Help!! Sticky situation relating to "abuse"

  1. 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.
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    About RNwithquestions

    Joined: Jun '11; Posts: 6; Likes: 16
    from US


  3. by   caliotter3
    Boy did the ADON screw you over. She gave you bad advice and now it seems she is not sticking up for you. Frankly, I am afraid that I see it that you would have been finagled if you did or finagled if you did not. You should have written every thing up and followed up to clear everyone and put it to rest. Should something like this ever happen again, you will know to do the reporting and calling and writing. Hope you don't lose your job. If you stay around there, avoid that ADON if you can. She is bad news as far as you're concerned.
  4. by   TheCommuter
    The nursing homes in my area each have an in-house designated "abuse coordinator" who makes the determination if the resident's allegations are really abuse or not. Does your facility have an abuse coordinator, and if so, did you report to this person? I know you told the ADON, and I know the ADON directed you not to document the allegation, but do you think she's going to admit that she told you not to chart on it? I doubt it.

    There's a chance that the DON might allow you to return to work, and if so, I would look for a more ethical place of employment. Good luck to you!
  5. by   RNwithquestions
    The incident occurred on a Saturday... holiday weekend... with no supervisor, understaffed and no unit manager.... OF COURSE. The DON was very pleasant on the phone. She knows the pt well and also full heartedly does not believe that any type of abuse occurred. She knows the ADON told me not to document so I am just curious if ADON will be in tomorrow or not. She did not mention anything about being suspended or that sort... just not to come in tomorrow and she will call me then. I'm just wondering if there is anything I need to do after the fact to protect myself... other then look for a new job because I've come to the conclusion that this place is just wayyyyyy too sketch. Crappy part was that I was planning on asking ADON to be a reference for me when I started looking for a new job but obviously now I won't.
  6. by   RNwithquestions
    I should also mention that I brought the incident to DON's attention this morning before ADON said anything. Nothing was said all day until I got a phone call at 10 PM.
  7. by   AngelicDarkness
    I'm sorry you ended up in that situation. I've been accused of "abuse" by family a few times, that now I document like it is the air I breath. My charting has saved me those few times because in detail I write exactly what happened. One family memeber asked me not to chart that his father was on the ground, because the family member helped to lift the patient up and everything was ok. (Patient was found on the floor when not at supper, told me he had not fallen but put himself there to get something under the bed). The next day I had two messages on my answering machine from the DOC following up because a different family memeber was looking into initiating a lawsuit because I negleted the patient after his "fall".

    The only advice I can think to protect yourself is write every detail down at home, that way if anything is brought up before you quit, you'll be able to pinpoint exactly what happened. Does sound very sketchy that the ADON would tell you not to chart. Odd. Hope it gets better!
  8. by   resumecpr
    If all else fails, you can have the lab work you ordered and the discussion with the family as back up. At this point you can't jump to conclusions about the DON's intentions.
    Best of luck. Lesson learned. Document, document, document.
  9. by   Esme12
    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.

    Good luck...:redpinkhe
    Last edit by Joe V on Oct 4, '13 : Reason: broken link
  10. by   vald96
    document....document....founded or unfounded, abuse and neglect statement you have to treat it like it happened...when you reported it to your adon that responsibility is already hers....
  11. by   RNwithquestions
    I just found out that ADON thinks she is going to lose her job. She also apologized to me which I am at least somewhat thankful for. I just feel that I got screwed either way. Please keep your fingers and toes crossed for me and boy have I learned a VERY valuable lesson.
  12. by   chiefswife
    have you heard anything yet?
  13. by   RNwithquestions
    No... nothing yet. My DON said she would call me with any updates or to call her by this evening if she hasn't had a chance to call. I asked her yesterday if she wanted me to submit any additional documentation or speak directly with the administrator. I just don't know why I shouldn't be able to work... I notified my superior IMMEDIATELY after I was told about the incident and even brought it to my DON's attention before my ADON did 2 days later. Isn't that what upper management is here for??? I can understand if my ADON looses her job... I just feel like I did what I was suppose to do by letting higher managment know.
  14. by   sharpeimom
    i suspect you just got caught in the middle of something. it isn't fair at all, but it does happen sometimes. keep us posted.

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