Blowing the whistle on your facility

[Lovely_RN, MSN]

For a few months now the quality of care has been drastically declining at the facility that I work at due to the administration trying to cut back on spending.

The staffing ratio was never good to begin with and now it's terrible. Meanwhile the acuity of the average resident has increased significantly. Our DNS has flat out told us that she is here to save the facility money and she thinks we have it to easy on the floors so no help is going to come from her. We are lacking in basic supplies for wound care and stock medications. The ratio of total care, psych, and rehab patients vs. regular geriatric patients has increased dramatically but instead of giving us more resources we are being given less! There are issues with narcotics, polypharmacia, and the use of anti-psych meds that have black box warning labels and yet are being Rx for the elderly like they are candy.

I am really close with a co-worker and we are both disgusted by what is going on in the facility. Since we are a union facility I thought that maybe these issues should be addressed with them but the person advised me against it. Basically I was told that it would come back to me and that there could be a lot of repercussions. I was told that I could be blackballed in the future and that maybe they could find something to use against me that would affect my license.

I want to see something happen but I have to be realistic....I have family to take care of...but my damn conscious would never let me say oh well I only have a few months till I can quit. I'm thinking of contacting the state but I'd like to remain anonymous...has anyone ever done anything like this? What happened? Did conditions improve at the facility afterward...were you able to remain incognito?

[oramar]

The I see post about unsafe conditions here all the time, more LTC than acute but all the time. Most the time people only want to know if they should stay or go. Some people like you, actually wonder if they can do anything about the situation. Yes you can report but to promise you that you could report without repercussions to yourself would be wrong. I wouldn't promise you that. Most people that report do experience somesort of retaliation. Big pat on the back to you for being the kind of person that even cares. Most people here will tell you just to move on from there. A small number will tell you that you have an obligation to report. What they won't tell you is how to pay your mortgage or put your kids through college with no income.

[SuesquatchRN, BSN, RN]

Talk to your union rep first.

Whistleblower protection won't work once you're fired, unless you have a buttload of money to hire the lawyer to defend you.

[Rascal1]

I don't know why the state could'nt be notified in confidence,if they have'nt already.

[caliotter3]

People I have known to blow the whistle have been found out despite "confidentiality", and have paid the price through threats, intimidation, and blacklisting. Anyone who decides to take this route should be at their new place of employment with plans not to change employers again for a long time. You would be surprised how many years a person's reputation can be the topic for discussion in the nursing commmunity. You can be long gone and still get blacklisted. Legal action is too expensive, time consuming, and in most cases nothing but a joke. So beware and be prepared for retaliation.

[ANnot4me]

Things in these places have been the same for years and years. They are warehouses for people society wants out of sight and out of mind. If the government really cared, don't you think they would have done something already. Really think about moving on and then reporting.

[Atheos]

Before we jump to conclusions how about giving us numbers.

I remember days of having 14-16 patients. Our CNAs have 7-8 (no trachs, no vents, few caths) and complain about how unsafe it is and how there is not enough time to get everything done. The same CNAs that stand around half of the shift with nothing to do.

So, before we all jump on administration or the nursing home which seems to be the MO here, give us some numbers.

What kind of patients do you have and HOW many do you care for.

[CoffeeRTC, BSN, RN]

I kinda believe the OP....lacking basic supplies, stock meds, short staffing....it happens. Staffing is a biggy to try and prove and sometimes there is enough planned, but with call offs etc......

Call the state or corporate. The state will let you make annon complaints.

Stanley...I see what you are getting at, but.....it happens

[Lovely_RN, MSN]

I actually wrote a list of my complaints.

On the floor I worked yesterday I had 41 patients and I'm the only nurse on the floor. I passed all the meds, I had two trached patients (no inner cannulas in sight), 12 wounds to dress, and 5 f/s to do with coverage before lunch. A lot of them are psych patients but it's 3 of them that are aggressive and non-compliant with meds. They go in and out of the facility all of the time for hitting other residents and staff. One has hit 5 people in the last 3 weeks (3 residents, one aide, and a supervisor).

