I'm the DON but the company is going to get me in trouble

Nurses Activism

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I'm the DON in a LTC facility. Things have been going downhill for about a month as far as getting approval from corporate to order supplies, such as briefs, cups, pill crush pouches, gloves, etc. I didn't like it but we made do with less. I now find out that we are losing lab services because the corporate machine hasn't paid the bill. I learned about this from the lab, not my employer. This bothers me for so many reasons. My questions are 1. When do I have an obligation to report this to the regulatory agency? 2. What kind of trouble can I get into as the director if I have no control over bill payments and contracts?

I am terrified of what is potentially happening here. I feel an obligation to my patients and staff but have been told that I am basically referring my own license if I report them to the state. I just want to do the right thing. I don't want to abandon my staff or patients but I also have an obligation to myself and my family. I have never experienced anything like this and I feel a strong ethical and moral obligation to so many people here. Any advice would be greatly appreciated because I am scared, which is not a common thing for me. Do I just walk away? I won't lie for anyone and I will always try to do the right thing but this is a sticky situation and I need help. Thanks in advance!

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Specializes in Hospice.

Fair warning: I have ZERO experience with state BONs on this kind of issue.

That being said, common sense tells me that you should consider the source. I would think you would be in even more trouble with the bon if you did not report and the issues come to light through other avenues ... which sounds pretty inevitable to me. That "advice" sounds suspiciously like an attempt to intimidate you into keeping silent.

As for when you become obligated, I would think when conditions start to fall short of minimum regulatory standards or start to endanger residents.

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Specializes in Vents, Telemetry, Home Care, Home infusion.

In most states, the Department of Health regulates Skilled Nursing Facilities, not board of nursing. Have you notified SNF administrator of these issues.... if they have not been concerned, there should be a corporate DON you should notify. It's not unusual for cash strapped corporations to be late paying bills, especially if reimbursement from Medicare/Medicaid late. If these persons appear unconcerned or hushing up issue, you can file a whistleblower complaint with Dept of Health or state Inspector General hotlines.

Excellent advice here:

Preparing to Blow the Whistle: A Survival Guide for Nurses - Medscape requires free registration

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I have notified my Administrator and she has notified the owners, as well as the members of upper management. My Administrator is very concerned, of course. The owner of the company issued a response that is nonchalant and inaccurate, at best. The powers that be truly seem to not care about the severity of the situation and have been quite distant and not the least bit helpful in resolving the problem. Thank you so much for the advice and the information that you have provided.

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Specializes in Education, Administration, Magnet.

If the patients care your staff is providing is impacted by the things you have listed, and you have notified your chain of command with zero outcomes, then I would recommend to report the issue. Not to the Board of Nursing but to the Department of Health Services.

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I appreciate the responses and have taken action by reporting to the regulating entity. I knew in my heart what was right and I guess I just needed confirmation that I was doing what was in the best interest of the vulnerable parties involved. I am relieved to have this chapter in my career closed but am nervous about my future, of course. In the end I have done what is right and I will hang my hat on that.

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Specializes in Tele, ICU, Staff Development.
I appreciate the responses and have taken action by reporting to the regulating entity. I knew in my heart what was right and I guess I just needed confirmation that I was doing what was in the best interest of the vulnerable parties involved. I am relieved to have this chapter in my career closed but am nervous about my future, of course. In the end I have done what is right and I will hang my hat on that.

Moral distress in nursing is all too common.

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I appreciate the responses and have taken action by reporting to the regulating entity. I knew in my heart what was right and I guess I just needed confirmation that I was doing what was in the best interest of the vulnerable parties involved. I am relieved to have this chapter in my career closed but am nervous about my future, of course. In the end I have done what is right and I will hang my hat on that.

Thank you for doing right. Where will you go from here?

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Specializes in kids.

The ombudsman Office?

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Not sure. I quit my job today and actually have peace and two interviews lined up. The good Lord will lead me to where He wants me to go.

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first, as a healthcare provider you have an obligation to report any violations directly to the state. Secondly, if the investigation is launched you are a whistleblower and can't be blamed. I would advise to consult with your legal team, but don't hesitate to reach to the Board of Nursing of your state.

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Specializes in Critical care, tele, Medical-Surgical.

Good for you for doing the right thing!

On page 2 of this PDF the long term care federal regulations begin:

https://www.gpo.gov/fdsys/pkg/CFR-2011-title42-vol5/pdf/CFR-2011-title42-vol5-part483.pdf

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