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Is it like this everywhere?

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Ok I need to vent. I have worked in this LTC for 4 yrs, 3 as an aide, 1 as an LPN. Since I have worked there, there have been 2 CNA's, one on day shift, one on evening shift. They both are verbally and at times physically abusive to the res. they both defy authority, if u ask them to do something they don't agree with.. as simple as laying a res. down or taking a set of vitals they flip and refuse and on top of that they think ...actually they do run those shifts (i'm 11-7) Well occassionaly i work those shifts and have a horrible time getting them to do anything.. I worked with them both when i was an aide and i have heard one of them tell res. " you need to die" "we're poisoning you" "shut up" they both refuse to care for some res. and family members have actually kicked these two out of several res. rooms and these two aides are not allowed to go back in there! well I have personally reported the two of them SEVERAL times, talked to the DON, did no good, talked to the administrator, did no good, called state.. nothing got done cuz of course they arent gonna act like that in front of state.. I am at my whits end.. there are tons of other stuff going on where i work.. tx not getting done, meds not ordered.. some res going 2 to 3 days without meds because they werent ordered.. narcs missing and it keeps getting worse.. is it like this everywhere? Or does this place need to be shut down? I am honestly afraid for my license at times.. any input/advice?

Super_RN, BSN, RN

Has 12 years experience.

Ok I need to vent. I have worked in this LTC for 4 yrs, 3 as an aide, 1 as an LPN. Since I have worked there, there have been 2 CNA's, one on day shift, one on evening shift. They both are verbally and at times physically abusive to the res. they both defy authority, if u ask them to do something they don't agree with.. as simple as laying a res. down or taking a set of vitals they flip and refuse and on top of that they think ...actually they do run those shifts (i'm 11-7) Well occassionaly i work those shifts and have a horrible time getting them to do anything.. I worked with them both when i was an aide and i have heard one of them tell res. " you need to die" "we're poisoning you" "shut up" they both refuse to care for some res. and family members have actually kicked these two out of several res. rooms and these two aides are not allowed to go back in there! well I have personally reported the two of them SEVERAL times, talked to the DON, did no good, talked to the administrator, did no good, called state.. nothing got done cuz of course they arent gonna act like that in front of state.. I am at my whits end.. there are tons of other stuff going on where i work.. tx not getting done, meds not ordered.. some res going 2 to 3 days without meds because they werent ordered.. narcs missing and it keeps getting worse.. is it like this everywhere? Or does this place need to be shut down? I am honestly afraid for my license at times.. any input/advice?

I find it hard to believe that if abuse is reported and family members ban these workers from those rooms that nothing is done about it. At the LTF where I used to work, if abuse was even suspected by anyone, it was to be reported immediately and immediate action was taken. There have been many people fired, some even unjustly, due to a smidge of suspicion. The place where you work sounds absolutely horrendous and extremely illegal. :o You need to keep track of these encounters, time and date and etc.

Wish you well.

:) Jaime

Well trust me.. nothing is done.. well honestly they MIGHT have got called in the office.. but these ppl have been working here for 4 yrs and it still happens one of them even got employee of the quarter recently! this girl is great friends with the DON by the way and I am not the only one who has reported her and the other aide.. ugh! it makes me sick.. i absolutely feel horrible for the res under there care

Super_RN, BSN, RN

Has 12 years experience.

Then your administration is not doing their job properly. Far from it. Apparently state is not doing their job either. Makes me irate.

Sounds like you work in hell. :o

Z

sounds like you need to get out of there asap.

leslie

sounds like you need to get out of there asap.

leslie

You took the words right out of my mouth. Narcotics are missing too!!! Run for your life before you lose your license. :o

ear

Specializes in psychiatric ER, Mental Health. Has 10 years experience.

I agree with the rest of the posters...move on!!

To answer your origional question, no, not all places are like this. I have worked in SNF's for the last 12 or so years. I am in a wonderful one now. My last job was a great place as well. Everyplace will have their challanges, but the things that you are mentioning are way beyond bad. Dont let this one place get the best of you. There are so many opportunities if you want to work with the seniors, look around. When you are checking out places, look them up. Ask questions during your interview.

