Incompetent Nurses.. Why are they working?

  1. In the LTCF where I work there are 3 nursing staff that should not be allowed in the building.. an LPN and 2 aides. The LPN can't handle doing her meds, makes daily med errors, signs the MAR for every resident before she gives her pills, they have to break up her shift and hire a TMA to cover her meds for the 1st 4hrs! One of the aides I mentioned verbally abuses the residents, scolds them for incontinence.. she's horrible! She's been reported and been forced to have a psychiatric evaluation, but the behavior still continues and they won't fire her. The other aide is legally blind and although she is a very nice person.. how can you check someones incont. product if you can't read a chart? This is very frustrating to me as a 2nd yr PN student, graduating in July. Do I want to work in a facility that doesn't function for the better quality care of the residents? I'm thinking no. How do you handle this?

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  2. 16 Comments

  3. by   susanmary
    Originally posted by Cherie:
    In the LTCF where I work there are 3 nursing staff that should not be allowed in the building.. an LPN and 2 aides. The LPN can't handle doing her meds, makes daily med errors, signs the MAR for every resident before she gives her pills, they have to break up her shift and hire a TMA to cover her meds for the 1st 4hrs! One of the aides I mentioned verbally abuses the residents, scolds them for incontinence.. she's horrible! She's been reported and been forced to have a psychiatric evaluation, but the behavior still continues and they won't fire her. The other aide is legally blind and although she is a very nice person.. how can you check someones incont. product if you can't read a chart? This is very frustrating to me as a 2nd yr PN student, graduating in July. Do I want to work in a facility that doesn't function for the better quality care of the residents? I'm thinking no. How do you handle this?

    Cherie:
    Why do you continue working in a facility that provides substandard care? You clearly cite incidents of patient abuse, neglect, negligence, incompetence, and malpractice. Get out of that environment now! You can do much better than to work in such a cesspool which rewards incompetence and negligence. If I found myself surrounded by incompetent staff -- I'd be out of there in a heartbeat! LEAVE! Also, please notify your ombudsman of any elder abuse -- if you witness ANY physical or verbal abuse you must fill out an incident report (keep a copy).
  4. by   Cherie
    Originally posted by susanmary:
    Cherie:
    Why do you continue working in a facility that provides substandard care? You clearly cite incidents of patient abuse, neglect, negligence, incompetence, and malpractice. Get out of that environment now! You can do much better than to work in such a cesspool which rewards incompetence and negligence. If I found myself surrounded by incompetent staff -- I'd be out of there in a heartbeat! LEAVE! Also, please notify your ombudsman of any elder abuse -- if you witness ANY physical or verbal abuse you must fill out an incident report (keep a copy).
    I continue to work there as of right now because I want to change things.. I haven't witnessed any abuse by the "horrible" aide, but I've heard enough from the other aides to know it can't all be a farse. What my ultimate goal in life is.. to gain a possition where I evaluate the aides/nurses on the quality of care they are giving their patients, retrain or fire when appropriate. I would like to see things change around this place.. but I have some doubts that the "new kid" is going to effect much. Although even as an aide I've made some pretty big changes for this woman. She likes to use the older hoyer lift sheets, and as we all know they are dangerous and should be thrown. So every morning when she gets to work, whatever wing she's down, she replaces the nice new EZ lifters with the old hoyer lifts. Well.. 3 weeks ago I took a stand, put a note in the communication book about the danger of using them, and stashed the remanding lifters in the Nursing Supply Room, and only the nurses can access them. I haven't heard boo out of anyone about it.. I'm still holding out hope to help a dying home.
  5. by   susanmary
    Originally posted by Cherie:
    I continue to work there as of right now because I want to change things.. I haven't witnessed any abuse by the "horrible" aide, but I've heard enough from the other aides to know it can't all be a farse. What my ultimate goal in life is.. to gain a possition where I evaluate the aides/nurses on the quality of care they are giving their patients, retrain or fire when appropriate. I would like to see things change around this place.. but I have some doubts that the "new kid" is going to effect much. Although even as an aide I've made some pretty big changes for this woman. She likes to use the older hoyer lift sheets, and as we all know they are dangerous and should be thrown. So every morning when she gets to work, whatever wing she's down, she replaces the nice new EZ lifters with the old hoyer lifts. Well.. 3 weeks ago I took a stand, put a note in the communication book about the danger of using them, and stashed the remanding lifters in the Nursing Supply Room, and only the nurses can access them. I haven't heard boo out of anyone about it.. I'm still holding out hope to help a dying home.
    Cherie, I sincerely wish you the best of luck. My above post still stands, but I understand where you are coming from. I wish you were working in my facility -- health care really need caring people like you who strive to make a difference. Cherie, have a wonderful weekend!!!!!



