Lie on notes? Don't follow care plan.

Specialties Private Duty

Published

I am on a case right now where the pt can be quite acute at times. But pt right now is well and the insurance decided to change when the patient got nursing. The mother had a fit and called the agency. The supervisor worked with the doctor to devise a new care plan that would fit the hours the mother wants. So instead of following this, the mother is still following the old plan, with hours off of feedings and not a lot of "true" nursing while nurses are there and then asking the nurses to just play with the baby and then basically lie on their notes. When I said I wouldn't do that. She said she was not asking us to lie. Just to not put any times. So I said I can't do that either because if I ever have to account for anything during my shift, I have to be able to reference my notes, and without times, I cannot do that. I am also being left with another child, in addition to my patient while the parents sleep. And I am BORED out of my mind for HOURS just playing. I have called the office and complained which is against company policy. I finally said I need a break from this case. But I am really disappointed that the only support I got from my agency about this, watching another child, not following the care plan and this other child places the client in unsafe situations etc was really just a sort of ho hum attitude. Anyone else find themselves in situations like this? I am doing this case for the rest of the month and then I told them I need a break from this one for a while. I used to really like it. But the children are not disciplined and I am not there to play. Angels mommy

The particular client that I mentioned, did not change my nursing note, she literally took it from the binder. Later on, I found where she had 'stashed' that note along with three notes from a previous nurse that she had 'canned'. She and her husband were very savvy; not surprising that they had a lawsuit in progress.

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The particular client that I mentioned, did not change my nursing note, she literally took it from the binder. Later on, I found where she had 'stashed' that note along with three notes from a previous nurse that she had 'canned'. She and her husband were very savvy; not surprising that they had a lawsuit in progress.

She stashed copies (I assume they were the client copies)? And she thought that would help her how?

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She stashed copies (I assume they were the client copies)? And she thought that would help her how?

I don't know why she put them where the nurses could find them. She should have been smart enough to know that the hard copy went to the patient record at the office. As for the field chart copies, they are supposed to be returned to the office after a period of time. They are the property of the agency. If the family wants copies, they are supposed to make formal requests in writing, and pay any associated copying fee, just like with any medical record. That has not stopped them from taking them to make their "own" "free" copies. I have posted before about the case where the RN primary nurse made copies for the family. That family was a veteran with the legal system, having prevailed in at least one lucrative lawsuit.

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Specializes in Home Care, Peds, Public Health, DD Health.

wow. I think I would high tail it from that case in a jiffy. looks like they were just looking for a way to pay for free nursing care for the rest of their lives or have the nursing care on a desert island in the lap of luxury? what did they think? nurses are rolling in it?:no: wow, some people, you go to caring for their loved ones to defending your lively hood and home! you really did work for some winners as the previous poster said!:devil:

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You would be surprised how many are open about their golddigging lawsuit activities and the agencies just go along. The agency expressed viewpoint is always "get another job" if you don't like how the clients treat you.

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It is insurance fraud. Get off the case as soon as you can. Even though you can omit times from a narrative note, if you ever got called to trial you would be required to swear to tell the truth. My documentation has to be signed and dated, and mine requires the time you signed it. If I put 3pm and I was really there at 7pm, this is fraud. The BON would not back you on that irregardless of the fact that the agency is complicit. We all learned this in our first semester. The old adage about listening to your heart may be contrite but it is true. Also, I know the tiresomeness of getting stuck with two kids and entertaining them. I have great kids, but I sometimes feel I do more for them than my own kid and it breaks my heart. I feel so guilty sometimes. But, that part is the least of the problems where you are. I am signed with three agencies just to broaden my options. I work for two steady and one per diem. It helped a lot.

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Specializes in Complex pedi to LTC/SA & now a manager.

Besides getting caught and charges with insurance fraud can get you on the OIG (federal office of inspector general) exclusion list which, among other issues, bars you from working for any individual, agency, or facility that accepts Medicaid or Medicare assignment/ payment. (Which knocks you out of the majority of healthcare employment.)

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Some form of non-compliance, this or other actions/nonactions, is quite common. You will run into this quite often. When you speak up, the agency will blame you for any lack of harmony. They would rather you close your eyes, kiss the posterior of the client, do as they say, even anticipate their unreasonable requests, and keep your mouth shut at all times. When you can't do that, you will find yourself increasingly singled out to the point where you won't be working. The good agency with good administration and supervision, that requires professional behavior of its nursing personnel, while not bowing down to every whim and fancy of the client, to the detriment of the patient, is quite rare to nonexistent.

Most agencies dont care about their nurses. Their paycheck relies on the contracts being maintained. At any cost. Even if it puts our licences at risk. I've been doing PDN for quite a while. And tbh im sick of it. Im throwing all I've got left in me into obtaining some type of facility job. At least then I can somewhat rely on a full time pay check. Its an unfortunate decision because I absolutely love these little patients and im very good at what I do. Im just beyond exasperated with PCG and the pettiness almost every single one has. At least in acute care its typically a shorter nurse to pt relationship. The cases like the one the OP describes is the reason im burnt out.

Its fraud.

Its illegal.

I didn't spend tens of thousands of dollars to put my lifeline in jepordy because PCG dont feel like taking my employment seriously.

Js.

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This whole post sums up my day. I cant believe we have to choose between paying outer rent and feeding our kids, or advocating and protecting our licences. This is just unbelievable. What a flaming disgrace.

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Specializes in Lvn to RN, new grad med/surg.

I also have a lot of those things going on right now. When I attempted to educate parents on the correct uses of medication and advocate for my patient then I'm not "doing things the way they like it" and there are "personality conflicts". Personally, I'm sick of it and will be leaving asap! Very sad state of nursing.

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Specializes in Pediatric Private Duty.

I'm glad I'm not the only one out there feeling this way. My problem is that the parents don't seem to understand I need a day off. I'm working a 16 night stretch with a Saturday off at the end. I can almost see the light at the end of this never ending tunnel. Unfortunately because I have a night off that shift is open, the mom can be difficult and the agency is having difficulty find nurses to cover. I'm getting pressure from both parents and the office to pick up the shift. I DONT WANT TO! How do you handle it when they are constantly bombarding you with requests like this?

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I'm glad I'm not the only one out there feeling this way. My problem is that the parents don't seem to understand I need a day off. I'm working a 16 night stretch with a Saturday off at the end. I can almost see the light at the end of this never ending tunnel. Unfortunately because I have a night off that shift is open, the mom can be difficult and the agency is having difficulty find nurses to cover. I'm getting pressure from both parents and the office to pick up the shift. I DONT WANT TO! How do you handle it when they are constantly bombarding you with requests like this?

I've been in that exact situation a couple of times. I flat out say "No". I then tell the agency and the parents that I have children that want to see me too...I work to live, not live to work. Period.

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