Being asked to sign on treatments not done

Nurses Safety

Published

  1. What should I do?

    • 24
      Quit
    • 7
      Advocate for better staffing
    • 17
      Contact the State Nursing Board
    • 0
      Sign the MAR anyway
    • 6
      Other solution

54 members have participated

I work in assisted living and it is my first job. The nursing supervisor is asking us to sign off on treatments we didn't do because we are understaffed and can't get to them in a shift. Most of the nurses do this. I won't do it. Not only is it illegal, but making it seem like everything is being done means there is no evidence for the need for more staff. In one case, an order for hourly rounding on a resident was written in the MAR. No way I can see this person more than once in a shift. I signed for one hour. But every other nurse signs off on all eight during their shift. I'm not neglecting this person, I'm prioritizing the one who fell, the one who is having trouble breathing and the one with chest pain. I can't take care of these emergencies and hourly round for something non-emergent. The supervisor puts a lot of pressure on because the "state requires that we're doing all the treatments." Not sure how to proceed to get what I want: better staffing. I've begun documenting with HR that I don't get lunches. Other nurses don't bother. It's additional paperwork to ask for your lunch time in pay. In the end I leave feeling like I wasn't able to do a good job for all the residents. Census is FULL and yet no additional staffing has been added to take care of the increase. Good caregivers are quitting due to the strain. Is there a solution? Or should I just quit before something bad happens?

Don't sign anything you haven't done. If they don't like it then quit, because it is better than them firing you.

Specializes in ER, ICU.

Please call the state. But look for a new job first. Even if you can do this anonymously, your facility might be closed and you would be out of a job anyway. First of all, protect your license, which you seem to be doing. Don't falsify your documentation. Anyone could call the state anytime and you don't want to be on the wrong side of that. But just quitting leaves a stinking mess behind that will undoubtedly lead to bad patient care at best, or a disaster at worst. Best of luck.

Specializes in LTC Rehab Med/Surg.

It's called falsifying documentation.

If you're caught, it's not just your job you have to worry about.

Never, never, never, sign off on what you didn't do.

I selected "other solution".

I would refuse to sign off on a tretment not done and call their bluff. Because it likely IS just a bluff. Employers like this are usually just paper-tiger bullies. They're in no position to fire anyone and their threats are empty. I'd look them straight in the eye and tell them I circled my initials and ask them what they're going to do about it.

And if they do punish/terminate you, well, no great loss. A job like that isn't worth falsifying documentation over.

Specializes in None yet..
As to your charts, the standard convention for charting omitted doses/treatments is to draw a circle around that square and initial it. Do that and nobody will be able to falsify your charts over your signature.

Thanks, GrnTea. I will remember this.

What you are describing is called fraud. And the state can and more than like eventually will hold nurses accountable for this.

Interestingly, the supervisor can and usually does claim ignorance when the chips are down. After all, it is not the supervisor's signature on the undone treatments.

If it says on a MAR to check a patient every hour, and you sign off on the one hour you are able to do this, and the patient falls--and you can't get back there, the next nurse doesn't bother--you potentially have a resident who could be on the floor for quite some time before someone actually notices. And the ER is going to know that--as is the family who pays top dollar for what they believe is a standard of care.

You could call the state--but don't be surprised if the supervisor says "I NEVER said that" and all of the nurses who sign off on undone treatments cover their butts too.

Unethical. If you can go, do.

Specializes in Oncology; medical specialty website.
Please call the state. But look for a new job first. Even if you can do this anonymously, your facility might be closed and you would be out of a job anyway. First of all, protect your license, which you seem to be doing. Don't falsify your documentation. Anyone could call the state anytime and you don't want to be on the wrong side of that. But just quitting leaves a stinking mess behind that will undoubtedly lead to bad patient care at best, or a disaster at worst. Best of luck.

​Her first obligation is to herself and her license, not the facility. If she ends up being on the wrong end of this, her license could be jeopardized, which would be bad for her and the patients she could be caring for down the line.

Specializes in Hospital Education Coordinator.

remember, if you know and do not report, you are guilty too.

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