The other day, I noticed another nurse signing patients' medication administration recordsbeforeshe administered each dose. When I questioned this practice, she said she might become distracted and forget to document the dose, which would place the patient at risk for getting a second dose. I told her she was violating hospital policy. Today I saw her repeating the practice. Am I obligated to report her?-C.L., FLA.

Yes. By ignoring hospital policy and generally accepted safe medication practices, your colleague is perpetuating a dangerous environment. What if a distraction causes her to forget to give a dose she's already recorded? The patient could suffer harm by missing a dose.

Failure to report this nurse would be condoning actions that could harm a patient, and violating hospital policy can be grounds for dismissal. Talk to your nurse-manager about your observations and the conversation you had with this nurse. It's the nurse-manager's duty to intervene. If she doesn't address the situation, follow the chain of command and file an event report.

Don't let anyone make you feel guilty for reporting unsafe behavior. It's your duty as a professional.