    [This message has been edited by susanmary (edited February 10, 2001).]
  6. by   Aussie Student
    Unfortunately, these places are rife within the healthcare system. I too have experienced such conditions in the workplace. I worked as an agency nurse at a nursing home. This was horrible, and I actually lost my job for speaking out. There was fecal matter up the walls of this facility, and residents were left to lay in urine soaked beds for too long.
    I am wanting to be a nurse who gives a damn about people. Unfortunately, however many facilities will employ substanded staff and place them in substanded conditions to save the all mighty dollar.
    What a terrible shame this is.


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    Cat
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  7. by   Cherie
    Originally posted by Tim-GNP:
    Unfortunately, if you do not report even "suspected" abuse, [regardless of verbal, physical, emotional, psychological] to your state's ombudsman and DOH, YOU are EVERY BIT AS GUILTY AS THE PERSON WHO IS COMMITTING THE ABUSE! I would get in touch with your DOH immediately. Anonymity is guaranteed.
    I wasn't aware of that.. so with the knew knowledge I will report her, for whatever good it might do. I hope this time they will do something about it instead of letting her off with an psych. eval. that obviously didn't do much the first time around!
  8. by   Cherie
    Originally posted by hollykate:
    you really need to report this situation to the government agency in your state that oversees nursing homes. It is great that you want to stay and "save" this facility, but they will not change unless legally forced to. And from what you describe little changes (hoyer lift pads) are not what this place needs. You can report them anonymously- but I would be sure to not be working for the surprise inspection, you could go down with the ship as well. We recently had a nursing home completely shut down immediately upon inspection. It was a terrible place, but we then heard it was even more difficult to find placement for all the residents. You're definitely in a difficult place. In addition, if the reputation is known about this place, it won't look good on your resume that you stayed, even if your intentions are good. To really effect change, you need to get the state inspectors, and the board of nursing involved. I mentioned the board only due to the med errors you say are occurring.
    Well.. all in all this isn't the worst home I have ever worked in, mainly because they either a: lack the funds for quality products, such as good linens. Or b: don't want to spend the $. At any rate, the aides I work with for the most part (excluding you know who) are great with the residents.. this horrible woman works on day shift, I've actually never even seen her before. But as I said before hearing it from several sources, including some residents, I know it's not a BS story. Like I said to Tim, I will be reporting her. As for the LPN who is grossly dangerous, one of the other LPN's has started bringing all of her med errors to the attn. of the DON (not the first time) but he is being very stern that if something isn't done the state will be notified.. so I'll keep you posted on that subject. And as far as being inspected when state comes around, that I don't worry about, I do my job and I do it well. Since I started there the only complaint I've heard about my work is that I'm too "by the book", said by one of the aides that likes to whiz through her work, and no longer works there.
  9. by   duckie
    Another reason unsafe nurses keep their jobs is that they know who's butt to kiss to make all their troubles disappear. Example: About 2 years ago, I followed a nurse on a daily basis that would leave meds she has signed out as given in cups in the residents meds drawers...so much for presetting??? On a daily basis, I would find she had removed my time and date from treatments and place a new tape on them, but never doing the treatment. I have a certain marking to my dressing that no one knows but I can look at a treatment and know it was mine. She also forget to take off countless orders that were found by me and many other nurses. Once I called her at home about an order she had told me in report she had received but it was never written in the order sheet so I told her she needed to come in and write it as she received it from the MD. She said she wasn't coming back in, that she was tired. I told her in no uncertain terms she would come back in or I would write her up. She came onto the hall, didn't say hi, bye, or kiss my rosey red butt, grabbed the chart, wrote the order, then threw it across the desk, knocking everything on the floor. Of course this display of unprofessional behavior was documented on a "Report of Concern". Then there was a time she forgot to take an order off when she received it but it showed up a week later, with forged initials for all 3 shifts for a week. I wrote incident report after incident report, keeping copies of each and a ledger. Want to know how the story ends...well, this was termed a "personality conflict" between the two of us and one of us would have to be moved from the unit since we obviously couldn't get along. The icing on the cake was when she called me a liar in front of staff and residents regarding a notification of a family member of an incident that occurred. I had charted I had left a message on the family members answering machine to call the facility and talk to me. Well, this nurse announced in a very loud voice, "They said you didn't leave a message and I would never believe you over them." Later it was proven I had left the message and another family member had erased it accidently. Well, I had enough and demanded this nurse be dealt with. So here I was, a nurse who had never been written up, verses a nurse who had been written up 20 plus times in less than 6 months by me and other nurses. I got to stay on a hall I had worked for over four years, only because I had 3 days more in the facility. What a crock!!! I knew I was fighting a loosing battle because this nurse had lunch daily with the DON and Administrator and it was well known, they were all pals and this nurse was their snitch. I guess I should feel lucky I didn't loose my job for trying to set this nurse straight but I'm happy to report that nurse no longer works there, nor does the Administrator or DON. She went on to be floated from hall to hall, being wrote up repeatedly and nothing ever happened. She didn't get fired, she quite to work at a local ER. Now does that make you feel secure of what!!!! All of this taught me a big lesson. Always write it down, keep a copy and I also keep a ledger of incidents that occur. I work very hard at my job, triple checking everything I do to prevent mistakes, so I cover my backside because the ones that can't do their job, know who's backside to kiss to keep theirs out of trouble.
  10. by   Cherie
    Well everyone who has replied, I do have some great news from the war front. I spoke to the LPN who was bringing all of the med errors to the DON's attn. and he informed me that this incompetent LPN will be dismissed, starting March 1st. I have yet to resolve the other issue and will have to keep you all posted. Thanks for all of your replies and input.

