I need some guidance and some help! 2 days ago at my LTC facility I had a severely demented pt state to her family member that someone "hit her". The family is deeply involved in the care of pt and are at the bedside nearly 75% of the time. They are all very loving, friendly and appreciative of the care that their family member receives from our facility so when the family member stated that the pt had mentioned this, the family member whole heartedly believes that it did not occur. The family member is also DPOA and upon discussion of this I informed the family member that we could do two things. 1. Involve the DHS, do a full investigation and rule out any type of abuse and 2. run some tests to check for infections r/t increased confusion. Both myself and family interviewed the pt and she was unable to produce any reliable information about being "hit"... again the pt is severely demented. 30 minutes later when we asked her again she said she was never hit. Family stated they did not want to make a big fuss over the situation as again they did not believe that any abuse really occurred. I got the order for the ua, cbc, cmp and cxr which ended up + for infiltrate. I immediately contacted my Assistant DON for clarification about documentation and ADON said not to document anything regarding the patient being "hit". I did not report the occurrence to DHS per family request, but at the same time didn't document anything per ADON. After the long weekend and working today I got a call from my DON stating that they were going to do a further investigation and not to come into work tomorrow. NOW I'M FREAKING OUT because I didn't report to DHS!! My boyfriend thinks I should speak to a lawyer and I feel my job may be in jeopardy because if it comes down to it, I know the facility license and not MY license is of top concern to my employer. Any words of wisdom and advice would be MUCH appreciated!! DON says she will call me tomorrow to let me know if I can come back to work.
Jun 1, '11
by Esme12, ASN, BSN, RN Senior Moderator
I smell a rat......
I am sorry you are involved in this....but from experience I would prepare for the worse. I find it strange you are told not to come to work pending further investigation if you weren't apart of the investigation itself. It does appear that the ADON is tossing you under the bus in lieu or her bad advice to you to save her own hide. I'm afraid your boyfriend may be right.
Do you have malpractice insurance
? I would contact them and request to speak to someone in the legal department. As a part of having malpractice is the ability to have legal council is one of the benefits. If you don't....get some. It won't help you now but it will in the future and no it doesn't mean you'll be more likely to be sued......I had malpractice insurance for at least 20 years and the only contact I ever had with them was to pay the premium......but it was worth the peace of mind.
Having the ADON tell you to document nothing is a real problem. When all is said and done, I would look for another position. This facility obviously doesn't have proper management staff and are willing to make cuts in some unscrupulous palces. You need to document, document, document. In the chart you document that the patient may have increased confusion due to c/o being "hit" with by unknown individuals with no apparent injury that the MD, DON or supervisor notified. Then fill out an incident report (which is true you don't mention this document in the charting). This way the incident report would have the paper trail of what your actions were in follow up ie: calling the ADON, speaking with the familyect.
The reporting of "suspected" abuse is a federal mandate with each state having their variations as to whom to report to....whether itis DPH or the states elder services.
to not report "suspected" abuse is a violation of the law. If you feel no abuse really occured....I would possibly wait to file the elder abuse forms but the incident report I would have filled out before I left the facility and I would as a ADON would have advised any employee to do the same.
Right now write eveyrthing down that you remember right down to times and names(initials) and keep it in a safe place in case you need it later. I hope this all turns out ok and you don't get fired.....but I would star looking for another job......but don't quit before you have anoher job. It's easier to find a job when you already have a job.
Last edit by Joe V on Oct 4, '13
: Reason: broken link