I finally fell prey to the LTC politicos after a year and a half.....

[mamarhonda]

And am currently looking for a new job. Just a little background I work in a 75 bed LTC as an RN (it was the only job I could find right out of school) worked there for about a year and a half. Haven't had any issues other than once last August which I got a "verbal warning" (but had to sign the paper?) fast forward to Saturday, my aide was going to give a shower to one of our residents and when she pulled off the ted hose there was fluid leaking from his heel.

Since I have been told time and time again not to ever put "pressure" area I wrote up the incident as a popped blister until my supervisors could look at it. I did ALL of the required paperwork, had my aides sign that we discussed this case and how to prevent it and put it into the "DON" mail slot in my station. I also had a resident fall that same night which I turned in the paperwork in the same spot (this will be important to the story later.)

I spoke with my manager on Sunday about it and told him what I thought needed to change and he told me to write an order for one of the things, so I did. I go into work on Tuesday and the day nurse on my station says our DON is hot because nothing was done about this incident for 3 days and kind of hints that I am going to be in trouble.

Well his weekly skin assessment hasn't been done in over 10 days and I am not the nurse responsible for his weekly skin assessment. Well I was kind of confused and not understanding why I would be in trouble for this, I did my required work.

So my manager comes into my station and I confront him, just plain out ask him if I am in trouble for this and he says well yeah kind of nothing has been done for 3 days and you never turned in an incident report to let us know this was an issue, ummmmmmmmmmmmmmmm excuse me??????

I said first of all I did turn in an incident report, I put the res on 72 hour charting, I charted on him and so did the next 8 shifts after me, I notified the family and doctor and I said I talked to you about it on Sunday and you told me to write the order for something and I did. HE HAD THE GAUL TO SAY "HM I DON'T REMEMBER THAT CONVERSATION." tears started flowing. So he later pulls me into his office to sign my write up so I ask him out of curiosity, I had another resident that fell do you have that incident report" which he answers yes, I said oh convenient. I know what the story is, he didn't do his job so instead of holding him responsible he probably pitched the paperwork so it looks as though I didn't do my work so I can take the hit.

Its a facility acquired pressure ulcer so that looks bad on him if he didn't do his work on Sunday immediately. I was such a wreck emotionally yesterday crying on and off all day and wishing and praying that something else will come my way soon as far as another job. I cannot believe what a bold faced liar my manager is, just goes to show you, you can trust no one. Sorry this was so long but had to get it out. Do you think I should have signed the write up or argued it more, like I said I was an emotional wreck and just didn't want to even look at my manager.

[barbarake21]

I feel for you, I really do. And I wish I had some good advice but I don't. I've seen similar things happen at my LTC facility - it happened to me once and I've seen it happen to others. Just wanted to let you know I'm wishing you the best.

[Kittypower123, BSN, RN]

I don't know what the write-ups are like at your facility, but at mine there is a space at the bottom to write your own comment or response. I would write your version of events in that area. Make sure to refer to the nurses notes in the chart. If nothing had been done, there would not be so much documentation in the chart.

[SummerGarden, BSN, MSN, RN]

I know that this may not help you now, but this is a lesson learned. Whenever you write up an incident report, especially involving yourself, be sure to make a copy before you turn in the report. Also, immediately send a polite email to whoever needs to know that you have turned in the report AND made a copy for future reference if needed. This should reduce the number of times your incident reports come up missing.

[Heycaryann42]

Never trust anyone when your license is on the line. It's true that nurses eat their young. All LTCs are similar.

[Sparrowhawk]

Nurses don't just eat their *young* they eat each other.

[FLArn]

FYI: Most places have printed on the occurance form that the form is NOT to be copied. Do NOT indicate to ANYONE that you made a copy of the form for yourself as the copies would be "discoverable" if the family/ resident should sue over this incident. Not sure but copying the form might also get you into trouble for violating facility policies. This type of situation is truly a "no win" for the nurse involved.

[barbarake21]

I was thinking this same thing. I would guess that making a copy of the incident form would be against HIPAA regulations. It truly is a 'no-win' situation.

[BlueBow]

This just brings back old memories. A similar thing happened to me. It's sad when you cant' fight back, because it seems to be a losing battle when you have nothing to show as proof except for what you charted, and you're afraid of losing your job. It's your word against his, and he's your supervisor. I wonder why this is so common in LTC facilities? I'm so sorry to hear what you went through.

[cienurse]

Your DON should have called you to the office and asked you what happened and where the paperwork was. As a DON myself, when anything happens on the weekend, I always ask staff members who were on duty what happened in their own words. I, myself, provide any counselling or disciplinary action that needs to be taken, but only after I have investigated, and VALIDATED, the issue, including copies of whatever documentation was done, or I note the lack thereof. I'm also sorry that you went thru this without actually having an opportunity to speak for yourself with the DON. His/Her door should ALWAYS be open for staff to stop by and discuss issues and staff should be able to feel comfortable to do so!

[Alibaba]

FYI: Most places have printed on the occurance form that the form is NOT to be copied. Do NOT indicate to ANYONE that you made a copy of the form for yourself as the copies would be "discoverable" if the family/ resident should sue over this incident. Not sure but copying the form might also get you into trouble for violating facility policies. This type of situation is truly a "no win" for the nurse involved.

Yes..you are not supposed to make any copies. But as demonstrated by OP's predicament, lack of a triplicate paper trail has a way of coming back to bite you on the caboose. Most original incident reports I have seen have a carbon copy. (Facilities get too cheap to keep buying originals so we just write on copies therefore ensuring no 2nd copy)

What I have done before when I knew or felt something may come back to bite me, I write the original report that goes to the DON, make copies for the ADON, Administrator and quality control. While I do not keep a copy for my self, it is really hard and takes a lot of planning and agreeing between lots of people for 4 copies of a report to disappear.

The way I figure it, by the time all these folks go to stand up on monday morning, they all have the report and are aware of what happened without one person twisting the event to suit their CYA needs.

And also, no privacy violation here.

just me.

[smurfynursey]

I wish I had advice for you! That sucks and I hope things get better!