Hunt-Munther sent the following statement via e-mail:
We are continuing with a thorough internal review of this matter and will not discuss or share information about any personnel matters that are considered to be confidential. Out of respect for our employees and the sensitive issues involved, we are not able to provide any further specifics at this time.
“The charge,” Thornton explained, “was that we would over-sedate patients at night so we could sleep. They told us, ‘Since you guys have been gone there’s been a 45 percent decrease in narcotic delivery to the patients.’ That was their standard line,” he said. “I don’t have a retort other than [asking], ‘Are the patients in pain?'”
Another of the four nurses was accused of administering medication too late in her shift or not at all, then attempting to cover her tracks in the inventory department and the computer system, Thornton said. However, he blames the hospital’s medication administrative software, which he believes can create misperceptions of what actually happens during a shift.
Thornton claims that the charges of spending too much time on the Internet and maintaining a “party-like atmosphere” are unfounded and reflect a lack of understanding about the night shift. “Part of the reason we get paid more is to be up all night,” Thornton said. “There is a lot of slack time. We read books, play games, watch the Internet, go check eBay.”
Administrators presented reams of data collected from servers that chronicled their Internet usage, he said, though he insists none of these activities jeopardized the health of patients in the ICU.
This particular night crew was known for bringing in food and playing music, with two nurses regularly strumming their guitars, Thornton admitted. “We’ll make sure patients around there are sedated,” he added. “It’s actually very soothing.”
Medications used in the ICU include the sedatives Diprivan and Versed (Midazolam) as well as the pain reliever Morphine — “Michael Jackson medications,” as Thornton called them. He could provide no details on the charge of patient abuse, though he believes the accusation has no validity.
The nurses were initially placed on unpaid investigative suspension, but wages for the duration of the leave were reinstated after a union rep intervened. Thornton said he and the other nurses were expecting to be called into the hospital again today to discuss “the next step in the process.”
Thornton believes the accusations are merely retribution for not staying in line. “It doesn’t seem like there’s any proof,” he said. “There’s no dead bodies. We do good patient care. … The problem is these nurses speak their mind about policies they don’t agree with. These nurses don’t toe the line.”
Reached Monday by e-mail, District Attorney Paul Gallegos said he was not aware of any investigation into these claims. “I would take such allegations, if they were supported by sufficient evidence, very seriously,” he responded. “I hope that hospital does too.”
This article appears in California Renovation.
was the sedation at the request or against the request of the patients?
The accusation, as I understand it, is that it was being done regardless of any request or lack thereof, unanonymous.
to correct some misquotes.
The acoustic music is not played regularly, maybe once or twice a week, in a separate room. We also make sure the patients nearby this area are the sedated and or ventilated ones.
The doctor making complaints about oversedation was Dr. Sageman, who now works for administration.
The medication administration software system is Pixis. The difficulty lies with having a pharmacy site in S. Cal during the night and the lag time before medications can be removed from the system as the orders are faxed, manually entered, sometimes taking one to two hours, much too long.
The next step in the process today is that management is terminating the nurses… of course they have recourse in the union to file.
It would behoove these nurses not to let anyone know where they apply, as others have had anonymous calls to a perspective place of work, which ended the interest in them, this very recent.
Mr. Thornton states the charge of over sedating patients is unfounded yet he goes on to say that while two nurses regularly strummed their guitars "we made sure the patients around there are sedated".
If the patients weren’t being oversedated why did the use of narcotics decrease by 45% after the nurses were suspended?
Mr. Thornton also states nurses are paid more to be up all night, says there is no party like atmosphere then states "there is a lot of slack time, we read books, play games, watch the internet." Is this part of an ICU nurses job description? Is this what the extra pay is for?
To again quote Mr. Thornton, "These nurses don’t toe the line." Obviously not!
No proof equates to "there’s no dead bodies." Were you just lucky?
Lastly the IC in ICU means Intensive Care. Care on that shift seems to be anything BUT intensive. More like Care-Less.
