Who do I turn to?

  1. 1
    Good Morning y'all,
    what's the first step in blowing the whistle on my LTC facility? Who do I turn to?

    I keep hearing the fear in workers' voices each time they speak of "the state was here last night" or "the state wouldn't like_____".

    How do I get in touch with "the state"? They need to show on my unit to witness and either correct or shut down the darn place!

    • Here's why:
    There's a fall every day
    • And:
    PHI is being shouted down halls, tossed about and not shredded, left on counters for all to read and hear everybody's business
    • And there's more:

    P&P blatantly disregarded to dress code/id badges/appearance/odor?
    Stealing snacks off food trays left for the residents?
    Using cell phones all during shift
    coming in late, leaving early, taking breaks when residents are on the call lights and ignoring them
    Insubordination, refusal to answer the call lights or tend to residents in need

    whew!

    So in addition to much more that just thinking about makes me incensed, can anyone offer some guidance to me to get the word out on this facility before I hightail it outta there and can salvage my own reputation and license?

    Thanks!
    Chloe
    RN-BSN, BA
    jadu1106 likes this.
  2. 14 Comments so far...

  3. 2
    It is my understanding that every nursing home must, by law, prominently post the phone number of the State LTC Ombudsman.

    Hubby and I had POA for his elderly aunt who resided in a nursing home. I called the Ombudsman once to report unsafe staffing and neglect of personal needs. They informed me that they were required to make an unannounced visit within 48 hours of receiving my phone call, could legally access medical records during that visit and would interview several residents and family members so as not to tip off the nursing home staff as to who made the complaint.

    I called back a few days later for a report on the results of the visit. They confirmed everything I told them, (and then some), and let me know what I could expect to see in terms of improvements. Things did get better at the facility. We desperately wanted Auntie to move to another facility, but she was unwilling to do so. I guess familiarity was more important to her than consistently good care. So sad.
    natrgrrl and jadu1106 like this.
  4. 1
    Sad indeed Jolie. I'm sorry to hear of this. I've seen the Ombudsmen poster. I will be sure to call in to them tomorrow when I report back to work.

    After I re-read what I wrote, I realize I barely glossed the horrors I've seen. But I would like to know what caregivers in other facilities consider an appropriate wait time for a call light to be answered. I was told last week when a family member was begging for my help, that 20 minutes wait is not unreasonable at all. Hmmm...auntie sitting shaky and overmedicated and in the middle of the night on the toilet with skin issues and risk for falls acceptable for 20 minutes, eh?

    Just doesn't seem right to me. yet the ADON is a horrible creature that allows this to continue in what she calls "the culture" of the facility.

    Why the hell was I hired? They obviously don't want an RN or any outsider.

    Chloe
    RN-BSN, BA
    SuesquatchRN likes this.
  5. 1
    You will need to have documentation before you do this or you won't have much protection from the fall out. Make sure you have documented dates, times, people, incidents, conversations, any time you have shared your concerns with the DON.

    If possible, the best course of action is to put your concerns in writing to the DON and administrator and see what kind of a reply you get back. This ensures that they cannot fire you for breaching the chain of command. Of course if you think that someone is in imminent danger then the chain of command may not apply if you have tried in the past to get things changed. The key is in your documentation.

    The ombudsman will come in and look around but I can almost guarantee you that they won't find much. Your documentation will be key. Once you have enough documented you can call the state agency that surveys you, in TX it is under a branch of the dept of health. Submit your concerns to them along with your documentation. You may even be able to do it online.

    Good luck!
    Jolie likes this.
  6. 0
    unless they have plans to blame YOU....of course i am NOT the least bit paranoid....
  7. 3
    Well, I just got off a lengthy phone call with my ombudsman. She assured me that I'm doing the right thing as advocate for my residents and she tells me they are already investigating based upon previous complaints, but due to confidentiality, she is not at liberty to tell me more. Then she asked permission to relay what I talked to her about with our state dept of health rep. I gave her a big ole green light and will continue to do my best to document all I see and hear.

    Thanks gang!!
    Chloe
    RN-BSN, BA
    Jolie, SuesquatchRN, and RN1989 like this.
  8. 2
    You go, Chloe!
    Chloe'sinNYNow and Jolie like this.
  9. 0
    I'm not all too convinced that I won't make it through the exit door before they boot me out. I hope on my exit from this facility, that I can make a difference in the residents' lives and quality of life. The way day to day and night to night care is given at this facility is horrendous, and I feel like I'm their only advocate! I've come to care for them so much!! And so many just don't have family around to be their mouthpiece or be able to speak for themselves. My heart aches for them.

    Surely there must be somewhere I can be a good nurse and still make the mortgage after I leave this place. All of you that know from my previous threads understand what a difficult time I"m having breaking into this new field as a 2nd degree newbie.

    Thanks to all of you for your support!!

    Chloe
    RN-BSN, BA
  10. 1
    Some of your complaints sound like staffing issues to me. Any DON worth his/her position would put a swift stop to many of your complaints. I know that cell phone use by employees is one thing I can't stand to see either.

    At the facility I work at, call lights are answered by nurses aids. Pts shouldn't be wandering around in their bathrooms alone at night, anyway, and while many of them do not understand the safety issues involved, it's up to the care providers to make sure safety restraints are in place so that wandering doesn't happen. It's been my experience that most falls happen at night.

    I can assure you that nothing ever happens when state comes. As soon as they are in the door - announcements are made throughout the building and everyone is on their toes! If only facilities operated the same way without state inspectors in the building!

    I've worked through inspections, and obviously everyone is doing everything the correct way. Everyone washes their hands after each patient and takes the apical pulse for a full minute and changes gloves nine times for one treatment, etc. All by the book. And while this is the perfect way to do things, just as many other things in life, it's not always possible or practical to do it that way all the time. Staffing and time constraints always override.

    When you are taking a driving test with the officer in the car, you obviously go out of your way to do exactly what you are supposed to do, and perhaps when the officer steps away, you are back to your old ways.

    Nursing isn't any different. Basically, you are either trained correctly in the beginning, and learn correct habits, or you don't. You either have a work ethic, or you don't. I was trained to never leave patient information laying face-up, and therefore I never do that. I take bp's before giving blood pressure meds, and check the aps a full minute before giving dig...but does every nurse? I doubt it.

    All I can do is the best I can do and try not to go crazy watching how everyone else does it.

    Good luck with your complaint and I do not doubt that it has its merits, but again, I think it's a staffing issue.
    bluegeegoo2 likes this.
  11. 3
    As an RN in most LTC's you have the authority to "write up" those who are not doing their jobs. Everyone on your unit is working under YOUR license. YOU are the one responsible for the care or lack of care being given. Speak up to the aides and if that doesn't work start writing warnings. Keep a copy for yourself, that way if the DON amkes them "disappear" you have evidence that you did something. As an LPN I have been charge nurse and even supervisor in LTC. I have had to do write people up. Not pleasant, but better than me being held accountable for injuries from a preventable fall or decubiti from poor care. You are bound by your licensure to be accountable for the actions of everyone to whom you delegate care. It is very hard to get control of a staff that is out of control, especially when you are new and younger than many of them. Having no backup from the DON is bad, but you must protect yourself and do something or get out of there before something really bad happens.
    You should be able to find the number for nursing home complaints under the DPH. It's called something different in different states. It usually does little good to call them unless the place is truly a cesspool and patients are dying or being injured by negligence. If that becomes the case, the RN is the person liable not the unlicensed aides.


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