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Category: Employment Law
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I am a registered nurse at an oncology hospital in the med

Customer Question

I am a registered nurse at an oncology hospital in the med center in Houston Texas. I just recently had some problems with my managers and have been put on notice. The are telling me I’m up for a peer review. I would like to go ahead and quit this job but my manager is telling me that IM better off staying as they will defer the peer review to the board of nursing in Texas.
The problem occurred with a patient that had CAR t cell therapy and he is periodically hypertensive. He takes pysch meds that are known to cause hypotension. His BP routinely goes down to the 80’s systolic and he remains asymptomatic. My problem is that I did not chart that he was asymptomatic and all I have to go by is the vital signs. In fact his BP was 90/50 at 715 am at the end of my shift but my managers insist that I should have called an MD to intervene. He received the pain med tramadol at 0710 which I think made his Blood pressure stay in the 70s systolic and did go to the ICU at 1100 am, Which is four hours after my shift ended. His BP was 105 at midnight. He had a blood pressure in the 80s for the most part of the day shift just prior to my shift which they treated with bolus without any improvement.
This patient has been on our floor for months and remains to be periodically having a BP in the 80 90 100s. The one time he went 75/37 was charted incorrectly for 0500am. I BP was actually taken at 0610. I have witnesses to this. I then rechecked his blood pressure manually and got 84/40.
Management insist I should have done more for this patient.
Of note … I was given a performance improvement already for a missed fever that was resolved without treatment. This occurred about 3 weeks prior to the BP issues described above. Now the bp issues and my managers put me on notice.
I have worked for this hospital for 7 years without issue. My managers In my opinion are being a little bit harassing as my patients bp never showed a true downward trend nether his pulse rate either.
So question 1) should I take my managers advice and stay at the hospital untill this peer review is complete and the notice expires?
I would like to quit this job but do not look forward to the nursing board looking down at me.
I could file a grievance with upper management?
Should I hire a lawyer for this grievance?
Question #2
Does this sound like on the job harassment and can management be held accountable for any of this?
Submitted: 1 year ago.
Category: Employment Law
Expert:  DrRussMD replied 1 year ago.
HIYou are asking medical and legal questions.I can answer the medical part.Asymptomatic ideally should have been charted.It does not appear that the patient was in any danger.It does not appear his BP readings were any different than during the course of his stay.I do not think there was a patient endangerment issue.Personally, knowing nurses in this situation, I would get allies together at the hospital and go through the peer review process.However, beyond that advise gets into legal issues and having a laywer for a consult is a good idea. OK, so you might have more questions or want to give me more information: Please use reply to expert if you have further questions. When you are ready, please click a positive rating [hopefully excellent—that’s how we are paid, per rating]. If you forgot something, come back. I am here