My mom is an LPN and works in a group home for mentally retarded (MR) clients, all of whom are in wheelchairs.

Recently, one of the clients got out of the home and was found outside tipped over in the w/c. A man driving by saw the client, stopped and went in the group home to tell my mom about the patient being outside.

As it luck would have it, the man is also the neighbor of the client's parents.

The group home didn't (at least not at the time) have any alarms to alert staff when the doors are open.

The client wasn't out for more than three minutes and sustained some minor abrasions. The parents and the doctors were notified and all was ok. So my mom thought.

In the mean time, apparently, the neighbor talked to the client's parents.

The next day, the client's mother called back and yelled at the administrator because my mom didn't specifically state that the client had been found her neighbor and not staff. The mom also yelled because the group home had no alarm system in place, like she does at her own house. This client has lived at the facility for about 18 months. The mom visits on a frequent basis and has NEVER questioned the lack alarms or even asked for them to be put in.

My mom said she was so upset over the client having unexpectedly gotten out of the group home, that it didn't even cross her mind to specifically tell the parents who had found the client. She was just thankful the client hadn't receive more serious injuries.

The administrator wrote up my mom and made her call the mother and apologize for not specifically stating that someone other than staff had found the client. The mother yelled at my mom for not preventing the son from getting out of the home. This client had never even attempted to get out of the group home. The other clients don't have the mental capacity to even consider getting out the door, much less actually succeed in doing so.

Then, my mom got an on-the-job visit from a state inspector for an investigation interview.

My mom feels like she is being made a scapegoat. She has worked at this group home for 15 years and has had no problems. She has a great relationship with the parents (she thought). She gets along with the administrator, but is getting no support from her, either. The administator has never had a backbone. And, in my opinion, she is just displacing her anger onto my mom for being yelled at by the client's mother. I also feel she is trying the shift the blame on my mom for a problem she should just take responsability for.

Does anyone else think this has been blown way out of proportion? Or am I overreacting?

My mom is devastated and I am furious. :angryfire

I am turning to you nurses, etc. to offer a different point of view as well as unbiased thoughts and opinions.

Thanks for your input.

I do not agree with the administrator having your mom call and tell them that their neighbor found their son; however, nurses have a responsibility to their patients and when something happens, right or wrong - we are held accountable. The no alarms is rather disturbing, personally and the administrator should have a more level head than he apparently does. She should be able to defend herself but she is still going to have to take some of the responsbility since it occurred during her shift, IMHO.

There should have been information related to the condition of the facility i.e. alarms, lockdown etc. on admission that people have to sign. I hope your mom wrote an incident report along with reporting it to all. As far as reporting it to the parents, that should have been first priority. The "abrasions" I hope were seen by the patients doctor as soon as possible also. I also assume there is set rules regarding steps to go through in any accident to the patients....and hope they were followed? The administrator ideally should have fielded any concerns of the parents but sadly that doesn't happen in some places. It appears that the facility NOW should know it needs an alarm on the doors, if this is not done, possibly sending a written suggestion/request? Has anyone spoken of a law suit, getting yelled at is one thing, but the incident could possibly escalate if the parents aren't satisfied.

It is these types of incidents along with some much more severe that makes getting nursing insurance a must for most.

If I were that nurse I'd apologise for the patient getting out but not for not stating it wasn't a staff member who found the patient. I can understand the mothers anger, but yelling over the phone is not on, I'd be hanging up on them.

I can understand your mother's feelings but you have to look at this from the viewpoint of the client's mother. She has entrusted the care of her child to the facility and now she learns that not only did her child get out but your mom didn't even notice, he was found by a neighbor. Your mom not revealing all the details of the situation might make the mother feel as if your mom was hiding something. The length of time the client was out there is really irrelevant from the mom's perspective. She needs to be able to sleep at night knowing her baby's safe. I do think the facility needs to step up and put some alarms on the doors pronto. They have been given a wakeup call and frankly, the cost they have paid is cheap. The lesson they should have learned could have come at a higher price in the form of the client's life.

The mother was overwrought and will probably feel embarrassed about it later. Administration is making your Mom a scapegoat, probably in case they are sued. I hope your Mom has documentation in place in case that happens. Since she doesn't make the policies regarding alarm systems, she's probably okay, but administration wants to make it look as if they are punishing someone in order to satisfied the irate mother.

If I was the mother I might have overreacted too, we all have our moments, and she probably loves her poor handicapped son very much, and worries about him being in a group home, and maybe feels guilty too.

