Elopement, told by DON not to document

Nurses General Nursing

Published

I work at an ALF and was told by DON not to document that one of our dementia tenants snuck out the front door. Tenant was wearing a wanderguard, however it did not make the facility alarms go off. Elopement policy states to document the incident completely, however this policy is for the nursing home attached to the Assisted Living Faciltiy. Are Assited Living policies different, since it is more independent? I do not know what to do. I feel the situation should be documented, as this person is not allowed outside the facility alone, and this is not the first escape. I also fear that sometime the tenant may get out and not be found. There will be nothing to support the fact that she has escaped many times if it goes undocumented. However, there is a risk of upseting the DON, and a loss of a job I love if I do not follow DON orders. I would like to talk to her superior about the situation, but all nurses were told we were not allowed to take issues to the superior??? What should we do??

An elopement should ALWAYS be documented, to protect everyone. If something happened to him and it wasn't documented that the facility knew he had eloped, the facility would be in deep ca-ca.

Specializes in Nurse Anesthesia, ICU, ED.

For the sake of your license document the incident then document the conservation with the DON. Gather as many witnesses as possible willing to cooperate with you on this.

Specializes in Cardiac Care.

Ditto. You have to document.

Document it. Should the worst happen, you will be answering for your action/nonaction. You can only state that you informed the DON. I have no idea what you can do about not having informed the MD or the family or taking steps to correct the situation with the alarm not working. This is a disaster waiting to happen. I do not envy you.

I agree with all the feedback and I would definately document this situation. I am actually writing about a situation that happend to my co-worker. I didn't want thread to be too complicated, however we share the same DON and this is a problem. She repeatedly gives terrible information, and incorrect instructions. Thank you for your advice. I am a new nurse, and sometimes we just need feedback from people more experienced.

Specializes in LTC / SNF / Geriatrics.

Yes, document! As your DON she/or he should know what the regulations and facility policies state. Does your facility have an elopement policy? You can always cite that as your guidance in what you do with your documentation. If she gets down on you for not following her poor advice, I would go to her superior because her poor advice and incorrect instructions are putting the whole facility at risk.

Regardless of what the facility's policy is about how to handle the elopement, you should always document the occurence itself. Also make sure you fill out a QRR or incident report....those stay in house and are just tools to correct problems.

For your own personal documentation, write down the incident itself and what the DON told you. Don't tell anyone you have that documentation because if something happened and it ended up in court, the only person who should know about your personal documentation is your attorney.

document what is happening

and bring the situation to the attention of her superior

this allows them to correct the situation from within,

otherwise, are there other authorities that need to be involved?

what would the health department have to say?

is there an ombudsman for the residents?

{I was reading about the function of an ombudsman last week when reading about the nurses who were charged for "abandoning" patients at Sentosa facilities, (while exploring more details about the situation in these facilities)}

Specializes in Neuro/Med-Surg/Oncology.

Check out these links about a similar situation:

http://kdka.com/local/local_story_043102637.html

http://www.post-gazette.com/localnews/20031023atrium1023p1.asp

Do a search on Atrium Nursing Home Pittsburgh and you'll get all kinds of reenforcement of the advice you're getting here. The nurse who did what the DON told her also got sentenced to jail time and probably will never have an active nursing license again.

Specializes in ICU;CCU;Telemetry;L&D;Hospice;ER/Trauma;.

The DON is placing you in the position of liability, as opposed to the facility....which is wrong....

She does not license you. Protect your license. You should document....and better yet, a copy should be placed with the superior above th DON, and it should be noted on the document that a copy was forwarded to both of them. This places the responsibility solely on the facility and them...not on the bedside nurse...

If a patient becomes disoriented, escapes, and dies as a result, the family can sue the nurse who was assigned the patient, unless she noted in her notes that the alarm was in place and working, and that she had in the past notified her superiors of previous escapes, despite the alarms system.

This then would be on them, for failure to correct the problem...(this is what they are clearly trying to lay on you!!) The alarm system is not your responsibility....do not shoulder it...the DON is out of line. If she attempts to fire you for doing the absolute legal thing, I would report her to the nursing board....she is asking you to do something illegal and is a risk management nightmare.

I agree! Document, document, document. Follow your policy because this is a dangerous situation, and if it should happen again the DON will blame YOU and say that YOU did not follow the facility protocol for elopement!!!!

Go to the administrator with this. If no one listens, go to Protective Services. (In MA we don't have ombudsman programs in ALFs). This resident might not be an appropriate candidate to remain there and need a more secure facility.

Good luck and keep us posted.

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