Made to Falsify Documentation :( - page 3 I'm just learning the ropes as a new CNA on board and charting is one of the tasks. We are supposed to check and change (if needed) everyone on our team (20 people) every 2 hours for... Read More

  1. by   jkaee
    It seems that you have just been formally introduced to the wonderful world of LTC nursing!

    The thing that you have to understand is that LTC is SO regulated, even more so than a nuclear power plant. There is no possible way that the staff, no matter how dedicated or how caring, can do all the things that the state regulates us to do. We spend so much time on care plans, documentation, charting and books, because that "proves" to the state that we are doing what we are supposed to do (according to them, at least). I understand your frustration, and things may go more smoothly as you gain more experience and your time management skills improve. It may not seem like it now, but you will be surprised at how well you can do things if you give yourself a chance to grow.

    My personal opinion is that the state doesn't care all that much whether or not the work is actually being done, as long as it is documented in the care plan or the CNA books. Is this right? Of course not. Do I suggest that you do that? I'm not suggesting anything, but I have worked LTC for over 9 years and I know how it works. And I also know that if the state TRULY cared about our elderly and wanted them taken care of properly, they would change the laws and increase our nursing hours and staffing.

    Please don't give up on LTC nursing. I never wanted to work in LTC when I was in school, but now I don't think you could double my pay to get me in the hospital. They have their own sets of problems, too. If this facility isn't working out, then look for another one. I've moved around quite a bit, but the place I work now is beautiful, well staffed and well run. Sure, it has it's problems, but I'm really happy there.

    Do what you feel is right, but be prepared for backlash. Care plans are meant to be written for the state mainly, and if you can do it, great. If not (as is the case a lot of the time), then I doubt you will see everyone in a tizzy over it. It's sad, because our seniors deserve a lot better, but until the state changes the staffing regs, it's not going to get any better.

    Good luck to you!
  2. by   Hellllllo Nurse
    Quote from jyoung1950
    LTC is a lose-lose business proposition. Sooner or later it's going to collapse under the weight of costs, state regulations and staff that give up on it.

    We all better start remodeling our homes so we can care for our parents ourselves.
    You are absolutely correct.
  3. by   Hellllllo Nurse
    Quote from jkaee
    And I also know that if the state TRULY cared about our elderly and wanted them taken care of properly, they would change the laws and increase our nursing hours and staffing.
    The majority of states have no staffing laws and have nothing to do with staffing nursing homes. The mgmt and administration of the nursing homes determine staffing. It is what the market will bear. As long as nurses are willing to put up w/ poor staffing, facilities will be able to staff however they wish.
  4. by   CapeCodMermaid
    We've changed our care plans -- they used to read "toilet q 2 hours"...yeah, right. So since we didn't want the state surveyors standing there with a stop watch, we now write "toilet after meals and prn" or before meals depending on the resident's preference. No one at this place has ever asked us to falsify documentation. If there are blanks on the CNA flowsheets, one of the supervisors tracks 'em down and they have to fill in for the shift they worked.
  5. by   Nurse Ratched
    Here's my experience:

    A lady I cared in the community for went into a nursing home. Later found out that it was dutifully documented that she was being ambulated x number of feet daily and eating 100% of meals and snacks when all the while she was losing weight, not walking, developing bedsores on her heels, and had snacks sitting uneaten next to her on visits. Her family member who is a dear friend was keeping a journal of events just for her own sanity as she watched her loved one decline despite her best efforts. Ultimately, the sheer hideous quality of care and lying on the part of the ECF staff coupled with the lady's precipitous decline in condition (a matter of a few weeks until she was nearly completely incapacitated) lead to a lawsuit. It was clear based on the family member's documentation and my deposition that the documentation was false.

    So no, it's not just initials on a piece of paper and it can come back on you.
    Last edit by Nurse Ratched on Jun 23, '04 : Reason: spelling - yes, I'm anal :)
  6. by   CHATSDALE
    every state has state inspections,,,they will accept anonomyus reportsse and they will pop in without notice and they can scare the living h out of admin/don etc
  7. by   pcelest2003
    I'm a PCT/CNA, whatever you want to call it. Anyway, you should never lie on any medical documentation forms. Are you crazy! I some states they will yank your certification. Ya see, people think that a certi/means nothing. But in you cannot work without one in an acute care hospital. Protect your integrity and your certification. In addition, your RN that you are working under should know better. CNA's get called into court too. You better believe it!
  8. by   bebymyside
    I've been asked by my superior to falsely document lies concerning a residents fall -- that the V/S were within normal range, there was no pain, no injury, etc., etc. I was yelled at -- "we have a duty to protect this company!!!!".

    I refused to do it. When I became a nurse I took an oath to be honest and cause no harm; my license is important to me and finally it's ethically wrong; if this was done to my own mother I would be furious.

    The results for refusing -- I was demoted, belittled, attempts were made to set me up, and eventually I was fired "at will".

    I was hurt to the point of considering giving up nursing; then, one early morning I received a call from a client on her death bed that wanted to speak with me. She could see what was being done to me and she demanded that I keep my head up and become an RN. She stated, "I will be looking over you dear and I will be there to greet you when you cross over -- don't be afraid".

    I did get an attorney to send a letter of the seriousness of whistle-blowing retailiation. After that, they left me alone. I now have monetary compensation and I'm going back to school for my RN.

    My point is, stay honest, stay true, and love your clients as though they were your own. This is your greatest protection. Yes there will be those that will be jealous of you but thats their problem.

    Remember one thing. A good honest nurse is a gift that many would give their right arm to have. Wouldn't you want such a nurse to care for your loved one?
  9. by   Blackcat99
    This is an old thread. I am so glad that I no longer work LTC. There were a few nurses at that LTC who refused to lie . When they refused to lie about doing treatments etc. they were all fired.
  10. by   CapeCodMermaid
    Get over yourselves. I refused to alter documents...refused to sign if I didn't personally do something. I didn't get fired. I got promoted.
  11. by   Blackcat99
    Quote from CapeCodMermaid
    Get over yourselves. I refused to alter documents...refused to sign if I didn't personally do something. I didn't get fired. I got promoted.
    Get over yourselves? Huh? I'm just a reporter here telling what happened at my old LTC. I think that it nice that you got a promotion instead of getting fired. I think it is more likely in most LTC's that one will get fired rather than getting a promotion.
  12. by   DDdove
    Everyone talks about state coming and getting in trouble for false documentation. I don't think state cares because this goes on constantly and all they would have to do is investigate on sites like this. If state cared they would be up at the state house demanding more staff in LTC facilities but they just keep playing the game so they can get their paper work done and get out of there. As for a LTC going bankrupt........don't bet on it. These places make sooooo much money and those at the top are living high on the patient's misery(and nurses). It is a big business to get into today and that is why we are getting all these assissted living facilities$$$$. Government knows too but as long as people need jobs....they will count on us being there to get used and blammed. I need a job bad!!! and I will be one of those who leave everynight sad for my residents feeling exausted and having no control. If not, I don't feed my family. I hope soon someone will have the organization to go to the government and demand justice for our residents and ourselves.
  13. by   CloudySue
    When the state came to my place, I was sure they'd find tons of the types of problems that occur from chronic understaffing, but we did rather well. The major tags came when someone blatantly did something stupid right in front of them, like a nurse gave meds via tube w/o gloves on. Even holes in the CNA book were hit as documentation errors, not neglect. When they did dig into the residents' charts, the only thing they came up with was our doctors and psychiatrist not following up on referrals or signing monthly orders. I came away that experience totally disillusioned that the state really was not trying to sniff out any underlying major problems. They are not our advocates.