There are good places and bad places, just like there are good people and bad people. Find yourself a good place.

VivaLasViejas, ASN, RN

Specializes in LTC, assisted living, med-surg, psych. Has 20 years experience.

You need to make like a shepherd and get the 'flock' outta there!! THEN call your state's Senior and Disabled Services (they're in the government pages of the phone book---these agencies go by different names in different states, but they all serve the same function), the ombudsman's office, even the police and your local newspaper or TV news station, and just keep calling until SOMEBODY takes action! Those residents do not deserve what is happening to them.......it is ABUSE and it is against the law :angryfire Worse yet, if you fail to report it and it comes out later that you knew about these conditions, you too will be in trouble, as all health care professionals are considered mandatory reporters. It sucks, but you know what your duty is, unlike the other people who work in that hell-hole you call a nursing home.

I wish you the best. It sounds like you're the only one advocating for those poor helpless residents......thank you. :)

Imho you need to get out of there fast. With the ways things sound, sooner or later the poop is going to hit the fan and your license could be at risk.

Daytonite, BSN, RN

Specializes in med/surg, telemetry, IV therapy, mgmt. Has 40 years experience.

I feel your pain. I was stuck in one of those places for awhile. Your state agency for the aged or whoever you report nursing home abuse to is not responding because they don't have enough ammunition. If your DON isn't going to help you collect evidence, you'll have to do it. Start documenting any incidents you see or statements they make to patients. You document in the form of a memo or a letter to the DON. Keep copies. If these fools are stupid enough to cause any bruising or other injuries to a patient, document it and report it to the agency immediately. Try to get patients to tell you what these fools have said to them if you can do it tactfully, and document it. When you "investigate" an incident you try to get information from everyone involved, all of which you document. This is the kind of documentation you want to see going into someone's personnel file. Then, call the state agency or write a letter and attach the copies of the documentation you have. They must investigate all complaints. When I lived in Ohio those investigators came to a facility where I was working within a few hours of a complaint that was made by a family. Just keep on documenting and reporting to the state agency. The investigators for these agencies see through the lines better than you think--they just have to have all the t's crossed and the i's dotted. That's how bureuracracy works. The bozos running the facility might finally do something when they get slapped with a big fine.

Have you tried marking the linens or diapers of patients? If they're letting incontinent patients lie in wet or soiled diapers you'll find out real quick. You can do the same thing with dressings--it's very easy to see whose is not getting changed if the dressing is marked with a date and time. We had a big med problem where I was working--one of the nurses wasn't giving patients their meds. She was sneaky about it too. She only skipped the meds of the confused patients. But, she was dumb and didn't take the time to throw away the pills. We got wise when it was time to reorder meds and only half of the meds had been given from some of the patients monthly supplies. They got her though. The pharmacy came in 30 minutes before one of her shifts and counted every medication in her medicine cart. After she finished her shift and left they re-counted the medicine cart. Boy! Did they have an eye opening! She was fired and reported to the state board of nursing. She was also recording blood sugar results that she was making up. Guess she didn't know that the glucose meters have a memory and store results. Unfortunately, they don't store the results of blood sugars you made up. I hope the state kept her license because she has no business taking care of people.

Thanks for your input... just to let u all know, state has been called (a few times by me) but things seem to well "improve" while they're in the building.. no one is going to tell a res. to shut up or die in front of a state inspector.. this place was hotlined by family members twice two weeks ago and four times last week. state came one day, looked at charts and left! just this month we have had 14 res move to another local LTC facility because of the lack of care.. we live in a relatively small area and word is getting around about how this place is.. just another question.. have u all ever felt like obligated to stay somewhere? honestly one of the main reasons i stay is because there are just a few of us out there that actually care.. and if we leave then what does that leave the res. with? I keep talking to the administrator and trying to get stuff done about these situations... it's so hard to leave the res that i've taken care of for so long

I would just add call the attorney general's office....they can't ignore this.

Also, Yes, I have stayed places because I felt so bad

about the residents...but that is no answer and only

prolongs getting attention to the problem.....and also makes yourself emotionally unhealthy dealing with this day in and day out. I have had patients beg me

to stay....you have to do what is best for your own health....no one will take care of you if you are not well mentally and/or physcially.

