Elopement and LTC

[acuriousLPN]

I currently work in Vermont and had a resident elope on my shift, I was at lunch and was not in the facility at the time of the incident.

Upon return, I was notified about what happened by my supervisor. The resident was already on 15 minute checks with a wandergaurd in place. This is not the first time that the resident has been successful in leaving the property.

A few hours later the Administrator was called and came into the facility to question people about the incident. I was also brought in for questioning. After I had sat down, the Administrator immediately starting what felt like attacking me and almost trying to pin the blame of the elopement on me stating that the resident must have left the facility at the same time as I and they were hiding so I could not see them. I obviously became defensive with these statements and actually waiting a moment when I left the facility to make sure that the doors had shut so I knew that they were secure. The administrator continues to tell me that I will end up losing my nursing license because of this incident if I do not "cooperate and work as a team with us (them)". I was not being uncooperative and was more fearful of losing my nursing license over something I literally had no control over. I did not cause harm, I checked to make sure my residents were safe before leaving for break, I notified my staff on the unit, and I also saw said resident on the unit as I was leaving it. I was also told that if I called out of work the following day because of the incident it would be suspicious of being guilty of causing the elopement. I have been a nurse for two years and have never had anything like this happen to me, I was and am still completely shaken up. Now, I am afraid to work in the facility for fear of retaliation or losing my nursing license.

Once the conversation was over the Administrator wrote down my statement, which I looked over, agreed, and signed. I made sure to get a copy for my records of the incident.

My question, has anything like this ever happened to someone? I feel like every time I've heard of an elopement situation the nurse on duty ends up getting fired or losing their nursing license over it. Also, if anyone has any information where I could find what Vermont's laws on something like this are that would be great. I have googled things but have only seen case studies or facility specific guidelines.

Any input would be great!

[withasmilelpn]

I would've stood my ground, said their accusations were baseless and unfounded, and that I would not be spoken too in such a manner. I would reiterate that I am indeed happy to work with them to determine what happened, however I can not tolerate such speculation on their part. As such accusations can affect my professional reputation, if administration chooses to take this matter further as in documenting these false beliefs in my personnel file, I would have no recourse but to protect myself. Accusations like these can be considered defamation, and I will proceed accordingly.

Are False Statements in a Personnel File Libel?

[amoLucia]

Elopements usually must be reported ASAP to the State DOH. Sentinel event - BIG incident. As you've mentioned that this resident (and any others?) has done this before, my guess is that that the facility is on 'thin ice' with the DOH and may be facing serious penalty. It would make sense to me that they're looking for a scapegoat to lessen its guilt.

Be sure that all precautions in place on the care plan were being followed. Was your facility P&P post- elopement protocols followed? I'd make copies of any pertinent documents (incl nsg notes, incident report, wanderguard & q15 min checkoff lists, etc) just so they don't 'mysteriously disappear' as this incident will most likely be investigated (was the pt OK?). And do it FAST!

If you have your own malpractice insurance, NOW would be the time to contact them ASAP to seek their input. They will probably tell you NOT to post on social media, so be aware.

Just for your own info, you can prob research your facility on the DOH website, esp for any elopement occurrences. Go back a couple years.

Don't know if your DOH does, but our NJ DOH used to require LTC facilities to have a binder of past surveys and investigations available for public review (most places kept it in the lobby somewhere. It used to contain the original findings with the facility's response (Plan of Correction). The POC should have as its responses steps that would be instituted to prevent/remedy any violations/deficiencies.

For your place to take such a threatening & harsh stance against you tells me they want to throw someone 'under the bus'. Sadly, further punitive may still be coming (maybe not. They may not want to 'pee you off' to not rock the boat). Regardless, be professional and don't let them rattle you. 'Stay under the radar' as best as poss.

Just an after-thought - how's the family in all this? Are they 'LAWSUIT HAPPY'? The facility might be trying to appease them also.

[CapeCodMermaid, RN]

I've worked in buildings where residents eloped on a regular basis. NO ONE ever lost her license --- even in one case (I wasn't working there at the time) where the resident was harmed. Your administrator sounds 1. like a bully and 2. like he doesn't even know how to do an investigation....people should be allowed to write their own statements not have someone else write one for them to sign.

Did the resident get harmed in any way? You had a wanderguard on them and 15 minute checks. We are not jailers.

[heron, ASN, RN]

Did they ever figure out exactly what happened? I gotta wonder if the admin. is trying to distract attention from a poorly maintained wander guard system or a failure to replace expired units. Those little gadgets we put on residents cost about $65 apiece and must be replaced every three months or so. Penny-wise-pound-foolish economies are fairly typical of incompetent administrators.

On the other hand, maybe the resident simply took the wander guard off or was let out by a visitor or non-nursing employee trying to be nice.

At my facility, we have a gadget that checks the wander guard units. We check residents and exits every shift right after report so that missing, malfunctioning or expired units can be attended to immediately. Takes only a few minutes in my small facility to help prevent a seminal event.

[mvm2]

Never mind questioned answered:saint:

[acuriousLPN]

No injuries were found on the resident and the facility does not seem to have an elopement policy in place. I had looked on their on-line database for a policy form and also asked other nursing staff that has worked there for years and they do not know of anything. Also, there have been numerous elopements prior to this one, but they did not manage to get as far away as this particular incident. The wanderguard system has not been working properly as many have told me. Luckily, I found some information that states if a patient is found under 15 minutes that it does not need to be reported to the state. That makes me feel a little better. I have to go in for my questioning tomorrow and am afraid. I know I did not do anything wrong and did everything I could to keep everyone safe and indoors.

[NutmeggeRN, BSN]

Penny-wise-pound-foolish economies are fairly typical of incompetent administrators.

This, a thousand times over!!!!!

[CBlover, BSN, RN]

How do you manage lunch breaks at your facility? Do you report off to someone? Do you have assigned meal times? Did someone know you were actually not in the facility? At my workplace we assign times and a nurse to "cover" us while we are gone. This means you are "covered." You are free to go eat lunch without feeling like something could happen while you're gone.

However, I would feel quite threatened by being told that if I called out of work the following day because of the incident it would be suspicious of being guilty of causing the elopement. I don't think threatening you will in any way begin making reparation for what happened and certainly would make me want to turn in a notice quite fast. Administration is probably and rightfully scared that this could turn serious and they are probably taking this out on you. I am very sorry for what happened to you.

[hppygr8ful, ASN, RN, EMT-I]

I'd make copies of any pertinent documents (incl nsg notes, incident report, wanderguard & q15 min checkoff lists, etc) just so they don't 'mysteriously disappear' as this incident will most likely be investigated (was the pt OK?). And do it FAST!

The problem with this strategy is that these actions you speak of are HIPPA violations and one can be fined and even sent to prison for posessing patient records outside of their workplace. Going to prison will deffinately affect one's nursing license and future employment propects.

Hppy

[CapeCodMermaid, RN]

HERON--I believe you meant to write SENTINEL event...not seminal....a seminal event would be one in which there was sex between residents . And, I've had residents with working wander guards who knew how to shut the alarm off and get out the door. Our policy states an elopement means OFF the property so if they go out the door and are found standing there on the property, it's not an elopement.....'honey, I only wanted some real air'.

[heron, ASN, RN]

Stinkin' auto-correct! Sentinel it is.

Interesting to note that thei Op says their system has been malfunctioning.