"Take down" in LTC?????

Specialties Geriatric

Published

I reported a situation to the Unit Manager that another nurse did what she referred to as a "take down" on a LTC resident. I am new to LTC and had no clue what she was talking about when she told me she was going to do this to the resident. I pleaded with her to allow me to take the resident back to her room and allow me to give her the IM inj. of ativan to her while in bed and that I thought she would allow me to give it to her because she trusted me. But this nurse had a head full of steam and didn't even want to discuss it. So she tripped her and knocked her to the floor and shot her with the ativan through her clothing. I don't even know how she could accurately hit her landmarks with the res. clothing still on. The unit manae ger told me this was abuse and should have been reported immediately, which I didn't do because the nurse was training me at the time and when I questioned her on it she told me it was policy, so how was I to know differently? My gut bothered me about this incident until I finally went to the unit manager about it. The nurse had left employment at our facility by this time (2-3 weeks later) (She walked out one day because she was riffed about something.)

Anyweveray.. last week I come into work to see her name on the schedule again. I was completely SHOCKED!! I went to the unit manager and asked her why given what I had reported to her and she didn't have much to say other than she didn't have control over it. I asked her if she had told the DON about it and she didn't reply. I told her to nevermind then because i had emailed the Admin. and the DON and explained everything in grand detail. She was later called into the Admin's office and asked if this had been reported to her, she said she had no recollection of it, even though we had just discussed it again that very morning. (LIAR!) I gave the CNA's names that witnessed the act and they were interviewed too. At this point I don't know what to do. If she comes back after I've reported this, she is going to make my life a living hell for ratting her out. She was already bullyish with everyone on staff and would scream and yell at everyone, bossing people around and telling them she was the new ADON (She's an LPN) etc. No one knew officially what her title was, but she acted as though she was the boss, so most of us believed she was.

My dilemma is that I don't know now if I did the right thing. My admin. was great and nice to me. The DON was not so nice and treated me like a nuisance. As though I had broken some unwritten rule to never rat out another nurse. I play by the rules and I don't want to see elderly people abused. In the nurse's defense, the res. was combative and she did bite her. I don't have this reaction from the resident at all. All I typically have to do is talk nice to her and she will follow me anywhere. This nurse has had run-ins with other residents as well. To me she is a loose cannon just waiting to go off again.

Please give me your insight. I am so new to LTC I'm not sure what I did was right or wrong now. I don't think the DON even believes me since the Unit manager has denied the report. Now I look like the bad guy, even though I wasn't the one who did this. What is the Admin. staff's responsibility to do with this information once it has been confirmed by the other witnesses? I don't wish to ruin this nurse's life, I just don't want her to come back to work at this LTC facility. She is always making life a living hell for the rest of us, not to mention the resident's too. Someone please tell me what I did was right or wrong?

What an absolutely horrid thing to do to a resident. I can assure you that if I witnessed such a thing, the "nurse" would be on her way home and a report would be sent to the BON!!!

For a very brief time I worked at a facility with a new DNS. She was fresh from a MR/DD facility. Her big thing was to do take downs on our Alzheimers unit. Fortunately her employment was brief. She not only lost her job, she also lost her license.

For a very brief time I worked at a facility with a new DNS. She was fresh from a MR/DD facility. Her big thing was to do take downs on our Alzheimers unit. Fortunately her employment was brief. She not only lost her job, she also lost her license.

Now this is what should happen to people who abuse the helpless. No questions asked, just GONE-- never to be a nurse again.

Geez, altho I'm new to long term care myself, I've never seen anyone, even in Psych, treated this way!! I found some CNAs trying to get an elderly lady to go to bed the other nite, and she was swinging and hitting and swearing - so I told them to leave her alone. We left her on the sofa for awhile, then later she was ready to go.

Altho I'm new to LTC, I worked in a hospital for many years and am very familiar with elderly people. I can generally get along with them because I try not to be confrontational with them. If they have dementia problems, I sit down with them for a bit, before I approach doing anything.

I agree.....Then what does one do when getting a time eval on giveing meds? Alhzeimer's PT can be gone ,wandering ,in a blink.My PT's had a large area to wander.

I agree with sitting with our pts for a while the approch is calmer and they know the tone of voice. when I worked with Alzheimer's I had A DON that timed me in giving meds I was the only nurse that took so long,of course I gave the medications.

As a DON in the Massachusetts LTC system, I would have had to report this incident to the state Department of Public Health and THEY would have to come in to investigate the allegation of abuse. (the facility is also required to do their own investigation). In this way, the facility and staff are SPARED the opportunity to play favorites. If they didn't report an allegation of abuse, and it was discovered say, during survey, they would be investigated anyway and in addition, reported to the Attorney General for possible prosecution.

I've been a DON for 15 years and we ARE mandated reporters to our state's reporting agency which in Mass is the DPH. Every facility must have an abuse policy that addresses pre-employment criminal record checks, on-going education of abuse/neglect, and clear policy that states who is responsible for reporting, and what is reportable. Very good reading!!

Please keep us posted, HHC_LPN, you are an employee I would love to have on my staff!!

You sound like a beautiful loving person. You are a blessing to those you care for.

We do have a behavior care plan on residents who have the potential for being combative. On this care plan I saw no notations as to what happened, but we have computer charting and I don't know what she wrote on that, if at all. Since no one seemed to know about the take down, I would venture to say that she didn't document it.

Thank you for your comments-- I do have a great rapport with a lot of the residents and I really LOVE my job. It's the first job I've ever had in nursing that I can't wait to get to work. I miss them when I'm not there and I worry about them when I know they are getting very ill. This particular resident will come to me for a hug every time she sees me. She knows I love her and will always do my best to protect her. There are so many of these people that need to know that they are not just a number to their nurses and to me they aren't. They're all special and I enjoy each and every one of them. The down side to me being so close to all of them is that it takes me forever to get through my med pass, because they wall want to talk, hug and catch up while I bring them their medicines. And they always get a hug goodnight when I tuck them in for the night. They know I really care about them and I know they need that. :icon_hug:

As a DON in the Massachusetts LTC system, I would have had to report this incident to the state Department of Public Health and THEY would have to come in to investigate the allegation of abuse. (the facility is also required to do their own investigation). In this way, the facility and staff are SPARED the opportunity to play favorites. If they didn't report an allegation of abuse, and it was discovered say, during survey, they would be investigated anyway and in addition, reported to the Attorney General for possible prosecution.

I've been a DON for 15 years and we ARE mandated reporters to our state's reporting agency which in Mass is the DPH. Every facility must have an abuse policy that addresses pre-employment criminal record checks, on-going education of abuse/neglect, and clear policy that states who is responsible for reporting, and what is reportable. Very good reading!!

Please keep us posted, HHC_LPN, you are an employee I would love to have on my staff!!

I can't tell you what it means to me to hear you say that. I have felt so unappreciated at my facility as of late since this episode. Thank you so much!!! :icon_hug:

I can't tell you what it means to me to hear you say that. I have felt so unappreciated at my facility as of late since this episode. Thank you so much!!! :icon_hug:

Happy to oblige!!! Keep up the good work.:cheers:

You did the right thing! I am sure that this resident appreciates you for the professional care that she receives from you. I am glad that she bit this nurse! She has probably been given good reasons to defend herself in any manner that she can. As a nurse you are a patient advocate so stand up and be proud of yourself. If the facility chooses to continue to keep this person employed....take the next step and report it to your state!

Keep your chin up, you arent' the one who did anything wrong.

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