Advocate for them, but leave for your own health.

Daytonite, BSN, RN

Specializes in med/surg, telemetry, IV therapy, mgmt. Has 40 years experience.

Don't despair. Like I said earlier, even though it seems that the state isn't doing anything during their visits or responding to patient complaints--they are keeping score and documenting the number and nature of the calls they are receiving. They have to have written documentation and proof of things before they can take definitive action. So, if you are calling them with a complaint and have no proof to back it up there is really nothing they can do. If a patient becomes injured (such as a broken hip from a fall, or bruises from manhandling) I'm sure they'll be there within hours to investigate because there is physical proof. That is why I suggested that when you come across an incident you write it up as objectively as you can. It's great if it involves medications because you can Xerox med sheets, count the numbers of pills in the patient's bin and document any statements from the patient or the patient's roommate (don't forget them, they see a lot!). Like I mentioned in my PM, our pharmacy came in and counted every pill in the medicine cart before and after the nurse suspected of not giving medications worked on her shift and the pharmacy documentation of this is the proof the state board of nursing needed to discipline her. Xerox's of the medication sheets showing the blood sugar results she had documented on patients records were compared to a list of the blood sugar results that were stored in the glucometer. Again, it was the pharmacy who compiled the list of dates and times of blood sugar results stored in the glucometer which was presented as proof toward showing the nurse was falsifying patient records.

I wouldn't keep complaining to the administrator too much. Let him know that you will be looking for incidents to document and that you would expect them to take some kind of action when you do that. These things tend to move along slower than we would like. If administration is doing their job right, the employee in question just kind of disappears from the facility. But, I've got to tell you. . .because of confidentiality you are not going to get feedback as to what kind of discipline is being dealt out to another employee. Also, once an employee is reported and is disciplined be prepared for them to lash out at you if they are still employed at the facility because they will be angry.

It sounds like the administrator may be sympathetic to your complaints. Is it possible that they may be having problems with the DON? You may not know that (confidentiality, again). Administration is not going to let staff know that they are unsatisfied with one of their executives because it creates all kinds of problems. If that may be the case, I'd document incidents (always keep copies!) on memos and I would kind of check to see if the administrator is aware of them (in a very tactful way, of course). It may be that they are looking for a reason to give this DON the boot but need proof before they terminate her so they don't get into any legal hassles if she comes back at them for unlawful termination.

Welcome to the wonderful world of administration! When I became a head nurse I did more documentation on staff related incidents than I ever did with any incident reports involving patients. It's what kind of made the job suck.

Daytonite, BSN, RN

Specializes in med/surg, telemetry, IV therapy, mgmt. Has 40 years experience.

It dawned on me that if the adminstration where you work needs proof to backup a DONs termination what they would need is one big incident where sometime terrible happens to a patient. If the file of the employees involved in such an incident turns out to have a bunch of documentation on bad things that they've done in the past (write-ups by other employees) and adminstration can show that the DON has done nothing to "fix" the problem with these employees, she's out the door. This is why I say keep copies of every memo you write. Put as much specific information into a memo as you can. If you read them a year later, you'll be surprised at how much you've forgotten about an incident. If you discover that the DON just threw your write-ups away, you have copies of them to show administration.

Are you getting my drift?

CapeCodMermaid, RN

Specializes in Gerontology, Med surg, Home Health. Has 30 years experience.

In Massachusetts, any one can call and make a complaint to the DPH. They don't ask for proof...they come to the facility and investigate it. Imagine how surprising it can be to be paged to the lobby because the DPH is in on a complaint and no one has complained......

snowfreeze, BSN, RN

Specializes in ICU, CCU, Trauma, neuro, Geriatrics. Has 16 years experience.

There are lots of wonderful LTC facilities. Good luck. What you are describing is not even close to what happens where I work.

wow thanks for all the advice, i am definately going to start keeping copies of my write ups and documenting things much closer and being more observant. i really am attached to this facility and i want to see it improve to where it was when i first started there, i love the residents and some of the employees there and i would hate to leave there and always wonder if i could have done more. again thanks for all the input.. more is definately appreciated

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