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need advice - delicate situation (long)



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  #1  
Old Sep 22, 2004, 05:26 PM
Registered User
Join Date: Sep 2004
need advice - delicate situation (long)

As I was reporting off the the next nurse at 10 pm the cna's told me they needed me in a room asap. An air mattress had somehow become unplugged and had deflated and the resident had fallen down under the mattress and it was over her head. When they found her she was cyanotic and I had my doubts if she would pull through. We put her on O2 and she pulled through ok. when I left she was back to baseline.

Here is my problem.

I was called into the DON's office a couple of days later and counseled and they really came down on me for making a nurses note about the situation. The DON said that I should've called her at home and asked her if she wanted that documented or not. The counseling is for not calling her. She said that it looks really bad and that a "seasoned nurse would've known not to write something like that".

I don't understand how you can not document something so serious. Since then they are on my case really bad for a lot of stupid things and the company just offered a raise for all nurses and they upped the shift differential for afternoon shift. She called my into her office on monday and said that she is with-holding both raises from me because of this counseling.

what would you have done in the situation?

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  #2  
Old Sep 22, 2004, 05:33 PM
Registered User
Join Date: Jan 2003

I take this is LTC? Ummmm, that wouldn't sit well for me either. I would have done an incident report, charted my findings and probably called the DON since equiptment was involved. That is definatly not something that I would hide. Was doc and family notified? I would also have them look into the bed manufacture and make them aware of this risk (hah..we know administration prob wouldn't do)
As far as not giving you the raise..if this is the only reason why...that is total BS and I would probably leave! Is there some one in HR or the administator you can talk to about this?

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  #3  
Old Sep 22, 2004, 05:33 PM
Registered User
Join Date: Jul 2004

I'm just a student, but we had a lecture specifically about this type of matter. Our instructions were to document everything that happens. Then turn around and write up an incident report. Do not include in your nursing documentation that you completed an incident report. But everything that happened to that resident, you NEED to document! So, I would've done the same thing.

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  #4  
Old Sep 22, 2004, 05:35 PM
Registered User
Join Date: Aug 2004
Unhappy Oh my!

I agree with you for documenting (objectively) about what happened. I wonder if the DON frowns upon documentation of falls or other negative issues. How would she have noted this in the record if the patient had died?

I don't have advice for a course of action, but I wouldn't stand by and be punished for appropriately documenting. Your state's Nurse Practice Act is more important to follow than her charting preferences.

Good luck to you!

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  #5  
Old Sep 22, 2004, 05:49 PM
Senior Member
Join Date: Jun 2004

What you did was totally correct. Did the DON want to be called so she could tell you not to document this?? Now that would have been wrong! And just what "seasoned" nurse would have to ask about documenting an incident that could have killed a patient? And to hold raises just because of this!? You need to look for another job. But first I would perhaps notify whoever it is one tells about shady LTC facilities. The residents deserve this, as the DON doesn't seem to looking out for their best interests.

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  #6  
Old Sep 22, 2004, 05:57 PM
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Join Date: Sep 2004

I would make a record of the dates involved. Write down what has been said and by who. You do not have to tolerate being harassed. Look here
http://www.dol.gov/elaws .this is a good starting place to see what labor laws protect you. Personaly I would have no problem contacting whatever authority regulates your workplace and informing them that your workplace demands that you hide adverse events.
To the DON ,as an experienced nurse I would tell her to forget it. I'm will not lower my ethics for anyone.
If you have the option I would find another job.

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  #7  
Old Sep 22, 2004, 05:58 PM
Angie O'Plasty, RN's Avatar
Moderator
Join Date: Aug 2004

Bravo to you for documenting this objectively.

As said by a previous poster, this does indeed look like equipment failure and should be reported asap to the manufacturer. There may be a defect that is injuring or killing other patients, and without this information, how will they know to correct the problem?

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  #8  
Old Sep 22, 2004, 06:07 PM
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Join Date: Sep 2004

after this incident I found out that the outlets in the building are very old and loose. According to the cna's this happens "all the time" and they just plug the things back in. An incident report was filled out and the md and family was notified.

The main reason she was so mad was because state was due to arrive any day. The woman ended up dying about a week later ( from totally unrelated problems - she has been bad for a long time ) and my nurse manager actually told me when she died "well, now at least we don't have to worry about state reading her chart" with a great big smile on her face.

I was so angry!!!! The chart was filed away before the state arrived. This all happened about 6 weeks ago. The whole raise meeting was on monday. I just can't forget about this! It goes against all of my morals! They called me into the office and handed me the chart and said "now you will make an addition to your note and you will write what we tell you to write"

This DON has no morals whatsoever!

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  #9  
Old Sep 22, 2004, 06:47 PM
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Join Date: Jun 2004

OMG!! Did you write what they told you to write???

Where is your administrator in all this? Sounds like this DON needs to go! I would call the state and report this immediately. They can come out on the complaint and review the chart and interview the staff. I would NOT let this go!

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  #10  
Old Sep 22, 2004, 06:59 PM
Registered User
Join Date: Sep 2002
Angry

Originally Posted by missykalo
after this incident I found out that the outlets in the building are very old and loose. According to the cna's this happens "all the time" and they just plug the things back in. An incident report was filled out and the md and family was notified.

The main reason she was so mad was because state was due to arrive any day. The woman ended up dying about a week later ( from totally unrelated problems - she has been bad for a long time ) and my nurse manager actually told me when she died "well, now at least we don't have to worry about state reading her chart" with a great big smile on her face.

I was so angry!!!! The chart was filed away before the state arrived. This all happened about 6 weeks ago. The whole raise meeting was on monday. I just can't forget about this! It goes against all of my morals! They called me into the office and handed me the chart and said "now you will make an addition to your note and you will write what we tell you to write"

This DON has no morals whatsoever!
This place needs to be closed down!!! This is grounds for getting the law,state involved ASAP!. Imagine what else they are doing to the residents behind your back? Or plotting against you?. "...you will make an addition to your note and you will write what we tell you to write"...???

What the???

THAT IS CRIMINAL. They are forcing you to write something against your will. ???



My goodness.

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need advice - delicate situation (long)

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