discovered and reported falsification of VS - page 8

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... Read More

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    There are way too many people who are out of work now, and I am sure there is a line of very good, competent and honest CNA's out there who would jump at at chance to work. Jobs are not a "right", they are a privilege for those who want to work, and who earn the "right" to have and keep a job. Your license is at risk for the CNA's incompetence and laziness. If you don't have support from your manager on this, I would suggest looking elsewhere because your manager doesn't have the guts to do the right thing.
    Hospice Nurse LPN, Otessa, Katie5, and 1 other like this.

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    On another note, I verify some vital signs when I believe that there may have been an instrumental error. Before I was a nurse, I was an aide on the same floor of the hospital where I am now employed. It was apparent that on both of our vital signs carts that if a person had a HR of 50 or below, it often doubled the HR (I think it was counting systole and diastole separately) and the BP was often lower than a manual BP (it didn't release air slowly enough,
    skewing the pressure lower). It's been shown numerous times over the years that the carts do this. I've tried explaining it to the aides, but they don't seem to understand, but when they do manual VS, they marvel at the difference. It's not that I don't trust them, but many of them don't catch this error in the instruments.
    As far as falsification of VS, it has occurred at our hospital, and the aide caught doing it was fired immediately. There was overwhelming evidence that she had been doing for about a week when she was finally caught red-handed. There are bad apples everywhere.
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    My CNA always puts respiration's @ 20. I know that's BS
    canoehead, jujuseah, and Otessa like this.
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    Quote from traumaRNdrama
    To those of you saying you measure your own VS before giving certain meds because you can't trust others/your co-workers to take and document/report accurate VS, which is clearly a VITAL and routine part of their job description/duties in a acute care setting: I'm curious, do you give patient's their coumadin based on the coags that the phlebotomist drew and the lab tech ran, or must you verify those coags for yourself as well? Do you shoot and read your own XRAYs as well? I'm not asking my CNA to do something outside their scope of practice by taking VS. Where does your mistrust end? The majority of my patients are on BP meds and/or some other med that could affect them in some profound way. You must have a lot more time on your hands then we do on my floor if your re-doing everyone's VS...
    When I worked on a cardiac step down, I always did my own BP and HR before giving cardiac meds...for multuiple reasons
    1) VS can change quickly in these patients, and I want to know what they are just before I give the med, not 30 minutes or an hour before.
    2) CNAs are human and can make errors. Their error becomes mine if I give a med based on it.
    3) There are always the few lazy ones like those mentioned in the OP who make them up.

    To me, this is quite a bit different than X-rays and lab results. For starters neither of those is in the scope of MY job. VS definitely are though, and when a nurse is giving a cardiac med it is his/her responsibility to know what the VS are at the time the med is given.
    PatchycatRN, Dazglue, ChristaRN, and 1 other like this.
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    Originally Posted by ohiostudent'RN
    My CI would ROAST you in olive oil and have you for lunch AND dinner if she EVER caught you eyeballing a BP.
    I've never worked LTC, but I can tell you that in some of our ICU patients, doppler or palp is the ONLY way to get a blood pressure.

    They weren't talking about doppler or palp; they were talking about just watching the needle quiver as the mercury dropped. Totally inaccurate, usefull only for telling you you should be hearing something!
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    Quote from traumaRNdrama
    Really? All medical professionals should be able to expect that their team members behave themselves professionally and ethically within their scope of practice as outlined by their nursing/professional board. Expecting that the vital signs recorded into the patients chart are true should be the norm, not the exception. Are you saying you delegate nothing? It sounds like you are implying that the delegation of VS to a CNA (all my CNAs are CNA2's, even more qualified) is inappropriate...
    In reference to the previous post that you are referring to, I just wanted to point out that back in nursing school I was taught that the decision to give or not give a cardiac/blood pressure med SHOULD be based on your own assessment of vitals JUST PRIOR to the med being administered. Of course, I do trust my techs, thankfully haven't been given a reason not to, it's just a practice I've always been taught and continue to this day. I think it's a smart practice for me - I just always imagine that if vitals are obtained during 2000 rounds and I have a med to give at 2100, alot could change in an hour and the few seconds it takes to obtain a set immediately before have more than once changed whether I would or would not give a med, had I relied on the previous set of vitals alone.
    PatchycatRN and TheSquire like this.
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    you did the right thing.
    this makes me absolutely sick..
    how long and how many times has she done this?
    she could very well kill somebody by falsifying v/s!

    maybe I didn't read correctly, but what happened to her?
    hope she was severely punished!
    this is so unacceptable.

    I would've done the exact same thing in your situation; and anybody that wouldn't report something like this is insane.
    sure, you might get some shiz at work but honestly, it doesn't matter.
    patients come first.
    gollybabbler likes this.
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    Quote from traumaRNdrama
    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

    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. 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?
    I always do my own vitals before doing meds, because I don't always believe what I see.
    Retired APRN and BrandonLPN like this.
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    I delegate routine VS to my CNA's. I trust my CNAs and do not believe they falsify their findings. However I take my own Bps and HRs for meds I am administering. This is how I was taught in school and is a requirement of the LTC facility I am working in.
    Retired APRN likes this.
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    Just finished nursing school...instructors taught (harped on, really) to ALWAYS take vs before giving cardiac meds. It is our responsibility to do so. What if tech takes vs an hour previous and something goes south, and you give med anyway. That has nothing to do with trusting anyone. It is about monitoring your patient. Clearly I am not working as a nurse, yet, but that was our nursing school expectation and how I intend on practicing.

    I love how all threads like this turn into a cna bashing session.

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