discovered and reported falsification of VS

Nurses Safety

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Hello Nurses!

I need to vent and am interested in others' experiences... Yesterday, as I went to administer a BP med around 1600, I checked the patient's VS machine history and the last set of VS was taken at 0805. Now I specifically remember checking the electronic chart around 1230 and seeing a full set of VS documented for 1200 by my CNA. I re-checked the e-chart and confirmed that noon VS were entered. My heart sank! I printed off the VS machine history and showed my CRN, too P.O.'d to confront the CNA myself in a professional manner...took my first break of the shift (I work 7-1930, was super busy) while the CRN spoke with the CNA. The CNA proceeded to interrupt my break to chastise me for not asking her about it before going to my charge and then offered me a BS line that she took her assigned noon VS manually "for practice" because in her last review the manager said she needed more practice... YEAH RIGHT!!! I pointed out that she sure as hell didn't take the temp or SAO2 manually, so where'd she come up with those numbers????? As I expected, she couldn't explain that and walked away... I only managed to sit in the break room for a couple minutes before I was compelled (by a sick icky feeling) to go check the chart and VS machine of my other patient she was assigned to... Same ******* thing!!!!!!! GRRRRRRR. I called my RN manager @ home on her cell phone to report the CNA. My manager stated that the conversation the CNA alluded to where our manager asked the CNA to practice manual BPs never occurred... At my manager's request my CRN and I initiated a check of every single patient's chart this CNA was assigned to that day....UGH :mad:

Unfortunately, this CNA is quite popular with a lot of the RNs, to the point that many of them hang out socially. The unit is quite clique-ish, and I am anticipating that I am going to get a lot of "poop" for turning her in, as she will be fired, I'm sure. Already, some people are taking her "side", like I'm just trying to get her in trouble! I am in no way regretting reporting her. My first responsibility is to my patients. :nurse: While I would love to be well-liked by my peers, and generally am, I'm not there to be everyone's buddy. What she did is unethical, dangerous for the patients, and makes me wonder how long has she been doing this? How many patients have been medicated based on her false data? It makes me wanna scream!

Anyone else been in a similar situation or have any advise for me? :confused:

To the OP - Stick to your guns on this one. Falsification of vital signs is very serious because nurses base their admin or withhold of meds based on those very vital signs. I am an LPN now but have been an aide for almost four years taking vital signs on all of my patients every workday. What if someone was given a blood pressure med based on false BP figures and they ended up crashing and coding because of it?? Myself I've always figured that it's easier to just record what's there anyway rather than make them up :-/ If they aren't within certain perameters and that causes more nursing charting and nursing tasks, well that's too bad, but they just are what they are and should be reported. I've gotten flak from some RNs in the past for certain results that I've reported but I'll tell you what, I'm not going to "fudge" on anything for any reason, ever - it's my patients lives that are at stake

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You guys realize this is a thread that was started more than 2years ago and reanimated last night, right. Either way false data requires corrective action/supervisor notification.

Yes I realize that it's an old discussion topic, but it's still relevant. And yes, anyone who does that should be reported, without question.

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When I was finishing my LPN., for LPN management clinical s. I observed along with several other people a CNA tell a patient who was in hospice " honey your gonna die anyway" while he was complaining on being turned.:luckily she was walked out the next hour..but after a month they brought her back to work!!..recently as a RN on a busy med-surg floor the CNA who was working with me lost it bc call lights weren't being answered in her timely manner..she proceeded to yell throw things and cuss, was asked to go home, shes back and nothing happened. I'm losing faith in the system.:unsure:

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Specializes in Pediatric/Adolescent, Med-Surg.

I worked with a CNA at a facility once that was caught faking vitals and I&O's. The way she was caught was a nurse went in a room shortly after the vital signs were documented, which were charted as being within normal limits, and realized the pt was febrile. The pt stated the CNA hadn't been in the room in hours. The worst part was while the tech was fired this was the third or fourth time she had been caught faking vitals. I can't believe they kept her around for so long

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The unit I work per diem on (and used to be FT there) doesn't let CNAs/PCTs/whatever you call them take any VS. It is the nurse's responsibility. They used to take them...until a few aides were discovered making up numbers. So, instead of firing them or doing anything to them, they just took the responsibility of VS away from the aides, and gave it to the nurses. I always take before BP meds, etc anyway but now we do them all. Just one more thing for us to do! With 10 patients, that adds a good amt of additional time onto our shift that we had to learn to squeeze in. Oh and those aides still work there.

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The unit I work per diem on (and used to be FT there) doesn't let CNAs/PCTs/whatever you call them take any VS. It is the nurse's responsibility. They used to take them...until a few aides were discovered making up numbers. So, instead of firing them or doing anything to them, they just took the responsibility of VS away from the aides, and gave it to the nurses. I always take before BP meds, etc anyway but now we do them all. Just one more thing for us to do! With 10 patients, that adds a good amt of additional time onto our shift that we had to learn to squeeze in. Oh and those aides still work there.

That really bites - both that you have to do regular VS and that those same aides still work there. Where I work there is no such protection - aides would be fired and new ones hired probably for less money. Where I work nurses do some of their own vitals sometimes but aides still do most of them

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I don't know everyone's environment here, but when you work ltc and 32 pts and ALL are on BP meds it is IMPOSSIBLE to take all your own VS. It ain't gonna happen

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I don't know everyone's environment here, but when you work ltc and 32 pts and ALL are on BP meds it is IMPOSSIBLE to take all your own VS. It ain't gonna happen

That isn't an excuse to make it up. I just admitted a patient today who still hasn't recovered from taking her labetalol and having a major hypotensive episode. We're talking about the potential to cut off adequate blood supply to organs because you think it's okay to rationalize fake vitals. That's no better than nurses who fake giving medications.

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That isn't an excuse to make it up. I just admitted a patient today who still hasn't recovered from taking her labetalol and having a major hypotensive episode. We're talking about the potential to cut off adequate blood supply to organs because you think it's okay to rationalize fake vitals. That's no better than nurses who fake giving medications.

I agree. I'm a nurse talking about how I can't take VS on all 32 pts so the aides who I delegate to with 10 pts a piece should be taking VS as directed. I was stating that the nurse should be able to trust the VS given to her because it is within the scope of the aide to do

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Specializes in LTC Rehab Med/Surg.

I've worked with the same CNAs for years. I trust the VS they chart.

Having said that, I recheck B/Ps whenever I give a med that will significantly lower that B/P. Expecially when what is recorded is marginal.

I also check my own manual B/P whenever I call an MD. Not because I don't trust the CNA, but because the numbers have to be the result of MY check.

That's just one on my many weird quirks.

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I don't think that's a weird qwirk. That is nursing judgement. Yes, CNAs are responsible for taking vital signs, but it is up to the nurse to verify those that are out of range or those that we question. I always recheck manually after an abnormal from the CNAs machine. It is expected, in my opinion.

CYA - Cover Your .....butt? :)

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Although i don't use this technique; you actually can measure a bp by looking at the dial and usually you can tell what the bp is by seeing where the dial "bumps". If you release the air slowly its usually pretty accurate. I dont actually do this but i have notice this when auscultating BP.

No, you can't. It's not at all accurate because the "bump" starts before the actual heart beat starts and ends. In a pinch, you can take the BP by palpation, i.e. you use your fingers to feel for the pulse in the brachial artery, but it's not appropriate when you have to measure VS for meds or for an acutely ill patient.

Laura

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