Where are the patient complaints? If the family members and the patients involved have had problems, why not bring them forward and let them be addressed? The problem is the administration with these certain individuals. Those who work the night shift and know what goes on, knows that not only in the ICU, but the ER amongst other floors all go into a “down time” every night. If medications have been passed, patients are clean, fed, and sleeping then their job is to maintain that patients stability within the unit. When your work is taken care of, then the computer is what every floor has to keep the nurses busy. Do you know that the hospital was understaffed in the ICU so often that the chance of them being able to leave the unit for lunch break for thirty minutes was essentially unheard of. Let alone give them their 15 min. breaks. So instead the nurses would stay on the unit and during their “breaks” or “down time” They would log onto the computer or play the guitar. Music heals, and patients have said positive things about their time in ICU with these nurses in particular.
With regards to the patients requesting pain sedation, most of the patients have “scheduled” medications which the DOCTOR’S will order and the nurses use their judgement as to whether administer the medications or not. Typically a patient does not have a lot of ability to make such requests due to the fact that they are in need of critical medical attention. So if the patient’s are being “oversedated” then the doctors should order less medication, because the nurses can only pull out of the “pharmacy” the allotted amount. I am sorry for the nurses and their families. They are a great loss to our hospital and our community.
charges of "over" medicating or giving medications at different dosage levels than prescribed are very serious. This blog may not be the place to air the issue.
Interesting to "watch" though, clearly some management-employee issues if these posters are on the "in"
I am appalled at how night shift nurses are being portrayed by this blog. Not all night shift nurses sit around with “down time” and play our guitar. Many of us have a work ethic and find things to do for our patients, like medicating post op patients pain, comforting the dying, and helping to bring new life into this world, not shopping on eBay. There is more to nursing “with in your unit” then medicating, feeding, and bathing! There are many things to be done that may seem menial to some people but how about wiping down equipment, reading charts, taking out the trash in the rooms.
We need to remember that our job is our patients and not to come to work to be entertained. Since when has it become your employer’s duty to entertain the employee?
Without these patients we would have no jobs. All of us who work at the hospital have chosen to be in a line of work that is supposed to be committed to service. How are you serving patients by playing on the internet?
It is well known that the ICU at St. Joe’s does not allow visitors after 8pm, I ask why? I know patients need their rest but they need their family too. If you are doing your job right and just, why can’t some one sit with their sick mother or father at midnight?
I think the five nurses who are on leave know what they did wrong. Maybe if they were finding things to do for their patients and not for them self’s they would not have gotten in trouble in the first place!
Right on Night Shift nurse.
some great feedback here.
cutoff time for visiting is officially 8pm but the rules are bent by the staff frequently by what is going on at the bedside. At times a family is allowed to sleep at the bedside in times of emotional need. Some nights are very busy and others slow, on the slow nights you twiddle your thumbs, on the busy you try to keep your head above water. its all part of the job.
These are some of the most experienced staff that are being let go, and i believe it is a loss to the community.
It could have been dealt with in a much more diplomatic manner, but this is the path now, and i have nothing negative to add.
Read over what the poster ‘Kel’ had to say, this is the real world in our department. Patients come number 1 in our nursing world, families just behind, our co-workers next, followed by doctors, and management bringing up the rear.
over n out. w. (wish the ncj could get it together!!)
i post this AGAIN from the comment section. i have no wish to cause any trouble. please read comments to refer to the below post:
my goodness. the above info was in, i thought. confidential email. i have no wish to pursue any further matters with the st. joseph of orange corp. as another correction, the grievances will be filed by r.n.’s to the hospital thru the union, not the board of nursing.
As a matter of public record, i personally have no ill feelings nor wish to speak in any negative way toward management of St. Joseph Hospital, although i don’t include the navigant corp. in this statement.
My hope is that as a nation we can move towards universal healthcare for all citizens.
