I Hope This is Not the Latest Trend

Jory, MSN, APRN, CNM · Feb 16, 2019

Yes, I hope it's a trend because these people SHOULD BE in jail.

Falsifying information and forging signatures is a choice. If that in turn causes a patient's death, then yes, you should be charged with contributing to that person's death.

Abuse of a patient, is a choice.

Severe neglect, is a choice.

I have no problem with these people sitting in jail.

Don't protect other nurses that make these choices.

mtmkjr, BSN · Feb 16, 2019

If this type of forgery is is a felony for anyone else, why not for healthcare professionals?

Tenebrae, BSN, RN · Feb 16, 2019

On 2/16/2019 at 12:11 AM, hyllisR said:
Staff Nurses are not responsible for writing orders for wound care. Period.

They are responsible for doing something when they see a wound deteriorating.

Wound care is the domain of nurses here. We decide how to treat them, and whether it needs specialist intervention

Tenebrae, BSN, RN · Feb 16, 2019

1 hour ago, Jory said:
Yes, I hope it's a trend because these people SHOULD BE in jail.
Falsifying information and forging signatures is a choice. If that in turn causes a patient's death, then yes, you should be charged with contributing to that person's death.
Abuse of a patient, is a choice.
Severe neglect, is a choice.
I have no problem with these people sitting in jail.
Don't protect other nurses that make these choices.

This, and a thousand times this.

Its all very well and good daying 'oh but management...."

If management want you to sign for something you didnt do, say no. If they pressure you, say no again and as often as you need to so they listen

Emergent, RN · Feb 16, 2019

I remember my first job at a rural nursing home. There was a nurse there who had previously been a DNS at a nursing home elsewhere. She took it upon herself to scrutinize the paperwork.

We had MARS with little boxes, they look just like the ones I see in the ER sent by the nursing homes when they send a patient.

Sometimes nurses would forget to sign off a med. I think probably the meds had been given, but those med passes were brutal, 2 hr affairs, tracking down 30 patients.

She was very aware of the nitpicking of surveyors, and rather OCD. Our DNS was an uninspiring woman known to keep hard liquor in a locked drawer and wore a lab coat with coffee stains on it.

So, Linda would go through and 'tidy up' the MARS, initialling the empty boxes with other people's initials.

I do think we provided excellent care there, thanks to some old school nurses who really cared!

Oldmahubbard · Feb 16, 2019

My first thought is that dozens of people knew, or should have known, what was going on.

Workitinurfava, BSN, RN · Feb 16, 2019

The director is ultimately to blame. How do you run a place and not catch the things that went on? A good director would have caught the things happening.

mtmkjr, BSN · Feb 16, 2019

23 hours ago, BarrelOfMonkeys said:
An article with a little more information. ?
https://www.google.com/amp/s/www.dispatch.com/news/20190214/seven-charged-in-neglect-of-two-nursing-home-patients-three-with-death-of-one-of-them%3ftemplate=ampart

For those who can't read the article without an account:

Quote
Two employees of a Columbus nursing home and a nurse practitioner who was a contract worker there have been indicted on charges of involuntary manslaughter in connection with the neglect of two patients in 2017, Attorney General Dave Yost announced Thursday.
Four other employees at Whetstone Gardens and Care Center, located at 3710 Olentangy River Road on the city’s Northwest Side, were indicted on other charges. A total of 34 charges were filed after an investigation determined that one patient died as a direct result of the neglect and the other patient, who is now deceased, was found to have suffered physical harm, Yost said. Neither patient was named.
Those indicted were:
Sandra Blazer, 55, of Grove City, assistant director of nursing, who faces one count each of involuntary manslaughter, gross patient neglect, patient neglect and tampering with evidence and four counts of forgery.
Jessica Caldwell, 30, of the Southeast Side, a floor nurse and unit manager, who faces one count each of involuntary manslaughter, gross patient neglect and patient neglect.
Akosua Ayarkwa, 29, of the Northeast Side, a floor nurse, who faces three counts of forgery and one count of gross patient neglect.
Sheila Dains, 53, of Logan, a floor nurse, who faces eight counts of forgery and one count of gross patient neglect.
Illuminee Muhongere, 48, of the Northeast Side, a floor nurse, who faces two counts of forgery.
Maegan Van Syckle, 39, of Westerville, a floor nurse, who faces four counts of forgery and one count of gross patient neglect.
Kimberly Potter, 53, of Delaware, a nurse practitioner contracted to work at the facility, who faces one count each of involuntary manslaughter, gross patient neglect and patient neglect.
In February 2017, a male patient who is believed to have died because of neglect developed serious wounds that turned gangrenous, Yost said. That patient was later taken to a hospital, where he died March 5, 2017, from septic shock, which results after infections lead to dangerously low blood pressure.
“This man literally rotted to death, and it could have been prevented,” Yost said.
A female patient at the facility did not receive care that nurses documented, the investigation by the attorney general’s office found.
“They said they provided it and they did not,” Yost said, adding that the patient’s medical records also featured forged signatures and indicated the patient received care during times “when the patient wasn’t even in the facility.”
“Every one of us has a loved one or has had a loved one who’s been in a (nursing home) facility,” Yost said. “We trust the doctors and the nurses and the staff at these facilities to care for those we love the most at their most vulnerable time in life. “When they turn a callous eye and ignore what’s right in front of their faces and fail to provide the services and fail to provide for our loved ones, these are crimes of the worst sort,” he said.
Ryan Stubenrauch, a spokesman for Whetstone Gardens and Care Center, disagreed with Yost’s characterization that one patient rotted to death.
“Each and every one of our residents, their health and well-being is and always will be our top priority,” he told The Dispatch. “We can assure every resident that’s there now and has been there, we have taken great care to correct the problems that led to the 2017 issue and continue to make sure that no such similar issue can ever arise again.”
Stubenrauch said four of the employees who were indicted were fired and two others have been suspended as the legal process proceeds. He added that several employees who weren’t indicted but were involved with the care of the two patients also were fired.
The attorney general’s office’s Medicaid Fraud Control Unit conducted the investigation into the neglect allegations of the female patient after a phone call in 2017 from a daughter of the patient, who expressed concern about the care her mother was receiving.
The alleged neglect the female patient experienced also was detailed in an investigation by the Ohio Department of Health, which conducts a variety of inspections of nursing homes in the state, some of which are done on behalf of the federal Center for Medicare and Medicaid Services (CMS).
The state health department investigation, which was completed April 10, 2017, found Whetstone Gardens and Care Center employees put the female patient — as well as the other 122 residents — at risk for serious harm, and the facility was ordered to take immediate action to address the problem. The neglect began Feb. 21, 2017, and lasted over a five-day period, the investigation found.
It found, for example, that treatments the patient was supposed to receive for a pressure ulcer were not administered or not administered properly. The findings of the investigation later caused CMS to fine Whetstone Gardens and Care Center $98,765.45.
The state Department of Health is reviewing old evaluations of Whetstone and will cooperate fully with the attorney general and other authorities, spokesman J.C. Benton said.
Yost said his office will prosecute the cases “to the fullest extent of the law.”
“We will get justice for these families,” he said.