I think the mom probably does has some guilt and is taking her anger out on the wrong person. Yes, your mother should have some responsibility, but why should she apologize for not immediately disclosing who found the patient?? I wouldnt. If there was no reason to believe that this person would try and "escape" and your mother has nothing to do with not having alarms or not then what is there to apologize for??

You just take the situation and learn from it so mistakes aren't repeated. Obviously, they need an alarm system now and the child needs to be watched closer. But it doesnt sound like to me that much could have have been reasonably done in retrospect prior to the incident. And administration is just scared of being sued and trying to throw someone under the bus. I am sure your mom felt bad enough already without having to go through all that.

I would have documented AND told the parent "alerted outside from bystander to see [res # whatever] laying on his side with w/c tipped over". And then the assessments and follow up and so on. I would want to know the details if I was a parent with a vulnerable child. Both your mom and the parent should be advised of the new interventions the GH has to prevent a further incident like that taking place. Anyway, hindsight is 20/20. At least an alarm policy will be put in place by the administrator. At least state has been there, collected their info.

I do also find it strange, that the admin. made your mom call back the parent and apologize? I would have refused to do that. I personally think most group homes [while some have amazing staff] are managed terribly, and I'm sure your mom is being thrown out to the wolves to some extent.

My thoughts on this are mixed. On one hand, the mother is upset and was concerned about the welfare of her child. But I think that the anger was misplaced. It was a group home, not a LTC facility or a hospital or a SNF. Is it a correct assumption to make that people who live in an unlocked group home have the right to go outside when they want to? If the group home is an inappropriate setting for this person - whom I do not consider a patient unless he is ill, because he is at his home, then the case management team needs to reassess.

I hope your mother documented everything, just to cover herself. If not, there is always time for a late chart entry.

Blee

This reminds me of an incident my family experienced. My 93 year old aunt went into long term care because she was dying of cancer. This particular facility did have alarms. My aunt was very disoriented due to the fact that she was being given morphine on a regular basis. One early morning she decided that she was going to go visit her friend down the street. She somehow managed to get the screen off the window and did leave the facility. A passerbyer noted her wandering around her friends home down the street and notified the facility. She also had minor abrasions and a bruise. The nurse on duty was horrified of course. My aunt was a prominent member of the community. As they were wheeling her back in she was saying to us. Don'nt blame them, it's not their fault. Quite the messy situation. My family chose to react to this situation in a different way than this mother. We accepted an apology and an assurance that steps would be taken to ensure that this would not happen again. We did not consider who found her wandering to be relevent at all. I personally felt a great deal of compassion for the nurse. **** happens. It seems to happen to nurses a lot.

This reminds me of an incident my family experienced. My 93 year old aunt went into long term care because she was dying of cancer. This particular facility did have alarms. My aunt was very disoriented due to the fact that she was being given morphine on a regular basis. One early morning she decided that she was going to go visit her friend down the street. She somehow managed to get the screen off the window and did leave the facility. A passerbyer noted her wandering around her friends home down the street and notified the facility. She also had minor abrasions and a bruise. The nurse on duty was horrified of course. My aunt was a prominent member of the community. As they were wheeling her back in she was saying to us. Don'nt blame them, it's not their fault. Quite the messy situation. My family chose to react to this situation in a different way than this mother. We accepted an apology and an assurance that steps would be taken to ensure that this would not happen again. We did not consider who found her wandering to be relevent at all. I personally felt a great deal of compassion for the nurse. **** happens. It seems to happen to nurses a lot.

Then, my mom got an on-the-job visit from a state inspector for an investigation interview.

This is not unusual. I don't know where you are, but in Michigan EVERY Recipient Rights complaint is investigated. At the AFC home where I worked, we had a resident who was hearing impaired. Even with his hearing aids in we frequently had to repeat ourselves to him. He also had a history of auditory hallucinations. This resident filed a complaint stating that he got up early one morning, went out into the living room, and was told by the live-in manager, "get back in your room, you f***ing b*****d". Nothing about the complaint was true except that the resident had gotten up early on the morning in question, but because the complaint was filed, it had to be investigated. We had several visits from county and state investigators, and all the residents were questioned. The manager was not allowed to be alone with residents until after the investigation was finished--this was a real problem, since the home only had 2 staff at the time (1. the manager, 2. me). The complaint was not substantiated, and the state investigator told me herself 'when I read this client's history I was pretty sure we wouldn't find anything, but we have to investigate every complaint.'

I'm sorry your mom had to go through this, and I hope everything gets cleared up soon. Even a seemingly frivolous and unsubstantiated complaint can be a major stressor for the staff involved.