To Kel.
1. ICU and ER are very different things. Down time in ICU my well mean no patients t all, or one or two waiting on an x ray or lab test…stable. ICU patients are SICK!And they are admitted to the hospital for total cre…not some studies to rule some simple thing out then go home.
2. Patients families are by in large not in the ICU at night. Even if they were they depend upon info given (or not) from the nursing satff about meds given and there effects. They my not know the nurses at the desk are bidding on stuff on ebay or on Facebook (yeah thats been happening all over the hospital)or watching the monitors since the screens face away from the patients cubicles.
3. There is a breakroom in the ICU and the admin supervisor can and sometimes did float in to help cover breaks. Also nurses cover each other….not every patient in that ICU is always an ICU level patient meaning the nursing ratios are lower ie PCU 1 patients can be staffed 3 patients to 1 rn, PCU 2 patients 4 to 1 rn and there are often patients like these housed in ICU depending upon bed availability.
St Joes fired me for resons completely unrelated to my job performance or care I gave my patients. I had very good evals and was a "team player". I feel I got no warnings, no write-ups…no nothing and yet I am still incensed at some of the brush-off comments in this article.
Nurses are one of the most respected professions in existance and behaviors like these and excuses like these sure as h*ll don’t help.
Sorry, I meant to say down time in ER may mean no patients or one or two waiting on a test or two….
I was well-acquainted with a former SJH ICU/Recovery RN (night shift). She preferred to spend her computer time hacking into personnel files. She also had the largest collection of meds in her dresser drawer I have ever seen. Probably an anomaly though.
VERY much an anomoly I would think given the routine counting of controlled drugs in the pyxis system and the close monitoring of computer activity…plus only select managerial employees even have access to personnel files and if you mean patients personal files unless they are working with that patient that would constitute a violation of HIPPA.
I hope if you saw all theses meds in a "dresser drawer" you let the appropriate authorities know. That person needs help.
I cannot believe this is true!
Music heals? That’s what you got? Nothing personal, but that’s inane. Sleep is good for you too, but that doesn’t mean ICU nurses should nap through their shifts.
This is all true, I worked with these people. It went on so long due to the constant turnover of nurse managers, a national problem. Also, this group of nurses was able to intimidate and run off nurses who tried to stop them. The vast majority of nurses at St. Joe and elsewhere are selfless and hardworking. It is also a shame that Dr. Selinger’s name was brought up in all of this. He is an excellent physician and has nothing to do with this controversy. I applaud the new management at St. Joe Eureka for taking a bold and fearless approach to dealing with this problem. Let us move past this and continue to provide the care Humboldt County needs and deserves.
Nice but i think something is missing.
These nurses are all quilty of the highest degree of dereliction of duty,and, slandering the entire nursing profession. They should have reviewed the CA Nursing Practice Act instead of spensing time on FACE-BOOK!!
They are a joke!!!!
Could never hang in a real ICU. I work in a big trauma center; one nurse was caught reading a nursing magazine while at work; she got fired on the spot, because we are only allowed to read Policy’s and Procedures. Sounds harsh??? Perhaps, but we know our policies and procedures very well, which is extremely helpful in emergency situations.
Playing the guitar!!!!! Unbelievable!!!
I wish those ICU walls could talk!!!!
Cameras are useless. We now have GPS chips inside our badges. Nursing administration monitors the amount of time we spend charting verses the amount of time spent on patient care, and, of course, on breaks.
Iphones and blackberries have been barred for years.
Nobody I work with are bothered by these rules. We are so busy taking care of our patients, it’s not an issue.
These nurses appear to completely have lost sight of their MO. It’s so incredulous to even fathom how this neglect went on for years and years. Perhaps send them back to nursing school to refresh what being a nurse is all about???
St Joe’s is just a little hospital in a podunk town. The nurses/docs here ain’t exactly Harvard grads.