    PS Duckie.. It's amazing what you can get away with when you have friends in the right places. I'm glad you don't have to deal with her anymore!



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  11. by   CashewLPN
    Please, get out of there... I worked in a failing facility as well for 6 months... I got out of there as fast as I could...

    A lot of the time I was the only nurse on a 60 bed Geri-Psych lockdown... acually... that was the SOP there... The work was atrocious... I tried for changes... our patients were mobile on our unit, but upstairs it was true insanity... the more sickly patients were a true mess...

    Please notify your state board of nursing, the state board of health... be mindful, you might lose your job in the process, but get out of there as fast as you can...

    good luck in your endevor..
    --Barbara, LPN
  12. by   Cherie
    Originally posted by Yeti1313LPN:
    Please, get out of there... I worked in a failing facility as well for 6 months... I got out of there as fast as I could...

    A lot of the time I was the only nurse on a 60 bed Geri-Psych lockdown... acually... that was the SOP there... The work was atrocious... I tried for changes... our patients were mobile on our unit, but upstairs it was true insanity... the more sickly patients were a true mess...

    Please notify your state board of nursing, the state board of health... be mindful, you might lose your job in the process, but get out of there as fast as you can...

    good luck in your endevor..
    --Barbara, LPN
    Barbara.. The reason I have not run away from this facility, is that these are 2 extreme examples.. and I have no other examples to speak of as of yet. I work with a great bunch of people, everyone is getting above and beyond the basic care that an aide/nurse can provide.. accept these two women. I'm not sure of their reasoning for not firing sooner.. but that we all know what a hard time it is to find help, and good help at that.. but I stand by my morals and I will work double shifts until they can hire someone to replace these people because I believe that these residents deserve better. I'm not going to turn my back on them. If I don't stand up for what's right, no one else will when I'm gone.. and I refuse to leave them in that state because I think that is an unacceptable option. Keep in mind, this is not a "bad" home. With these few acceptions this is a nice place to live, even if the funding is low.. because the rest of us actually give a damn. I guess that should answer everyones question to why I'm still there.

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  13. by   traumaRUs
    When I was an LPN I was on NH care side. I too wanted to do the best for pts. It was very hard. That's why I left. Now, (years later), I'm an ER nurse who gets the NH pts to care for. I know which facilities send their pts in clean and well-taken care of and which don't. There is no reason to let older people lay in their own urine/feces. I report a lot of facilities and in my state - IL - as a mandated reporter I have the right to review the action, which I do. So, my advice is to quit working there and report it to the elder abuse hotline in your state. You have to ask yourself if you would want your mother, grandmother or other family member cared for in your facility? Best of luck. I know its a hard decision.
  14. by   hollykate
    you really need to report this situation to the government agency in your state that oversees nursing homes. It is great that you want to stay and "save" this facility, but they will not change unless legally forced to. And from what you describe little changes (hoyer lift pads) are not what this place needs. You can report them anonymously- but I would be sure to not be working for the surprise inspection, you could go down with the ship as well. We recently had a nursing home completely shut down immediately upon inspection. It was a terrible place, but we then heard it was even more difficult to find placement for all the residents. You're definitely in a difficult place. In addition, if the reputation is known about this place, it won't look good on your resume that you stayed, even if your intentions are good. To really effect change, you need to get the state inspectors, and the board of nursing involved. I mentioned the board only due to the med errors you say are occurring.

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