Have you ever been asked to falsify notes?

[HisTreasure]

Has a family ever asked you to chart more interventions than required or done during your shift in order to make the patient appear more fragile than than they really are so they won't "lose hours" or in some cases, to get even more hours? Don't purger yourself if you have, but if you have a story to tell please do!

[HisTreasure, BSN, RN]

I recall having a parent ask me to be "very detailed" about my interventions. This was some years back. I did as I was asked, as I am always open to constructive criticism. A day or so later she came back and asked AGAIN. As I mainly worked late evenings and overnights I didn't have a lot of the same duties as the earlier shifts so I really had nothing more of value to add. Told parents this, who asked me to embellish how many times during the night the patient needed suctioning, how often he had episodes of emesis and/or desats, how often he had diaper "blow outs." Being a fairly new nurse I worked hard to appease them: I changed him more (even when he didn't necessarily need it and it disrupted his sleep), I suctioned when he really was capable of clearing himself, etc. That went on for about a week (3 shifts) before I told the parents I didn't feel especially comfortable. Not much later they "found reason" to ask the agency not to send me back. Years later I get referred to a family as an independent just to get my toes wet in PD again and the name sounds familiar. I drive down the street the day before the interview as a normally do

(to see if it's a safe neighborhood, has parking, travel time, etc.) and it all comes back to me. It's the same family! I mention it to a local nurse that they're looking but weren't a good fit for me and she reveals she's already working the case. Here's the kicker: They get 18 hours per day of nursing and 24 hours a week for respite. Their plan worked, and parents are still requesting nurses "over document". Kid has a trach and mist collar now, g-tube fed overnight, PO feeds by day, hypotonic. Cognitively 1-2 years delayed, but only in certain areas. I know full-time vented children with severe TBI, full time GJ feeds and contractures who get fewer hours...

[Adele_Michal7, ASN, RN]

Yes, on every case I've ever worked- by the parent and almost always pertaining to time.