APS reporting and then termination

Published

Hi everyone!  LPN of 10 years here. Today I was fired from my job for insubordination. 
 

Background: facility I worked for I did wound care management. I requested specific orders for a resident. And applied that dressing order. Days passed when I made rounds for wound care. The CNA alerted me that resident was showing s/s of infection where the wound was dressed. Basically I came into a situation where someone changed the dressing (DON and another nurse) and left in place for two days with no monitoring an inappropriate dressing. I attempted to look beneath the dressing and a gush of blood and pus came out. I immediately took this person to the nurses station where I work for 15 minutes to slowly remove the dressing with NS. What was under it was atrocious. The whole back of the hand, epidermis, came off and you could see it was infected. That should have never happened.  
 

I won’t go into specifics. But I did report it to DON who basically told me it was fine. I told her it is not. The dressing applied is not the correct dressing and resident now has an infection when all of this was entirely preventable. 
 

I made a call to APS. Well today APS came into facility to investigate. And I was told that whole day that admins were going to retaliate against me because they assume I made the report. 
 

Well reports are anonymous. Yet after APS left the facility I was fired an hour later for “insubordination”. The insubordination directly related to this incident. The DON stated during a meeting I left when discussing what happened. I did. I left to help with an assist and then came back. I tried to say that but she did not let me. Then she said I was insubordinate because I updated the POA about my concerns for this resident and needing an antibiotic started. Well my job is to notify the POA. She said that was confidential information. (it is not confidential for the POA). 
 

Well I documented everything over the course of a week. To the T. And I got let go. I contacted an attorney who believes I have a case for wrongful termination. Especially when I only get accolades for my work and even have typed praise from my administrator. Is it worth even pursuing? I hate feeling like advocating for resident care is the wrong thing to do. But I couldn’t accept what happened. Especially when I provide wound care and other nurses totally disregarded the orders for his hands. Causing more damage. 

PoodleBreath

69 Posts

Specializes in Hospice, LPN. Has 17 years experience.

Are you sure you want to stay at this job? Sounds like a nightmare and since you are the wound care nurse, when State does their survey they'll be pulling records on all your patients. Even if you've gone above and beyond, and your documentation is perfect it will be a massive headache and your facility will try to throw you under the bus. 

Maybe it's time to cut your losses.

CrunchRN, ADN, RN

4,460 Posts

Specializes in Clinical Research, Outpt Women's Health. Has 25 years experience.

Thank you for doing all the right things. I would pursue a financial settlement, but work elsewhere as they will always have it out for you.

kbrn2002, ADN, RN

3,729 Posts

Specializes in Geriatrics, Dialysis. Has 21 years experience.

Take your wound care expertise to another job.  I'd tell you to go ahead and file that wrongful termination lawsuit but I'm afraid with the current shortage of nurses, especially trained and experienced nurses with a specialty certification if you are indeed certified in wound care proving loss of income might prove difficult as you can easily find employment elsewhere. 

HiddenAngels

790 Posts

Has 9 years experience.

This sounds like textbook whistleblowing.  I would seek counsel.

I'm sorry this happened to you.  And they wonder why people don't like to speak up. Just, Wow.

neuron

553 Posts

Has 5 years experience.
On 4/21/2022 at 3:27 PM, Heart_nursing said:

I immediately took this person to the nurses station where I work for 15 minutes to slowly remove the dressing with NS. What was under it was atrocious. 

I made a call to APS. Well today APS came into facility to investigate. 

This doesn't sound like the appropriate action to take, to take this patient to the nurse station, and undress a wound. Maybe the administrator or DON was unhappy because you didn't follow the chain of command, file an incident report, etc? Not sure if you called APS that day or after you received a response from your administrator. Not that the administrator is a nurse, but if there's a problem it seems that APS was not the correct agency to call. 

Specializes in Wound care.

It was the appropriate action. The dressing applied was incorrect and applied tightly. Hand was red and warm and swollen. I couldn’t leave something like that in place….especially when it was the WRONG dressing applied which ended up causing more harm than good. 
 

Nurses can’t just apply whatever dressing they want to a wound. We have to follow orders. And when a nurse doesn’t follow orders and it causes harm to a resident that is negligent care. And I did do an incident report. Contacted provider. Notified POA. And DON. And as the wound care nurse my job was to make sure wounds improve. So to come in and make rounds and find this….well it is my documentation attached to it. And nothing was documented on why the dressing was changed and not monitored and actually left on for two days when it was a daily dressing change. 
 

APS most certainly was the correct entity to call. Especially when it was being brushed under the rug. 

neuron

553 Posts

Has 5 years experience.
2 hours ago, Heart_nursing said:

It was the appropriate action. The dressing applied was incorrect and applied tightly. Hand was red and warm and swollen. I couldn’t leave something like that in place….especially when it was the WRONG dressing applied which ended up causing more harm than good. 
 

Nurses can’t just apply whatever dressing they want to a wound. We have to follow orders. And when a nurse doesn’t follow orders and it causes harm to a resident that is negligent care. And I did do an incident report. Contacted provider. Notified POA. And DON. And as the wound care nurse my job was to make sure wounds improve. So to come in and make rounds and find this….well it is my documentation attached to it. And nothing was documented on why the dressing was changed and not monitored and actually left on for two days when it was a daily dressing change. 
 

APS most certainly was the correct entity to call. Especially when it was being brushed under the rug. 

 Somebody should have addressed the wound. Whichever nurse was assigned for wound care. It sounds like a practice issue and not an abuse issue. 

Specializes in Wound care.

The wound had been addressed. I was the wound care nurse.  As I stated there were current orders on the wound. Resident had skin tears with steristrips applied. Provider orders. And then one day I made rounds and another nurse applied a compression dressing. Didn’t document the situation. And left on for two days until I made rounds. Resident’s hand was red, warm, and swollen due to an inappropriate dressing applied. This dressing could not be left on. So I slowly removed it and in doing so saw nothing but signs of further infection and maceration. 
 

im not sure why you’re responding when it seems you don’t understand that a nurse can’t just do whatever she wants to a resident/patient. They have to do as the provider directs. And no resident should have a negative outcome due to negligent nursing care. 

 

And the wound was addressed.  Resident needed antibiotics and a completely new dressing applied based on this scenario.

 

so: when another nurse applies the incorrect dressing when there are specific orders in place and it causes more harm to the resident….also lack of documenting and monitoring….this is a negligence issue