Is this abuse how do I report?!

Nurses General Nursing

Published

Please be gentle maybe I am wrong in assuming this is abuse.

I am currently working at a SNF/Rehab. This is my first nursing job as an LPN.

I have a patient who has dementia and has recently starting mental declining according to other nurses. I haven't been the nurse in 1 month for them. I came in on sunday and was informed they due to have IM Geodon Q4H. When i got report the nurse said they had been refusing the med.

When I went in to the room and offered the med, I tried to convincing but patient stated "I have the right to refuse, i don't want those shots"

This patient recognized me, had conversation with me. Some confusion was evident, but this would be baseline for them.

I documented as refusal. Well supervisor came to me and said they received a text from the administrator (no medical background) stating this patient was "not allowed to refuse" and I HAD TO GIVE IT.

I told the nurse that this patient has the right to refuse, they are not a harm to themselves or others and I would not be holding them down and forcing them this is not a psych facility.

To which response I got "To bad, its a med error if you don't give it, and you can hold them down and give it"

I refused so the supervisor took my keys from me and administered the med while the patient yelled and stated "this is my right to refuse, this is illegal"

Please tell me I wasn't wrong in refusing to give this med. I was absolutely devastated that a fellow nurse would not advocate for this patient when they were doing NOTHING. They got the med and were so sedated they wouldn't even eat or wake up.

Is this not considered a restraint? Abuse? What do I do?

I've conversed with other nurses who don't agree with what's going on either. Truly they want to sedate this women so she cannot 'yell'. We have all been documenting that she is alert and oriented and being quiet, not threatening anyone.

When she yells she is getting people to leave her alone . I have people yelling at me to leave them alone.

Apparently she's been refusing 'care' so they deemed her 'psychotic'

With the right aids and caring demeanor this pt causes no problems.

They have sedated residents before especially before tours. Once told me if I didn't give a sleeping/sedated woman her prn xanax I would be written for a med error.

Thankfully I have another job lined up.

I have reported them today. Terrified for my shift tomorrow.

Specializes in Pediatric.
EXCUSE YOU!

REALLY???

MOST NURSES EITHER PARTICIPATE, OR TURN A BLIND EYE, TO WHAT GOES ON.

How dare you make a sweeping derogatory generalization of us LTC nurses.

I have never done such a thing nor have I knowingly let something go on or turned a blind eye to something unethical. immoral or illegal.

I have always done my best for those under my care.

The majority of nurses I have worked with over years do not reflect your opinion.

Your words speak volumes but they are saying something you can't hear.

Don't yell at Caliotter. She's a great nurse and contributes greatly on here. I have observed what she said too. She didn't say she observed you personally doing this.

Specializes in Pediatric.
I've conversed with other nurses who don't agree with what's going on either. Truly they want to sedate this women so she cannot 'yell'. We have all been documenting that she is alert and oriented and being quiet, not threatening anyone.

When she yells she is getting people to leave her alone . I have people yelling at me to leave them alone.

Apparently she's been refusing 'care' so they deemed her 'psychotic'

With the right aids and caring demeanor this pt causes no problems.

They have sedated residents before especially before tours. Once told me if I didn't give a sleeping/sedated woman her prn xanax I would be written for a med error.

Thankfully I have another job lined up.

I have reported them today. Terrified for my shift tomorrow.

Omg that's insane! Sedated residents before tours?!

Specializes in Critical Care.
EXCUSE YOU!

REALLY???

MOST NURSES EITHER PARTICIPATE, OR TURN A BLIND EYE, TO WHAT GOES ON.

How dare you make a sweeping derogatory generalization of us LTC nurses.

I have never done such a thing nor have I knowingly let something go on or turned a blind eye to something unethical. immoral or illegal.

I have always done my best for those under my care.

The majority of nurses I have worked with over years do not reflect your opinion.

Your words speak volumes but they are saying something you can't hear.

