Board: Nurses allege coercion to alter records

COMPLAINT: The Guam Board of Nurse Examiners is investigating a complaint that alleges a doctor at Guam Regional Medical City coerced a nurse into changing a document regarding a catheter size used during an operation. The GRMC building is shown on Aug. 20. Post file photo

A doctor at Guam Regional Medical City is said to have coerced nurses into changing records under the rationale of protecting a nurse after a catheter that was the wrong size was used during an operation.

Limited details of the incident were discussed during a Nov. 18 meeting of the Guam Board of Nurse Examiners, which is looking into a complaint on the change in documentation.

Board member Gia Ramos is overseeing the case at the GBNE. She said she interviewed GRMC Senior Vice President and Chief Nursing Officer Jennifer Cruz. Ramos learned that the nurses heard the doctor order a size 12 catheter but the doctor claimed to have ordered a size 13.

"They did the proper procedures. They had the size 12 and another person double checks the size. I think there's two more people that double checks the size. So from the nurses' standpoint, they heard a size 12 ... and it was inserted to find out later that it was the wrong size," Ramos said.

The doctor became very upset, she added.

"I guess he went berserk and was yelling at them and got really upset, and told them to alter the documents. To put on the notes that they gave the size 13," Ramos continued. "Because of the doctor (being) really upset and saying how – I guess one of the nurses is the main nurse – his argument is that he wanted to protect the nurse. That she's going to get reported to the board, she's going to lose her license. So therefore, we need to help her by changing the size in their documentation from a 13 to a 12."

The nurses did not want to comply but were afraid of the doctor and ultimately did change the documentation, Ramos said.

As for the patient, Ramos said she understood there was no harm to him but he was really sick and did end up having a bypass. Whether that bypass was due to the wrong catheter size is not known, she added.

Hospital management learned of this case due to another issue, according to Ramos. The nurses did not come forward until two days after the alteration incident and have now been reprimanded and suspended, she added.

The Guam Daily Post asked GRMC for comment on the case, including whether the nurses will be returning to the hospital, whether management looked into the claims that the doctor coerced the nurses and if any disciplinary action had been taken against him.

The hospital has not commented. Their spokeswoman stated that it is GRMC policy not to comment on personnel matters.

The Post also asked about the current status of the patient but was told that the hospital could not comment about private medical information due to the Health Insurance Portability and Accountability Act, or HIPAA. Overall, GRMC had no comment at this time.

Meanwhile, at the GBNE, Ramos asked how the board should handle the complaint, which was made because the nurses did alter the document.

From the board conversation on Nov. 18, it appears that there is one nurse who is the subject of the complaint. Ramos said she hadn't yet spoken to the nurse, although she had reached out.

"How do we handle these kinds of cases? I still need, of course, confirmation from the nurse who is accused. But they're the ones who came forth and told the director as to what happened. They were kind of harassed and coerced into changing the document and they did state that they did alter the documents," Ramos said.

The matter was tabled until Ramos could speak to the nurse, complete her investigation and present a recommendation to the board.

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