Falsifying nursing documentation

[jenack]

Falsification of documentation to satisfy Joint Commission Requirements for Stroke designation. My nurse manager demanded that the charge nurse and patient care facilitator enter documentation on stroke patients that they did not care for. This type of documentation is a felony however it is often required of nursing staff anytime Joint commission, magnet or any other regulatory agency comes to our hospital. This time the manager is having nursing enter neuro VS and Glasgow coma scales every hour on stroke patients when the nurse caring for the patients entered them every 4 hours as ordered by the physician. We were told all ICU patients get Q 1 hour neuro checks regardless of what the physicians orders are. The manager is not asking the nurses who took care of the patients to enter the information in the medical record she is making the charge nurse and patient care facilitator create documentation that does not exist. What is the best way to handle this situation? If the nurse refuses they fear being fired, if they falsify documentation they will not only loose their license but could be sent to prison.

[Here.I.Stand, BSN, RN]

Wow... do they realize what would happen to your stroke designation, if TJC were to become aware of false documentation?? (in addition to the universal issues that come with falsifying legal documents)

If the nurse manager really believes this is okay, why doesn't she falsify the charts herself? Rhetorical question... she knows darn well her demands are illegal.

[jenack]

TJC can see who documented the VS, it would be obvious if one nurse documented every four hours and another nurse filled in the remaining times. The false documentation will also show the date, time and the nurses name who entered the falsified documentation.

She will throw the nurse under the bus if it is discovered and denies she ever told the nurse to falsify the documentation.

[JKL33]

Hmmm. In a desire to uphold their facility's high ethical principles, they should "consult" the Compliance hotline.

I'm only being half facetious. I know its a tricky situation; I have no faith in promises of confidentiality with regard to things like this.

[kataraang, BSN]

Report it. That's ridiculous. Make it an anonymous report if you're worried. But your compliance officer is not going to go talk to your manager and throw you under the bus. Your license is more important than your job (but I doubt you lose your job). On that note, do you really want to be working for a place that endorses this?

[Ruby Vee, BSN]

I'd rather lose my job than my license or my freedom.

When your boss wants you to do something unethical, say no. Then dust off your resume and start looking for another job.

[Jedrnurse, BSN, RN]

Darn those loose licenses. Somebody catch them!

[Kooky Korky, BSN, RN]

Darn those loose licenses. Somebody catch them!

Yes, this is one of my pet peeves. Loose instead of lose. Your instead of You're. I guess they just don't teach spelling, grammar, subject-verb agreement any more to kids, and have not taught these things for at least 2 generations.

He had did instead of He did or He had done, for instance.

Ruby and others who have advised that OP cut and run - it's just not practical to run every time there is a problem.

OP - you have to decide whether to tell your boss you will do it but then don't actually do it, or you could just say outright that you don't want to get in trouble and also have a guilty conscience. If she then threatens you with evil, tell her you would appreciate it if she would do it or, at least, tell the nurses who cared for the patients do it - of course, they should refuse, too.

Does accreditation require hourlies? Or is this some impossible standard the employer wants to impose?

Tell her you need her order to you to be in writing so you can keep it in your file.

Is this an idea your boss has or did someone order her? What does Risk Management or the hospital attorney say about it?

Sue her for stress, go out on disability. Your claim would be legitimate IMO.

Sorry you're faced with this criminality when all you're trying to do is give good nursing care to those in your charge. God bless and protect you.

[Kooky Korky, BSN, RN]

Report it. That's ridiculous. Make it an anonymous report if you're worried. But your compliance officer is not going to go talk to your manager and throw you under the bus. Your license is more important than your job (but I doubt you lose your job). On that note, do you really want to be working for a place that endorses this?

She won't lose her job based on refusing to falsify charts. They'd cook up some other reason.

[quazar]

This is where that boring part of orientation and the yearly mandatory education about corporate compliance kicks in and is actually beneficial. Report her, there is a way to do so confidentially/anonymously within your system. Don't falsify, report, and I agree with the pp it's not worth your job to stay at this place if the higher ups support this kind of nonsense. I'd walk if it wasn't addressed and corrected immediately.

[luv2]

Do yourself and family a favor. Quit this job. Tell them you have an emergency or something and QUIT....DO NOT GO BACK!!!!

[Purple_roses]

Your manager is a nut.

What exactly does she think will happen when JC sees that neuro checks were documented q4? They will see the q4, then they'll see that the orders where placed for q4. I mean....maybe you'll get dinged. But JC is either going to see that your floor is falsifying info or that your floor is following orders (orders which apparently simply need to be modified for future cases). Which scenario does your manager really want to deal with?