mtmkjr, BSN · Feb 16, 2019

On 2/15/2019 at 9:08 AM, Horseshoe said:
Who was forging the nurses' signatures?

From the article above, it appears the DON as well as the floor nurses.

Advanced Practice Columnist / Guide · Feb 16, 2019

For me, the bigger picture is the systemic failure of how we provide care to our vulnerable elderly citizens in our long term care system. Unlike many wealthy countries, our system is rigged with unequal care due in part to socio-economic, income and insurance disparities, poor government funding, poor staffing, bureaucracy, and a prevalence of for profit facilities whose CEO's take advantage of the system.

Long term care facility patients have one of the highest level of care burden from nursing staff. That's the reason why they are there because either their families are no longer able to provide that care or there are no longer any family members present. In the US, people with financial means can pick the best and most highly rated nursing facility for their loved ones.

Those who qualify for Medicaid (which basically means all your liquid assets have been reduced to zero, hence, you qualify), have very little option but to leave their loved ones to places such as the one mentioned in the suit with low standards of care and chronically high staff turn over if they can even retain staff. If you look at their state inspection reports, they have been receiving failing scores for years.

It's easy for a nurse like some of us with options for other areas of employment to run away from these places, work in another field, etc. But that doesn't take away the fact that these long term care residents need care. If we all do that, yes, these places will be left with people with past criminal offenses, uncaring and untrustworthy individuals, you get the idea. That's how come a woman who can't even speak for her own rights can get raped and carry a pregnancy unnoticed in these settings.

https://projects.propublica.org/nursing-homes/homes/h-365272

https://www.medicare.gov/nursinghomecompare/profile.html#profTab=0&ID=365272

https://assets.aarp.org/rgcenter/il/2007_19_usgerman_ltc.pdf

https://www.med.uio.no/helsam/forskning/nettverk/hero/publikasjoner/skriftserie/2010/2010_2.pdf

Wuzzie · Feb 16, 2019

Our system for caring for our elders is so severely broken that it’s no surprise that things like this happen. However, I don’t believe for a second that it vindicates the actions of these health care providers. I believe that even though we are nurses if we behave badly we need to be held accountable. By closing ranks we will continue to see bad nurses continue to be allowed to practice. This is a wake up call for our profession

That being said, here is an interesting article on a different approach to long term and skilled nursing care for our vulnerable population

https://www.theatlantic.com/business/archive/2015/04/a-better-nursing-home-exists/390936/

Advanced Practice Columnist / Guide · Feb 16, 2019

55 minutes ago, Wuzzie said:
However, I don’t believe for a second that it vindicates the actions of these health care providers. I believe that even though we are nurses if we behave badly we need to be held accountable. By closing ranks we will continue to see bad nurses continue to be allowed to practice. This is a wake up call for our profession

Oh I agree, but with all due respect to the OP, these kinds of stories are not new nor are they a new trend. These have been happening in nursing facilities for years and so cases of elder abuse and neglect have been prosecuted criminally in court for a long time. I am not associating these stories with the other thread on med errors ?.

https://www.ncoa.org/public-policy-action/elder-justice/elder-abuse-facts/