Falsifying documentation

It sounds like you've followed up, and action was taken. We don't know if documentation was falsified, since we don't know what actually happened.

First and foremost I would like to say that no, there was no 'relationship with this nurse'.

And yet...

I have personally seen the consequences of her actions before with a previous incident, there was no open disclosure to the patient by management and he was not told why the skin on his entire bottom extending up to his back had broken, he was under the impression he was allergic to tegaderm which the nurse involved in the incident told him!

And..

I had to continually remind management and monitor to ensure that he was told the truth and not made to believe he was allergic fo something he was not.

Yeah...you have a beef to grind with this nurse.

Based on your posts, you have nothing but hearsay statements from the patient and his wife to rely on - and hence why management is not really getting involved (at least, to your liking).

Now, I am just a newbie nurse but I know that there are patients who self-harm (i.e. remove their fentayl patches, take out their IVs, increase the rate on their IV pumps, etc.) and then try to blame the nurse for their actions.

Is it really hard to believe that with this incident, this incident, the other nurse is actually telling the truth? Is it really hard to believe that maybe the patient or his wife removed the dressing for whatever reason (i.e. they did not like the way the nurse did it)?

Think about it. If she really was skipping the wound occasionally, then why did they not videotape her doing so?

Yuck. This is story is another reason why nurses should be allowed to have body cams. Like, seriously~

Just like in any other type of work make sure the actions of others don't pull you down.

i like to call it "covering your a**"

Jig,

Sounds to me that you work for a horrible company if they are willing to lie to a patient. You mentioned a previous event where a patient had skin breakdown up his back, and was told he was allergic to tegaderm. That's BS! Get out of there, while you still have your Nursing license!

yup you mentioned there was no dressing and life goes on. let the patient make the complaint to your supervisor.

And I have had patients refuse to have their treatments done, and then report that "no one does my treatments!" trying to get the nurses in trouble. I have personally had patients that would allow me to do their foot dressings and then refuse their buttocks dressings. I have also had patients remove their dressings within hours of my doing them (and these people are A & O x 3.) You can never be sure the patient does not have a personal agenda (like secondary gains - attention from others.)

The reason which I didnt directly approach the nurse first about this issue is because there is a history of her being dishonest and trying to cover things up in the past.

If you were in this situation, what would you do?

Put on your big girl panties and talk to the nurse about it anyway.

Patient is A&O - wife was also present and witnessed it all.

Also, when people mention that I need to talk to the nurse first, can they give me an example of what they would say?

In my head, due to the seriousness of the issue, I believe that this is not in my scope to deal with. The only thing I could think of saying the nurse is 'Why did you falsify the documentation' which is not appropriate for me to say.

If others suggest that I try to ask questions to investigate the issue, once again, that is not in my scope of practice to do, but rather managements.

I could say to her that 'Patient x made complaint that you did not do x dressing' but due to the past history this would give her an excuse to make up prior to management approaching her.

Your suggestions are all welcome and helpful to give me other perspectives/points of views on the matter.

Also roser13 - I absolutely agree with you. Also of note, the wound deteriorated significantly after the event.

When you talk to the nurse, describe what the patient told you and what you found. When you talk to management, describe what the patient told you, what you found, and your conversation with the nurse. What you may have heard about past mistakes, blame shifting or cover-ups is background noise only, and it's not your place to discuss that either with the nurse or with management. Stick to the facts about THIS situation. The manager may well be aware of the problem and may ask for documentation. In the documentation, describe what the patient told you and what you found. No emotion. Just quote the patient and describe what you found.

Hi, that's true but for the duration of time I have been there, it seems that dealings with incidents is inadequate and appear to just be brushed under the carpet.

Caught in an ethical and moral dilemna, feels like I dont have any more left in me to advocate for the patients anymore.

You have no idea what is going on behind the scenes, nor should you. If management is dealing with this nurse, it's a confidential matter between management and the nurse involved. Management cannot discuss the situation with you.

The wound significantly deteriorated after missing one dressing change?

The wound significantly deteriorated after missing one dressing change?

OP clearly has an axe to grind. Initially I felt supportive, and wanted to advise. However, OP has continually rebutted any attempts to advise based on the original question, and appears to have wanted support in an original preconceived notion. OP wanted something a certain way, and it wasn't that way. Advise application for management if desire is to judge.

Hey, OP.

Ever thought that maybe, just maybe, the patient or the wife removed the dressing?

Yuck. One of the dangers of bedside nursing - patient does something stu..."questionable" and then tries to pass the buck to the nurse

I agree with you. Often patients or their families do things and don't admit it. I have heard many times that "so-and-so didn't do such-and-such" only to have proof that the patient was not telling he truth. Just because the wound dressing appeared different than documented, does not mean anything wrong occurred. I would not offer any complaint forms to the family. They know if they have a complaint they can call the office. If they ask me for a form, then I will produce it. I will make sure, as many others have stated, that my care and my documentation is very professional at all times. I would also mention the patient's comments to the nurse invovled (I always do). It gives her a chance to explain herself or at least be more aware of her care.

I'm concerned that the wound deteriorated significantly because this one dressing was not applied. This does not sound possible if wound care is done daily. If it is not done daily, I would seriously question that a wound only detriorated because of one missed dressing. Lots could happen in-between dressing changes. This is not an incident report. What mistake would you say was made? Also incident reports are for internal use only and are not part of any other record, so not useful for outside agencies. This is not reportable to the BON because you cannot prove or even suggest false documentation. It is very serious business when you go after someone's license, so tread carefully in those waters.

Although wound care is a very serious issue, you are prmiarily responsible for what you do and document. If the wound is getting worse, report it, but for medical reasons rather than reporting on the nurse.