I've got a situation...

  1. Hi Folks!

    I usually post over in the student forum but thought I'd post this particular situation here...

    For the past semester I've been taking a CNA class as part of a pre-requisiste to get into my nursing program and have been doing clinicals at a LTC facility for about 8 weeks now. At any rate, last week I noticed that my patient had bruises on her arms while giving her a shower. I know older folks bruise more easily so I just filed away the bruises in the back of my memory. Later, when taking my pt to lunch, she started making statements that really raised my suspicions. She would say things like "you're not going to hit me are you?" "Where are we going?...are they going to hurt me?" "Please don't hurt me" etc... I of course told her that I would never hurt her and that she was safe with me. I then seated my pt in the dining room and immediately talked to my teacher about the bruises and the comments. After lunch, I went back to my pt to bring her back to her room to speak with my teacher. Upon speaking with my teacher my pt grabbed my hand an told my teacher that I was very good to her and that we were both the "nicest nurses in the hospital". She then told my teacher that "After you leave, they hurt me." I felt awful!!! She looked terrified and even asked my teacher not to tell anyone! My teacher explained that she had to report the incident by law and that she didn't have to worry everything would be O.K. We spoke with the nurse in charge reported our suspicion of abuse to her and she mentioned that yes, they were indeed investigaing the situation and even suspected a couple individuals. At this point, my teacher told me that she would also follow up with Administrator.

    This week, my teacher pulled me aside and asked me if I'd be willing to report the incident to the administator and explained that I might be called to testify at a later date. I told her that I had no objections and would be happy to talk to administrator. In this meeting, we come to find that no one has reported suspicion of abuse to her and that this is the first she's heard of it! She took my name and phone number and asked me to write a brief written statement about what I found. It was at this point that I mentioned the name of a person who I felt my pt was most frightened of.

    When all is said and done, I'm left hoping I made a difference but left with several questions...

    As a student, did I do the right thing by writing my statement or is this something my teacher should have taken responsibility for? If this goes further...what should I expect? Also, if people were suspected of abusing the person, why were they still working at the facility in the first place? Why was the administrator not informed to this situation sooner? I just don't get it!!! I've never liked this facility but this is just too much!! I'm disgusted and appalled!!!! There's no excuse for this kind of behavior!!! ...

    Anyway, thanks for letting my vent!!!

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    About Hooligan

    Joined: Nov '01; Posts: 510; Likes: 8


  3. by   Mkue
    Bean, you are right, there is no excuse. You did the right thing by speaking up for your patient. I'm not too familiar with how the process works i.e. student/instructor statement. Let us know what happens.

  4. by   bagladyrn
    Absolutely you did the right thing! You stood up for this patient as you would want some one to stand up for your own loved ones! As we never know who an abused person will feel able to trust, anyone who becomes aware of the possibility of abuse should do exactly as you did. Since you were the one she said this to, it is appropriate that you wrote the statement, as coming from your instructor, some of it would have been secondhand info, and not legally admissable.
  5. by   jemb
    I don't see how your instructor could have written the statement since you were the one that first noticed the bruises, and you were the one that the patient confided in. The instructor's statements would be 3rd party comments, based on what you told her. You did the right thing.
    ^5 bean.... you did the right thing!

  7. by   tattooednursie
    You did do the right thing. And you will be a respcted CNA because of it.
  8. by   NurseWeasel
    I applaud you for having the courage to speak up. You were a witness and you will be required to give testimony, as will the instructor for what they saw / heard.

    As to why the suspect is still employed, administration has to build a case so they don't get sued for wrongful termination. Imagine if YOU were wrongly accused of abuse and terminated without an investigation! Fair is fair.

    Be sure to follow up if you don't see results. You don't want this getting shoved under the carpet.

    Again, thank you for standing up for what's right! ((hugs))
  9. by   Hooligan
    Thanks all! I know I was doing the right thing as far as reporting the situation...I just didn't know if it would be appropriate for the statement to come from a student or if the teacher played a role considering she's responsible for all of our actions. But I guess you're right...she would be 3rd party and not admissible. Once again...thanks everyone!
  10. by   Robin61970
    Good for you!!! AT the risk of sounding condescending(which I am not trying to be) I am proud of you for what you have done!!!!
  11. by   sjoe
    1) Talk with your instructor and keep her up to date on what is happening here.

    2) This is one more reason to always make and keep your own notes when things like this happen, as well as charting them. You probably will want to consult your notes again before you testify, if you do.

    3) Surely you are not surprised that nobody told the administrator. They didn't want to get themselves, or their friends, in trouble (or be stuck doing any extra paperwork).
  12. by   rncountry
    OK Bean, now the next step. Please call the state and make sure the facility has filed something. If there are injuries of unknown origin to a patient the facility is required by law to report that to the state. They have 5 working days to do so.
    Next it is common practice to suspend any indivduals that are suspected of abuse, or actually anything else. An active ongoing investigation should have the individuals out of the building because otherwise there may be people who would talk but won't because of fear of the employee who is continuing to work. I am telling you this as an old DON. There is no need for a DON or administrator to tell staff or patients that the person is suspended, there is simply scheduling changes. Susicipon may be there on the part of other staff, but truly that cannot be a concern of management. Their primary concern must be an appropriate investigation and their patients.
    Because I have seen and been involved with a facility that did not appropriately report injuries of unknown origin, and which were most certainly from patient abuse, is the reason I am telling you to follow up with the state. Even though the facility is required to do the reporting, too often it is not done. When the state has a report like this they are required to come in and conduct their own investigation within 30 days. You might also want to contact the omsbudsman. Cover your bases and insure your patient is protected.
  13. by   BrandyBSN
    You did the best thing you could do Bean, im proud of you!

    I was called to court a few weeks ago to deal with a domestic violence case. It was a little intimidating at first being questioned by lawyers but I had to do what was best for the patient.

    Something in your post caught me eye though, you stated "It was at this point that I mentioned the name of a person who I felt my pt was most frightened of. "

    Be very careful when writting statements that may be used in legal matters. Be completely objective. write what you saw, and DIRECT quotes from your patient if you can remember them. writing who you "think" may be responsible can make you appears too emotionally involved, and is drawing a conclusion that you can't make without patient statements or proof". I'm sure you knew all that already, but its good to have a refresher course from time to time. example, "pt WAS crying", rather that "patient seemed upset". One is objective, the other is subjective.

    I think you did a great job. That took a lot of guts to step up like that. You're on your way to being a fantastic patient advocate. Congrats!

  14. by   emily_mom
    Good for you, Bean! Patients need advocates, especially when they are too afraid to speak up themselves. Also, make sure you contact the state. If they didn't file a report, they can get in big trouble. Many don't follow up to see if this has been done. Unfortunately in LTC, it rarely does. They tend to sweep things under the rug for many reasons. Lack of staff is a biggie. I hope all turns out well, and I hope her family gets her the heck out of there. She is obviously unsafe!