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I would agree with mollyredone, but would go further, Not only do you need to record everything you say to him (and get him to counter-sign the record), you need to record everything you tell your own seniors, and get THEM to counter-sign what you have told them. THIS PERSON IS DANGEROUS. You, as a conscientious employee, should not have to take responsibility for this person, but, if the worst happens (and it well could), you want to make certain that you are not held responsible in law, but that the finger is pointed in the right direction. If you get your own seniors to counter-sign your written concerns, you will, not only be protecting your own future, but will also cause them sleepless nights until they do something about the situation.

As you describe the events, these are not mistakes. They appear to be wanton disregard for procedures and protocols. Most facilities have a training period, usually 3 - 6 months wherein a new employee can be discharged without jumping through the usual hoops. I suggest you use this escape route if it is available. Just out of curiosity what is this person's back ground and how well was it checked out?

Send him on his way now, while he is in his six month probationary period. It will be much harder to do later. You cannot manage an employee whom you cannot trust.

Ditto what AmcCord and Tricore said. The medical director's name is on every result. If he/ she is unconcerned that is a very bad situation!

One way to document the persons non compliance is through event management and training. Part of the training should require documented competency before they start submitting patient test results on their own and direct observation should be a part of that. If this person cannot pass their competency then you have documented evidence. If you know this person is not following SOP, you should be able to document such in your event management system. Hopefully your SOPs also out line that concurrent documentation is required. Based on the Fair and Just Culture of event management, this sounds like the Reckless behavior where the person is making these conscious choices and disregarding the risk involved. This type of behavior should not be ignored and requires corrective action. Patient Safety and the "Just Culture."  A Primer for Health Care Executives Prepared by David Marx, JD

That's an awful situation! I have had to retrain several techs who made mistakes. How long do you usually train them? I would document everything he does wrong. Does your procedure state that you have to put your results in immediately? Ours does, since that is what CAP requires. What's worse is that your higher ups aren't alarmed by your observations. If he is not following procedure, or changing his actions based on what you have communicated to him, I would not sign him off as being competent.

Early in my career we had a tech working in chemistry who was, shall we say, a tad bit arrogant! I figured he had measured 5 mls while making up reagents enough times he could do it without a graduated cylinder. He just "eyeballed" it. It was requested he seek employment else where as one set of CAP Proficiency testing was failed miserably and his reagent prep was determined to be the cause.

Scandalous, Scott !!!!!

Very, very, very short term only. A day after the test, most of it went from my brain directly back into that book. LOL.

If you get a certificate of calibration there is no need to confirm.

Update: We wrote a letter outlining our concerns. HR listened to us and it is now official - we do not have to register with the State of NH as Medical Technicians!

You are trying to make 3% screening cells from 3% panel cells???

We do 2 folks to id all specs. Phlebs use bedside scanning/printers. Phlebs draw about 70%. We firmly reject all non-signed specs. No exceptions. Especially from ED - every hospital I've been in, the ED is notorious for mislabeling, mis-identifying specs. We're slowly getting bedside scanning/printing to nursing. L/D and ER are the most common places for WBIT (wrong blood in tube) across the country. To drop your policy requiring positive id verification because people didn't like it, and then put your phleb staff in the middle is not right. If you cannot get phleb staff to not use these specs, then I'd suggest another system - bloodloc, typenex, etc. Safe transfusions begin with the spec.