I've got a situation...

Nurses General Nursing

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Hi Folks!

I usually post over in the student forum but thought I'd post this particular situation here...

For the past semester I've been taking a CNA class as part of a pre-requisiste to get into my nursing program and have been doing clinicals at a LTC facility for about 8 weeks now. At any rate, last week I noticed that my patient had bruises on her arms while giving her a shower. I know older folks bruise more easily so I just filed away the bruises in the back of my memory. Later, when taking my pt to lunch, she started making statements that really raised my suspicions. She would say things like "you're not going to hit me are you?" "Where are we going?...are they going to hurt me?" "Please don't hurt me" etc... I of course told her that I would never hurt her and that she was safe with me. I then seated my pt in the dining room and immediately talked to my teacher about the bruises and the comments. After lunch, I went back to my pt to bring her back to her room to speak with my teacher. Upon speaking with my teacher my pt grabbed my hand an told my teacher that I was very good to her and that we were both the "nicest nurses in the hospital". She then told my teacher that "After you leave, they hurt me." I felt awful!!! She looked terrified and even asked my teacher not to tell anyone! My teacher explained that she had to report the incident by law and that she didn't have to worry everything would be O.K. We spoke with the nurse in charge reported our suspicion of abuse to her and she mentioned that yes, they were indeed investigaing the situation and even suspected a couple individuals. At this point, my teacher told me that she would also follow up with Administrator.

This week, my teacher pulled me aside and asked me if I'd be willing to report the incident to the administator and explained that I might be called to testify at a later date. I told her that I had no objections and would be happy to talk to administrator. In this meeting, we come to find that no one has reported suspicion of abuse to her and that this is the first she's heard of it! She took my name and phone number and asked me to write a brief written statement about what I found. It was at this point that I mentioned the name of a person who I felt my pt was most frightened of.

When all is said and done, I'm left hoping I made a difference but left with several questions...

As a student, did I do the right thing by writing my statement or is this something my teacher should have taken responsibility for? If this goes further...what should I expect? Also, if people were suspected of abusing the person, why were they still working at the facility in the first place? Why was the administrator not informed to this situation sooner? I just don't get it!!! I've never liked this facility but this is just too much!! I'm disgusted and appalled!!!! There's no excuse for this kind of behavior!!! ...

Anyway, thanks for letting my vent!!!

~Bean

Good for you, Bean! Patients need advocates, especially when they are too afraid to speak up themselves. Also, make sure you contact the state. If they didn't file a report, they can get in big trouble. Many don't follow up to see if this has been done. Unfortunately in LTC, it rarely does. They tend to sweep things under the rug for many reasons. Lack of staff is a biggie. I hope all turns out well, and I hope her family gets her the heck out of there. She is obviously unsafe!

Kristy

Write down the incident for your own records. Maybe print out what you told us. Have the dates of the incidents. ANd the date you spoke to the administrator. As time goes you'll forget the little specifics....just incase this goes any further.

I will repeat, as this bears repeating. Immediately, if you have not already done so, write this down for your OWN records. You should have an actual copy of the statement that you turned in.

This is because when you go to court or hearing or are questioned you have Exact detailed information. Right now you know you will never forget. However, the reality is we do forget. Often it is a small but critical detail that is forgotten. Remember you will swear under oath and if you have the slightest doubt about a point or detail this can sometimes make or break a case. It could make it seem that your were not a reliable witness. Sometimes things go a couple of yearrs even before bieng asked to testify and a lot of guilty people get off because witnesses forget details.

Though this should be investigated soon a suit or charges could be filed at a later date reeeequireing a hearing. Of if the investigation finds there has been abuse it could lead to a type of court hearing much later.

You stated the nurse said complaints has been made yet the administrator had not known. I would be concerned.

Most states require that student nurses report suspected abuse to adult protective serevices. I believe your teacher was following appropriate protochol by reporting it to the facility first, and giving them the opportunity and courtesy to do it themselves. However, there is no guarentee they have reported it. As a designated reporter (by virture of your student nurse status) you have the right and (technically) the obligation to follow up to be sure the facility did follow through. I see no harm in you reporting it. However, your instructor probably does not want to step on toes as schools are dependent of facilities for thier students to have a place to do clinicals. You are thier guest. The question is do you want to jepordize your schools access to this and maybe other facilities when it get out a student reported them.

This is an ethical and legal delima for you to discuss with your instructor.

Yes, it's good to keep your own records. But, I also want to reassure you that it is rare for these things to go to court, unless the family files a lawsuit in civil court. Almost always, after a report of suspected abuse is made, the facility and the State resolve it and you wouldn't be involved further.

Read carefully what recountry wrote. What she said is absolutely correct, and so there is no sense for me to repeat her good advice and experience.

To answer your question, YES, it is very appropriate for you to report it to the administrator at your instructor's request, and for you to have made a written statement.

As for you being a student, ANY person, including "civilians" should report suspected cases of abuse. As a student, CNA, nurse, or anyone involved in any direct care to patients, YOU ARE REQUIRED BY LAW to report. Everything you did was appropriate and right on target.

I know this is upsetting for you and a concern. Please know that you did the right thing. Thank you for being there for that patient.

Specializes in Home Health.

Excellent job Bean. I can only think of two reasons why the DON didn't know when other's said she was told. 1. She really wasn't told, 2. They have had problems before, or are being sued, and she just didn't want you to think she was told. IN that case, I would be very worried that your incident report was filed into the trash can.

rn country is right, call the state to follow up, something doesn't sound right here. I'll bet they never filed this info with the state. And while I understand weasel's point of view. It has been my experience that the suspected offender is suspended and removed from the situation! NO WAY should they be cont'd to work! We once had a CNA, she was excellent, but was having serious family problems, and totally lost her patience w a confused pt, and slapped him hard across the face. She was sent home, and not to return until after the investigation. She did this right in front of other staff! She was fired after the investigation a week or so later.

Bean

Simple answer. You did absolutely the right thing. If the abuse can be proved, and someone loses a job, or even faces assault charges for the abuse, so much the better. Every morning, for the rest of your life, you can look in the mirror and say honestly to yourself "I made a difference in someone's life. I put a stop to abuse."

Feel good about yourself. Be proud of yourself. You deserve it.

Kevin McHugh

Bean~

God bless you Darlin'... You did the right thing. :)

Bean, you did great. And now, you have been thru one of the worst things nurses go thru 1) Realizing that one of your pts is being abused and 2) doing something about it.

Specializes in Trauma,ER,CCU/OHU/Nsg Ed/Nsg Research.

((((Bean)))) You did a great job! Unfortunately for you, this situation is giving you a Baptism By Fire, huh? But, fortunately for your patient, you were there to stand up for her. Kudos to you- you have a great career ahead of you.

Good Job! You absolutely did the right thing.. :)

Bless you! You did the right thing. Many would have turned a blind eye but you didn't. I hope they get what they deserve. Abuse is wrong and it is good to see courage where it is needed. :-)

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