Night before last I was alone on the Alzhiemers unit, my partner was on lunch and the housekeeper was cleaning on the unit. I was washing my hands in the medicine room when she came and got me and told me that one of the residents was in the floor. I went and checked the resident for injuries and deformities. I then called the front desk and had them send the nurse over to my unit. The Alzhiemers unit and ICF/PCF unit share a nurse, we have a CMA and two CNAs that work on the alzhiemers unit. The nurse, an agency nurse I don't know, came over in about a minute. She checked her and made sure that nothing was falling off, etc. We then helped the resident out of the floor. We put her in the wheelchair and I put her lapbuddy on and while I was putting the Lapbuddy on the nurse took the sheet that I had intended to use to cover her legs and tied her in the wheelchair. I was in shock, she said something about making sure that I untied her before the next shift showed up. She went back to the PCF/ICF unit and did the incident report. As she was leaving the unit my partner was returning from lunch. I showed her what the nurse had done. We took her and untied her and layed her down to sleep. I told my supervising nurse the next night what had happened and she said that she didn't want to know about it. Today however the DON and Social Work were running around asking questions about the night before last. Apparently the nurse had told the CNAs to do it to a resident on the skilled unit. The refused and went to the administrator who yelled at the nurse saying that she had better not ever hear of her doing it again. Since no one that I told told their supervisor it looks like I am lying and they may say that I never told them to cover their butts. If I could go back I would have called the administrator at home but whats done is done. Everyone is going to say that I should document to cover my a$s but we have no where to document. CNAs are not allowed to chart in the charts. The nurse that I told didn't report it to anyone. The Occupational Therapist is my witness that I told a nurse. The bad part is that it was almost 19 hours after the origional incident. Despite all of this when asked if she had tied a resident to a chair the nurse said that "she" had not tied anyone down. Well, lets see who does that leave.......oh yeah, me!:angryfire I am so angry right now and I am so sorry that I didn't report it sooner. I thought we had mentioned it to the CMA but I called tonight and asked and she said that we hadn't mentioned it to her. I told the DON what I had witnessed today and she sent me to the acting administrator who I told, she told me to write out a statement of what I had told her. I am terrified that my job is in jeopardy and that because of my stupidity the facility has been opened up to tons of liability. The company that is managing the facility has said that there are somethings that are making them consider pulling out of the sale. The facility was out of money when they took over, if they hadn't we wouldn't have gotten paid for the last month. They have told us that if at all possible that they would stay and close sale on the facility but that some issues have been coming up like a thing with an agency nurse that made them feel like we may not be the best investment. They are talking about what happened with me. I am worried that I have helped my 130 residents lose their home and my coworkers may lose their jobs. I am worried sick . I want my facility to stay open and I want the residents to feel safe in their facility. I want my job and I am afraid that if we don't close, that they may fire me. Any advice, remember I have no way to document. CNAs dont chart.
""Working in a Nursing home can be very tough work physically and emotionally. Some of these stories would blow your mind. The State turns a blind eye to Nursing Homes though. Nurses and CNAs have way to many residents to care for. I would like to see the state inspector get up 15 patients in an hour and a half, give each res. a bed bath/ proper peri-care with warm water, oral care, hair brushed. clothes matching, etc....no short cuts. I would like them to deal with the combative patients.....""
I have to agree with you (I have been around nursing since the dark ages of restraints of all kinds - in psychiatric units and dementure units and old people's homes.) Hard work, thankless work, short of staff, sometimes almost impossible conditions, dealing regularly with death and dying clients and their relatives and then having to put up with Agencies and other temp. staff, along with some some bad practices still carried out by some.
Been ther and done that too many times but now I have to agree - document, name names, times, details and make copies and make sure that you get them to the people at the top and in official positions. You are not to blame - we need more nurses like you over here in Australia. Love you. Chin up, you are doing something that majority of nurses would not - aged care "Real Nursing". :)
I don't think anyone has mentioned this, but......
according to federal regulations, when abuse or possible abuse occurs, it should be reported immediately to the Abuse Coordinator or Administrator of the facility. The nurse should have been removed from the facility immediately.
Then an investigation is done. It is not your job to decide if it is abuse or not, but it is your job to report it as soon as you see it.
(I am trained as an Abuse Coordinator in a facility that had similar problems in the past.)
Just remember to tell the truth.
And don't feel bad that you didn't report it right away.
If there's one thing I have learned about nursing, it is that you always remember your mistakes and never make the same one twice!!!!
Hmm. Well have ya'll been in a situation where you didn't HAVE a posey, chair restraint or wrist restraint immediately available? (Guess nobody here works for HCA or places like that...LOL)
Sometimes we improvise for a time. If someone is gonna fall or pull a line and hurt themselves and you'll be liable for something either way, we sometimes have to make choices. I don't know WHY this nurse did what she did...I just object to the whistle blowing and finger pointing before a reminder face to face. That may have been all it took...someone saying "You know, we really can't do this anymore...let me go find the proper equipment and we'll talk about it later".
I primarily do ICU where I WILL be liable if the patient hurts themselves so we sometimes make choices based on this knowledge. Its not a policy nor best practice to use sheet restraints, but I HAVE in extreme circumstances UNTIL I could find appropriate equipment.
I have to agree with you on both points there. I can recall a time when being overloaded with 60+ residents, 2 IV's, 8-12 TF's, accuchecks and insulins for the IDDM's and after already filling out an incident report for a resident who fell out of her bed, after which she was gotten up to her wheel chair, (assessed with no injuries noted) and as soon as I'm gone to the other hall, being in charge of 2, I learn she has fell out of the wheel chair. We had 1 CNA to each hall. I was even helping to do rounds. The facility doctor was quite slow on 3rd shift to return calls, yes I've been there, done that. We do what it takes when it comes to keeping a resident safe. Also, in LTC more and more residents are being "weaned" off psych drugs. Understandably these are fall risks but still for some weaning them off without a PRN makes for a combination for one very irritated resident who wants to hit everyone and everything in sight as well as stand up and walk on her/his own forgetting their balance is certainly not up to par. I realize restraints are and have been abused in the past but I also believe they are sometimes neccessary. We should not whistle blow until we have talked with the person, found out the reason and tried to help with solutions. IMO :uhoh21:
I am worried sick . I want my facility to stay open and I want the residents to feel safe in their facility. I want my job and I am afraid that if we don't close, that they may fire me. 
Mister Chris, MSN, NP
182 Posts
""Working in a Nursing home can be very tough work physically and emotionally. Some of these stories would blow your mind. The State turns a blind eye to Nursing Homes though. Nurses and CNAs have way to many residents to care for. I would like to see the state inspector get up 15 patients in an hour and a half, give each res. a bed bath/ proper peri-care with warm water, oral care, hair brushed. clothes matching, etc....no short cuts. I would like them to deal with the combative patients.....""
I have to agree with you (I have been around nursing since the dark ages of restraints of all kinds - in psychiatric units and dementure units and old people's homes.) Hard work, thankless work, short of staff, sometimes almost impossible conditions, dealing regularly with death and dying clients and their relatives and then having to put up with Agencies and other temp. staff, along with some some bad practices still carried out by some.
Been ther and done that too many times but now I have to agree - document, name names, times, details and make copies and make sure that you get them to the people at the top and in official positions. You are not to blame - we need more nurses like you over here in Australia. Love you. Chin up, you are doing something that majority of nurses would not - aged care "Real Nursing". :)