While it should be rare, and certainly isn't true of every nurse or LTC nurse for that matter, these beliefs are disturbingly common if the threads here are any indication. I'm always amazed that there's reliably not just a single 'rogue' nurse in these threads who argues some variation of 'nurses/patients can't refuse doctors orders.

Specializes in Rehab, acute/critical care.

I'm glad you followed your intuition that something wasn't right. I would feel the same way. Some of my patients get Geodon capsule PO and don't mind taking it. If it was ordered IM, I can't honestly blame someone for not wanting that every 4 hours.

Good luck with your new job, hope you enjoy it a lot more.

Unless the patient had been certified by a judge, she had the right to refuse the drug.

Who in their right mind ( or not? ) would want a needle stuck in them every 4 hours?

Glad you are outta there, report it.

EXCUSE YOU!

REALLY???

MOST NURSES EITHER PARTICIPATE, OR TURN A BLIND EYE, TO WHAT GOES ON.

How dare you make a sweeping derogatory generalization of us LTC nurses.

I have never done such a thing nor have I knowingly let something go on or turned a blind eye to something unethical. immoral or illegal.

I have always done my best for those under my care.

The majority of nurses I have worked with over years do not reflect your opinion.

Your words speak volumes but they are saying something you can't hear.

How dare you yell at me on a public forum with your histrionic accusations. I have worked in more than one LTC facility and only stated what I saw in each and every facility where I worked. How noble of you that this shoe does not fit you!

Be very careful KMarieD. There is a lot of employer retaliation to go around out there, as I can state from personal experience. You might want to consider whether you should attempt to preempt any derogatory actions with your new employer by bringing up the situation in a guarded way once you get a feel for how things are. There is nothing worse than having an offer of employment rescinded when you were the person doing what was right. Good luck.

I admit I've only skimmed most replies but was disturbed in the OP that the patient was discussed in a text. I was informed at my facility that texts are "discoverable" as evidence and patient information should never be sent via text. I believe there is also concern that with texts, a HIPAA violation could occur.

No advice to offer, but this just stuck out as something really odd to me.

Be very careful KMarieD. There is a lot of employer retaliation to go around out there, as I can state from personal experience. You might want to consider whether you should attempt to preempt any derogatory actions with your new employer by bringing up the situation in a guarded way once you get a feel for how things are. There is nothing worse than having an offer of employment rescinded when you were the person doing what was right. Good luck.

Thankfully I am already set to start and have all my paperwork signed. I'm going into an ENT office. They asked me why I was leaving and I just said that "I jumped into the first job I was offered because I felt like I wasn't going to have an easy time getting a job as a new grad. While it has been a learning experience I don't feel I researched the facility I am working for enough and it's just not the right fit"

They accepted that and understood even said "Working in LTC must be hard, not the type of work we want to do"

I don't plan to bring any of this drama with me to the new job. I'm terrified of my last two weeks at the facility though.

Good. It sounds as if nothing got to the new job. Just have a reply in mind should they say, "We got a call from..." Hopefully, you can make it through your two weeks notice with nothing surfacing. Best wishes.

Specializes in SICU, trauma, neuro.
I'm sorry I didn't realize this was considered asking legal advice. Thanks for the advice. I'm researching my avenues right now.

I don't think anyone was criticizing you for asking, just being clear to cover themselves. Kind of like how every so often someone will say "I know we're not supposed to offer medical advice, but please consider talking to someone about this anxiety." It's definitely an important question you ask!

Thank you for caring, and for acting on the side of caution. I have a soft spot for LTC and LTC nurses, as someone who's had grandparents in LTC and who started her career there as a CNA.

I'm not 100% but it seems like if this med was court ordered you would know about it? And the supervisor would have said something about said order--not "just give it" and threatening a med error for exercising your nursing judgment. (Med errors are not supposed to be grounds for discipline anyway, but that's another topic.)

Google "long term care ombudsman in [your state]". That should have helpful info for where to report.

And congrats on the new position! :up:

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