ltc state survey problems

  1. I've been working in a nursing home for 7 months. I've been a med nurse for 10 years. I left 2 part time positions that I liked a lot to take this position. We are currently undergoing a state survey which I knew would go poorly. In fact, I wont't be suprised if we get closed down to admissions. I was suspended 2 days ago because the RN who took off an order did it incorrectly and a med was omitted. Nothing was stated in report that there was a med change. I had also been pulled to the floor that I very rarely work. Not to mention I work as an Aid 70% of the time due to calloffs. The management stated that they had to repremand someone since state was in the building. Needless to say, other good LPN's have been suspended or severely reprimanded due to RN mistakes. I'm not dogging RN's. We have a few good ones. Our facility, though, pulls people of all positions from the woodwork. This includes CNA's to Administration. My question...am I going to have a job when this is done and overwith?
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  2. 7 Comments

  3. by   mustangsheba
    Yes. You will have a job. It just might not be at this facility. Experienced med aides must be as much in demand there as they are here. Tell me if I'm wrong. Did this error result in someone's death or hospitalization? The need to find someone to reprimand just because state is there is faulty thinking. They are more interested in how the error is corrected and documented and how this type of error will be avoided in the future. Of course, I speak from an Oregon bias. I wish you well. This is really tacky. Can you go back to the places you worked before?
  4. by   Tim-GNP
    The best thing to do in this case is to pull a surveyor to the side and explain what has happened. True, your anonymity will not be protected, but administration would dare not fire you [if they did, you could sue for wrongful discharge not to mention retaliation. I am sure you would be protected under whistleblower legislation]. It is not fair to you. The facility will probably be cited for failure to investigate medical errors appropriately, but too bad... sounds like they deserve it!
  5. by   JLBLPN
    terriv..........It sounds like the ship that you are on is sinking....maybe you should consider getting off before you go down with it. I am an LPN but work in Inservice Education. I handle, manage, investigate and track all medication errors made in our facility. It sounds like your facility needs to have set guidelines for handeling all med errors so that all are treated equally. I currently use a point system. Every error is throughly tracked and depending on the the type, route, time and drug class of error points are issued....(omission, wrong dose, wrong med..if med was po, IM, IV, and the amount of time before the error was caught...etc.......)
    Then i keep an ongoing flow record for all med errors for each nurse and as the pionts are obtained are certain levels there are steps to take to correct the errors from happening again. I educate on every error made. Another step is to change the process your facility has about checking new orders. We have every nurse check all new orders and sign them until 3 nurses have checked them and signed that they are correct to prevent transcription errors fron happening. Good luck! Keep in touch and let me know how you faired..including with your survery.


    [This message has been edited by JLBLPN (edited January 27, 2001).]

    [This message has been edited by JLBLPN (edited January 27, 2001).]
  6. by   ktwlpn
    Originally posted by JLBLPN:
    terriv..........It sounds like the ship that you are on is sinking....maybe you should consider getting off before you go down with it. I am an LPN but work in Inservice Education. I handle, manage, investigate and track all medication errors made in our facility. It sounds like your facility needs to have set guidelines for handeling all med errors so that all are treated equally. I currently use a point system. Every error is throughly tracked and depending on the the type, route, time and drug class of error points are issued....(omission, wrong dose, wrong med..if med was po, IM, IV, and the amount of time before the error was caught...etc.......)
    Then i keep an ongoing flow record for all med errors for each nurse and as the pionts are obtained are certain levels there are steps to take to correct the errors from happening again. I educate on every error made. Another step is to change the process your facility has about checking new orders. We have every nurse check all new orders and sign them until 3 nurses have checked them and signed that they are correct to prevent transcription errors fron happening. Good luck! Keep in touch and let me know how you faired..including with your survery.


    [This message has been edited by JLBLPN (edited January 27, 2001).]

    [This message has been edited by JLBLPN (edited January 27, 2001).]
    We were surprised this week by the surveyors-possibly because we are in the midst of a transition as a new DON came on board this week also.Seems we are missing documentation-as they audited charts for instance they saw a nurses note documenting a fall with head injury and order for neuro checks-unfortunately the neuro flow sheet is no where to be found.On my answering machine today-my day off-a call from an administrator-seems I documented a fall back in Nov-but guess what? The incident report is missing-and-"could you come in now and fill one out for the surveyor"I did not get the message until late in the day as I do not sit by the phone on my day off waitng for a call from work-will I have a job after tomorrow? I am not going to loose sleep tonight over it....but I am kind of nauseous...and shaky...
  7. by   Tim-GNP
    ktwlpn:

    Under NO circumstances should you go into the facility and 'reconstitute' an incident report. If they lost it, 'hard cheese' they should have had a better mechanism for keeping track of I.R.'s. Your facility needs to be honest with the DOH, and tell them 'we lost it!

    If the facility tries to discipline you for not calling back, go to the surveyor's and tell them that the facility is harassing you into falsification of documentation. A lost incident report will be the LEAST of their worries. Especially when they get the O.I.G. in there for medicare fraud!


    -How far that little candle throws his beam...so shines a good deed in a naughty world.

  8. by   nursejanedough
    Tim, good answer. I have seen a lot of "questionable" documentation since I have been doing legal chart reviewing. I feel like I am watching my 4 year old doing something that she thinks no one else sees but it is so obvious to adults. Like taking cookies from the cookie jar, but leaving the cookie jar on the floor, etc.
  9. by   terriv
    well, this was my topic, and guess what. i did not get fired. but a woman of 13 years did due to a dressing order. i would think she could have been placed on a probationary period. seems to me that someone as dedicated to their company would be more valuable than the rif-raf that comes and goes. just wanted to keep you posted and thank you for your I&O.

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