D.O.N. concerned more with census than NH residents care

If I were you,
I would get out of there. Not sending a patient to the ER for emergency treatment when needed is considered negligence. If this happens, you can bet eventually a family will sue, and do you think the DON will bavk you up?? NO. She will cover herself; you will be fired; and named in a negligence lawsuit.
I am sure you worked much too hard for your license to lose it like that!!

Did I hear you say...you or someone else...made an anonymous complaint to the state BON or another governing body?....ooops, did I say that?

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First off Welcome to Allnurses. Secondly, you are working off your license. So call the MD and notify them of any abnormal assessments and if the MD wants the resident sent to ER then they should go. I have worked LTC for a long time as an LPN, RN, and a nurse manager. You need to cover your own butt and protect your residents. Chart carefully your assessment and you conversations with the MD and family. Try to not take short cuts with this because you are busy.Sometimes families will chose to not allow an ER transfer and that is fine as long as the MD is on board and the nurse keeps all updated on condition and changes. This way you will be protected when DPH arrives for a complaint of improper nursing care. Good luck.

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Welcome to all nurses!!!! Now you need to run, not walk away from this job. When you are standing in court or defending yourself in front of the BON this DON will be no where to be found. DON or not if they need to go ....THEN THEY GO!!!! I would find another job if I were you. What does she think if they stay her census stays up until they all die ,then what. Then state comes busting through the door investigating these numerous deaths and look who's name is on the charting. You will never back your license by saying "Well the DON didnt want to send them out". It is a sad situation when money and census comes between doing the right thing.

Maybe someone can move this out of the intro forum?

This is total BS. Every year around the holidays they post a note about contacting the DON or ADM before sending a pt to the hospital. Um, no. Heck no. I am the nurse practicing on my license, not the ADM. I will assess the pts and call the doc for further orders. A lot of times a doc will try to just send the pt out even if it is something treatable in the NH. In those situations I will ask for treatment at the nursing home and they will most often agree, but if needed they are sent out. (A lot of nurses won't question a docs order and will just send them out for minor things....that is where the notes come from)

Now the main reason I end up sending pts out is that over the weekends or holidays, labs don't come for pick ups, pharmacy is delayed or it is almost impossible to get an X ray done. If we would have better services at our nursing home, I would definatley make sure my pts stay in their home for treatments, but heck we all know the reality of the situation.

You are the nurse, you are praticing on your license and under the doctors orders. Not the DONs or ADM.

Good suggestion. Thread is moved to the Long Term Care Nursing forum for additional viewing, feedback, and support. Good job, folks...who have responded thus far.

Can you spell "G" tag??? When in doubt ship 'em out...the DNS needs to get a grip! Where I work when the census goes down we take highly inappropriate (read psychotic) patients we are not equipped to deal with....