Who do I turn to?

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.

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!

unless they have plans to blame YOU....of course i am NOT the least bit paranoid....

You go, Chloe!

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.

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.