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- Jun 10, '12 by student foreverQuote from Rob72This is the KEY: a paper trail! Take the time to doc every shift all the combats and be consistent with it. It enables the nurses to talk to others with concrete evidence in hand. Plus you will have this same evidence should you need it if the issue of everyone's safety is not resolved.Yeah. In cases of diminished capacity, the healthcare proxy (in out-patient settings) or the CMO (Chief Medical Officer) bear responsibility for the actions of the individuals.
Document explicitly what you observe, experience and do.
I understand the tempation to not take the time to doc. Is there a way you can keep copies of the docs for yourself?
- Jun 14, '12 by amoLuciaIt may only be a matter of time before this resident becomes increasingly dangerous to others including visitors and other residents. Has there been any episodes of patient to patient aggression??? I believe that this is an event that is mandatorily reportable to the Dept of Health Survey people and/or the Ombudsman Office. Also if the police become involved because of family notification, there will be an investigation.
As others point out, the paper trail is CRUCIAL. Administration will be seen as negligent in protecting others from injury and this opens up a whole can of worms re: liability and litigation possibilities for the facility. Also, has any employee been injured??? This would fall under Workman's Comp, and employers HATE having to deal with job injuries like these.
You absolutely MUST make out employee incident reports for scratches, welts, squeezes, etc from injuries sustained by all staff who are injured by this resident. The documentation has to be there! It is for your protection too, should there be delayed sequellae.
It is sad that the resident has so declined and is really not responsible for his/her actions, but others must be protected. Just as an aside, I've seen lightening-quick action occur when an administrator, manager or other dept head has been injured. One last thought, is there a corporate office that can be anonymously nottified? As much as I hate anonymity issues, sometimes the corporate route may help, or a union representative inquiry might just shake the tree!!! Good luck!
- Jun 26, '12 by MaremmaHmm I am dealing with a lot of these same issues too. Last night was way out of hand for behaviors from several of my patients.
As if I do not have enough problems with all the "rehab" people, new orders or change of orders constantly coming in for them, phone constantly ringing for one patient or the other, family members coming at me all evening long mostly to complain or demand something. 2/3 of my patients also being chem stick/coverage diabetics(also some of which become behavioral because they keep getting stuck in the ends of their fingers 4 times a day) I have way to many dementia patients that sundown.
One was attempting to get up from her chair and I could see it was going to tip. I ran over to her to stop the chair from flipping and she punched my right in the throat and spit in my face at the same time. UGH! This was right in the middle of trying to do the paper work part for a different patient that had grabbed one of my aids right in the middle of a brief change and twisted her arm. He used so much force you could still see his fingerprints in her arm 15 minutes after the incident occurred. AND at the same time trying to get through to the POA of ANOTHER patient that was ALSO behavioral wound up sitting on the floor beside her bed then scooting herself and being combative when staff got near her to try to assess her and get her to understand we were trying to help her get off the floor. This lady still had the staples in her thigh from a hip repair surgery but that didn't slow her down any apparently with the combative behaviors.Just to make it even more "fun" A FOURTH patient was starting right back up again with is hallucinations and corresponding behaviors. It is beyond safe for anyone down my hall on any given night.
Look for another job? I have to wonder if it is any better anywhere else that calls itself a "nursing home". Staffing seems to be inadequate to deal with the increasing number of patients with dementia related behaviors everywhere. I feel completely inadequate to handle all of this at once as well.
I always stay late to be sure ALL behaviors and ALL interventions are documented for anyone that does "even the littlest thing". How long do you keep documenting and reporting this stuff before you can expect to get medications or med changes made for each patient anyway?
Really even so it doesn't help with the problem of all the new ones coming in with these kind of issues. We are still in a perpetual state of "danger" because even if we do get the newer ones settled down, some of them are a lot harder to get properly treated and then more new ones keep coming too with violent or unsafe behavioral problems. I feel like a punching bag most days at work and I am getting to old to keep taking one beating after the other. One of these days I am going to wind up the one with broken bones.
We had an employee wind up with a literal broken neck from a patient grabbing her pony tail and yanking her backwards. Work comp is a joke. God help anyone that winds up seriously hurt at work. They don't want to help you.They are not there to help you get better and get back on your feet. They do all kinds of evil tricks to keep from having to pay for anything much less proper care of an injury etc. If you wind up with permanent damage you are really in trouble then. people have committed suicide from the abuses suffered them from their work comp insurances and employers. It is truly a nightmare what they do to people. And yet THIS is our only "safety net" to working in such an abusive environment? Scary indeed.