Advice needed

I am a LPN working in an LTC/Rehab unit. I have been on the job for 19 months now. I recently had an experience that has got me quite worried.

I have a resident who is a paranoid schizophrenic. she has halluciations and can become verbally abusive and physically abusive. Last month she fell out of her bed (she is a very large woman and has a habit of laying on the edge of bed despite us trying to discourage that) She refused to go to the ER, but she went after much talking to. The DON told me that they were trying to get her out of the facility and made the situation sound worse then what it really was. She told the ER doc that the patient threw herself out of bed in an attempt to kill herself. Long story short, no psych consult at the hospital and no xrays done.

Two weeks later, the 7-3 shift had her out of bed in her powerchair to swap out her "big boy bed", I was passing meds down the hall when one of our MDS nurses comes by and said that she heard the pt saying that she was "dying" and to make sure that I document the behavior. (like I wouldnt!!) 15 minutes later this lady was on the floor. She admitted to putting herself on the floor b/c she didnt want to sit in the chair anymore. The ADON reams me and the cna for not being psychic to know ahead of time that this would happen! the lady had no injuries and it took 6 of us and the hoyer lift to put her back in bed.

The next day the ADON comes to me while I was passing meds, and said why didnt you document that the patient was overheard saying she was going to kill herself??? WTH!!! I was never told this. The mds nurse only told me she heard her say she was dying. No suicidal ideations were ever mentioned. The adon goes on to say, that the mds nurse said she told you of this. I go to the chart and below my entry for the previous days events, the mds nurse had put in a late entry stating that the patient had been overheard saying she was going to kill herself and that she had notified the charge nurse (me) immediately. The adon also told me that they were trying to get a tdo on this resident. I remember from psych that in order to get a tdo, the patient has to be a danger to themself or others. I am convinced that they doctored the chart in order to try to get this lady out of the facility. I am disgusted and dissapointed in my management. This patient has never once threatened suicide. What should I do? And since the mds nurse is a nurse and supposedly actually heard the resident say this, why didnt she document it in the chart before my documentation of the fall????

Sorry for the ramblings on!!

LPN