For wound care I did not have any mesalt, solosite or calcium aginate. I had no adhesive dressings only gauze (rolls and 4X4), ABD pads and tape. The irrigation sets had not been changed for the eight GT patients by night shift because we had none. I had no tylenol 325mg, maloox, enteric coated aspirin 325mg. I ran out of albuterol for the nebulizers (had to borrow from another unit). The emergency box is missing...the 02 tanks in the emergency closet were empty and I had no tubing for the tanks or cannisters or tubing for the suction machines. The narcotics don't fit in the narcotic box so they are stored on the med cart. Labs that arrived on Friday were sitting at the nurse's station and no one called the doc with the results. The monthly renewals had not been touched, I'm responsible for charting writing the 24 hour report, auditing the CNA books. The lock on the med fridge is broken and the place has roaches...do I need to go on?

I'm going to delete this later on cuz I don't know maybe I'm giving out TMI.

[ANnot4me]

Run now before you burn out!I think you have more than justified your position, BxRN2B. Here in NZ they just had an expose on a SNF where someone from the news crew worked as a caretaker. Now everyone is up in arms as if this is something new and only takes place at that facility. The nursing union even reacted like they were shocked. I lasted all of two or three shifts in a SNF. Aide slept all night and then tried to tell me what do. Patients not toileted, falling and etc. Too bad because it could be satisfying work.

It happens all over the world where people believe elderly people have no value in society and are a burden. I love seeing Asians and Pacific Islanders and their sense of family and responsiblility.

[debRN0417]

If you call in a complaint, you can do it confidentially and do not have to give your name. But please, provide information that can be confirmed when the inspectors go in to the facility. Simply stating "we don't have enough help" is not going to substantiate a complaint or get deficient practice. Give names, times, and actual incidents that can be verified. Also state just exactly what the situation is so that it can be thoroughly investigated.

[ktwlpn, LPN]

I actually wrote a list of my complaints.

On the floor I worked yesterday I had 41 patients and I'm the only nurse on the floor. I passed all the meds, I had two trached patients (no inner cannulas in sight), 12 wounds to dress, and 5 f/s to do with coverage before lunch. A lot of them are psych patients but it's 3 of them that are aggressive and non-compliant with meds. They go in and out of the facility all of the time for hitting other residents and staff. One has hit 5 people in the last 3 weeks (3 residents, one aide, and a supervisor).

For wound care I did not have any mesalt, solosite or calcium aginate. I had no adhesive dressings only gauze (rolls and 4X4), ABD pads and tape. The irrigation sets had not been changed for the eight GT patients by night shift because we had none. I had no tylenol 325mg, maloox, enteric coated aspirin 325mg. I ran out of albuterol for the nebulizers (had to borrow from another unit). The emergency box is missing...the 02 tanks in the emergency closet were empty and I had no tubing for the tanks or cannisters or tubing for the suction machines. The narcotics don't fit in the narcotic box so they are stored on the med cart. Labs that arrived on Friday were sitting at the nurse's station and no one called the doc with the results. The monthly renewals had not been touched, I'm responsible for charting writing the 24 hour report, auditing the CNA books. The lock on the med fridge is broken and the place has roaches...do I need to go on?

I'm going to delete this later on cuz I don't know maybe I'm giving out TMI.

You can make an anonymous complaint to the DOH via phone or e-mail.Most of what you posted about could be observed by any visitor-if you really want to cover your tracks you can imply you are a family member.They will follow up within a few days. With tightening budgets my facility is also running out of supplies in all departments including housekeeping and dietary.Tighter inventory control is going to be a fact of life for a long time but it can't impact patient care like this.Improper control of narcs is a clear violation-not having meds available is also...Make a call but don't ever tell anyone you have done so and get out of there fast. Come work with me-I work on a 42 bed unit-2 to 3 nurses on days and occasionally 4 cna's but usually 5 to 7..Some of our gals are independent with their adl's.No trachs at this time-a couple of tube feeds,one wound vac-a few skin tears.Some IDDM's-lots of multiple med people-they all have lotions,potions,pills,drops,sprays and nostrums for everything! All in all I'd say things are pretty good. We do seem to have a disproportionate amount of wacky family members now though-that makes up for everything else,I think=argh...