Apparently, this stuff (doing internet browsing, playing guitars, and otherwise doing personal things while being paid premium wages) with the ICU nurses have been going on for at least 10 years. It took one courageous traveling nurse to finally blow the whistle. No one else in 10 years wanted to stir the pot !
There should be no "down time" in an ICU. These nurses are being paid extra to work nights. They should not be allowed internet access or cell-phone calls and texting.
Unfortunately, nurses in acute-care settings are allowed a lot of leeway. I have often seen nurses in the OR and ICU routinely buy stuff on-line or busily thumbing their phones while the patient is anesthetized or sedated. It is true that most of the time they don’t need to do anything, but it seems strange to me that they get away with this. Keep in mind that nursing is among the highest paid jobs in the U.S.
Finally, the use of hospital internet access for personal access would be considered abuse of corporate resources by most non-medical companies, and lead to immediate termination. It is also an indication of stupidity that these St. Joe’s nurses did not realize that all their internet transactions at work are easily discoverable by the IT department.
I dated one of the nurses that was let go and there is no doubt in my mind he is guilty of all and even more than what was told by St. Joe’s. He acted very normal and nice until he got a nursing job in another state, after that he began to act delusional, aggressive and secretive. I found an almost empty drug vial in his bag when he came home from work one day. Has anyone thought of the possibility that the narcotics usage went down by 45% because the nurse (s) were stealing the drugs for their own use? This is a distinct possibility according to what I saw in this man. He had a bizarre change of personality after he got the new nursing job and the things he said to me about his patients was so vulgar and uncaring, I will never forget it.
We do good patient care. … The problem is these nurses speak their mind about policies they don’t agree with. These nurses don’t toe the line.”
Reached Monday by e-mail, District Attorney Paul Gallegos said he was not aware of any investigation into these claims. “I would take such allegations, if they were supported by sufficient evidence, very seriously,” he responded. “I hope that hospital does too.”
Hmm. Paul once again punts the ball..off it goes… off to never never land……yet he has an opinion on a subject he has no knowledge of…
Hmm. Hmm. Hmm. Hey Paul was ya surfin again??
We do good patient care. … The problem is these nurses speak their mind about policies they don’t agree with. These nurses don’t toe the line.”
Reached Monday by e-mail, District Attorney Paul Gallegos said he was not aware of any investigation into these claims. “I would take such allegations, if they were supported by sufficient evidence, very seriously,” he responded. “I hope that hospital does too.”
Hmm. Paul once again punts the ball..off it goes… off to never never land……yet he has an opinion on a subject he has no knowledge of…
Hmm. Hmm. Hmm. Hey Paul was ya surfin again??
The acoustic music is not played regularly, maybe once or twice a week, in a separate room. We also make sure the patients nearby this area are the sedated and or ventilated ones.
Aka Music Therapy I like the idea and implementation..good for both patient and over worked nurse. What bout’ the conscious patients? Use music therapy on them.
Presently my pain scale is 0. But would not mind hearing some good acoustic strummin’ from an over worked nurse.
HH
If these nurses wanted to provide music therapy, I’m sure they could’ve arranged to do that in a legitimate fashion and during their free time. I doubt many patients in ICU want a live musical performance in the middle of the night.
I posted a comment on 1-5-2-10 (comment # 22) which, unfortunately, I must now retract. The drug vial in this nurse’s bag turned out to be a legitimate anti-acid. The vulgar and uncaring patient remarks; my interpretation of an over-dinner dissertation regarding patient bowel care. Bizarre personality change; he says the same thing about me. Delusional, aggressive and secretive; words written in anger during an emotionally upsetting time. Speculation regarding drug use; truth is I’ve never seen this nurse do any drug nor even drink hard liquor. Comment # 22 was written after reviewing the NCJ news article and blog comments. Several glasses of wine later with some thorough and lengthy female analysis soon made the worst case scenario seem very plausible and the comment was posted.
As to music on the ward, still seems more suitable to daytime hours to me.