I have a huge problem with this... opinions please

[dawn30]

I work in an LTC that has 3 units. 2 units are connected and one is a locked unit. tonight while doing my med pass, i heard yelling coming from the other unit and see the nursing supervisor go flying by the opening between the 2 hallways w/ a resident on her heels. I heard her yelling " you assulted me" so i immediately went to the unit to see if she needed help. (we have very few men working in the facility so all available nurses respond when there is a problem) when i reach the nurses station, the unit nurse(agency) is sitting behind the desk looking like a scared cat and the super is on the phone w/ the police. the resident is standing at the desk holding a replacement trach tube package in his hand and gesturing wildly at the super. I asked the unit nurse what happened and she said he hit the super. the supervisor then yells GET HIM AWAY FROM ME so i escorted the resident to the lounge and got him to sit down. when i got him calm enough that he could talk to me he stated i can't breath and need my tube changed. (he's not on o2 just has the tube in his trach) i go to the unit nurse and tell her he needs his tube changed. she doesn't move. i check the resident and again go to the unit nurse and tell her he needs his tube changed NOW.... still, she doesn't move. I grab gloves off her cart, take the replacement tube from his hand and change it. The old tube was extremely dirty. he instantly calms down and begins to apologize saying he just couldn't breath. he explained that he had been asking to have the tube changed for hours and they kept ignoring him, walking past him etc.. the last time he stuck his arm out to stop the super and that's when she said he assulted her. the police arrived and so did the assistant administrator. i explained to the officer that the resident was not a threat to anyone and was completely calm now. the administrator said we still had to send him to the crisis center as per protocol. the super had to be sent home early because she was crying and SOO upset!! i gave the administrator a written statement of everything i saw heard said and did. there is now a strong possibility that this poor man will not be allowed to come back to our facility becuse the super says he assulted her. I am furious at the super and the unit nurse. why didn't anyone take the two seconds and change the poor mans tube??? any opinions?

[pedsnurze1]

I haven't read the entire thread, but it's clear to me that this event should be reported to Adult Protective Services. The fact that the resident allegedly assaulted the nursing supervisor is irrelevant. If this resident's trach had not been changed or cleaned in some time, it creates ample suspicion of neglect, and if I were an investigator for APS I'd be all over that facility like a bad smell.

From a surveyor's point of view (I spent two days this week in a CCMU training, so I learned a lot about how the state looks at these issues), this resident is not a perpetrator, he is a VICTIM, and the facility will fare very poorly if it tries to force him to move at this time. The facility will, at the very least, be asked what interventions were in place to prevent or manage assaultive behaviors.........all APS will need is evidence that his trach was not changed in a timely fashion, and not only can there be severe financial consequences for the facility, the involved staff could also face sanctions depending on whether a pattern of neglect is established.

The OP did well in documenting things, and I agree with her that this incident was handled very poorly by some of the other staff members. But it does need to be taken a few steps further, and both the OP and the facility's management should understand the seriousness of this incident, and that APS MUST be notified if they haven't been already.

For Sure

[ebear, BSN, RN]

MJA-47 :welcome: to allnurses!!! What a beautiful post!!

ebear

[ktwlpn, LPN]

That was meant for me.......I don't know why you didn't just direct your comments TO me. *sigh* For the record, it was not my intention to imply that she was "making things up" at all. As I plainly stated: "I don't know what happened". Therefore I am not drawing battle lines.

------------because TOS states we are to address the POST and not the POSTER...Your posts were not the only ones that I perceived as argumentative...