Made to Falsify Documentation :(

Specialties Geriatric

Published

Ok...so I'm just learning the ropes as a new CNA on board and charting is one of the tasks. We are supposed to check and change (if needed) everyone on our team (20 people) every 2 hours for incontinence as the single CNA. Our floor is heavy and there's no possible way. Yet, at the end of the shift we are expected to write the times in perfect 2 hour increments that we checked each person, and our initials. I have a problem with this. Problem #1 The resident isn't getting the care (s)he deserves obviously! Problem #2 There's no way I can do this all by myself and the nurses say there's nothing they can do and pass the buck. Problem #3 Those are my initials on there and that means that my integrity is on the line. I take that seriously.

The same of the above goes for ambulation which rarely gets done for those residents who cannot walk to meals or the toilet. Lots of other stuff gets fudged too. I doubt it's the facility that I am working at because it's really one of the nicest ones around. All of the CNAs do this and they care but they say there is no possible way that things can be done properly as they would like to.

Does everyone do this? Is it commonplace to lie on charts for the files just in case the state comes in to check?

Thanks,

Shel

First of all........I have a problem with the "there was'nt enought time" excuses. I work in a LTC facility(little over a year) and have worked all of the units. One of our units holds up to 44 residents. During the day that unit get 3-4 aides, at night 2. Another unit holds 28 residents, they get 2 aides 24/7. Also, there is a unit that can hold 35 they get 3 aides during the day and 2 a night. Alzheimers unit holds 16, they get 1 aide and 1 nurse during day, then 2 aides afternoon and 2 aides at night, while nurse is on other unit but still available. Finally, there is a unit that holds 21 residents and has 2 aides during the day and at night 80% of the time has one aide. Now, with all of that said, I work 7p-7a. I have many of times worked the unit with 21 residents by myself and have still been able to do ALL of my checks, my charting, pass linens/clothes, take residents who are able to the bathroom as needed and answer call lights.In addition, in the mornings.....bathe, dress, and provide care to eight or more residents within a 2 and a half hour time frame.... Sometimes I even do the I&O's for my nurse as well as her vitals. Yeah, it sucks and if you are not able to do it, then you need to go and talk to someone in charge, however it can be done. I am sorry, but that is exactly why LTC facilities and STNA's get bad wraps! I do agree that the staffing sucks, however that is no reason to not give 110% to our residents. I am 6 months pregnant and can do it!

Furthermore, no---one can MAKE you falsify anything!

Julee

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I don't know how this facility gets away with some of the stuff I've seen. gripe, gripe gripe. :chuckle

Probably because it doesn't get reported to the licensing authority.

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This is my new job! I quit life as a pharmacy tech to get my feet wet in the nursing field as a CNA. I'm currently a new nursing student and I've pretty much made my mind up already that I am not cut out for LTC if it means I have to lie through my teeth. I'm not quite sure what to do now. I don't want to be a whistle blowing rat and cause all kinds of uproar. The facility already has a tough time with staffing and I feel like me quitting will not only put me out of a job, but it will make the problem there worse. I thought I could always milk the place for my certification and then leave for a hospital job. Are hospital jobs any different though? Do you have to lie and say you do things that you don't? Maybe I'll talk to the DON or the Administrator. They seem like approachable people. The Administrator also talked about Integrity in general orientation so I could probably build a bit off that. I'm just at a loss...

You need to be a patient's advocate, even in a CNA position. There are plenty of other jobs that would not require you to put your integrity on the line!

One doesn't *have* to lie anytime! You do have a choice.

I have a feeling upper management is well aware of the situation. Your best bet would be to report it. Look into making an anonymous report to the licensing agency/Medicare.

If you are a praying person, please pray long and hard about the choices you are making.

Good luck!

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First of all........I have a problem with the "there was'nt enought time" excuses. I work in a LTC facility(little over a year) and have worked all of the units. One of our units holds up to 44 residents. During the day that unit get 3-4 aides, at night 2. Another unit holds 28 residents, they get 2 aides 24/7. Also, there is a unit that can hold 35 they get 3 aides during the day and 2 a night. Alzheimers unit holds 16, they get 1 aide and 1 nurse during day, then 2 aides afternoon and 2 aides at night, while nurse is on other unit but still available. Finally, there is a unit that holds 21 residents and has 2 aides during the day and at night 80% of the time has one aide. Now, with all of that said, I work 7p-7a. I have many of times worked the unit with 21 residents by myself and have still been able to do ALL of my checks, my charting, pass linens/clothes, take residents who are able to the bathroom as needed and answer call lights.In addition, in the mornings.....bathe, dress, and provide care to eight or more residents within a 2 and a half hour time frame.... Sometimes I even do the I&O's for my nurse as well as her vitals. Yeah, it sucks and if you are not able to do it, then you need to go and talk to someone in charge, however it can be done. I am sorry, but that is exactly why LTC facilities and STNA's get bad wraps! I do agree that the staffing sucks, however that is no reason to not give 110% to our residents. I am 6 months pregnant and can do it!

Furthermore, no---one can MAKE you falsify anything!

Julee

Do you have restorative and ambulation exercises to do on your shift? I had 13 residents on 3-11 and if I were to do all the restorative and walking that are in the patients' ADL's, it would take me approximately 2 hours.

As it is, I already am busy toileting my continent/semi-continent residents and there's a couple of them that want to go every hour (and our restorative charge nurse says that that doesn't count toward walking) getting my residents ready for bed, dinner, dealing with families, getting the residents back and forth to evening activities. Without the restorative/ambulation exercises I finish up between 9:30 and 10. After they are in bed, I'm busy emptying hampers, taking dirty pad barrels downstairs to laundry and bringing back empties, neating up the rooms.

Then I have a break, then rounds and getting to bed another lady who likes to stay up till 11:00 and then finishing my paperwork till quitting time.

I do not have 2 hours to do complete restorative exercises as outlined in their ADL's. Were I or any other aids indicate that we weren't able to get restorative done on the ADL's, the restorative charge nurse has already told us that they will be done, end of story. No excuses.

So if we complete restorative as they are expected to be done, that means that there will be a few residents still up when the 11-7:30 shift arrives. I don't know about your night shift workers, but our's would scream bloody murder.

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Specializes in ER.

Absolutely, positively don't document something you haven't done. It could affect your life in multiple ways, for the rest of your life. Taking the heat for not doing something would be much better- though more painful.

What's up with walking to the bathroom not counting as walking? Take them for a stroll to the doorway and back while you've got them up (if they are going to be that fussy) and call it the official "walk". Combine as many tasks as you can- that's my motto. But absolutely don't put your own integrity on the line for a company that doesn't have any of it's own.

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Specializes in Critical Care / Psychiatry.
Finally, there is a unit that holds 21 residents and has 2 aides during the day and at night 80% of the time has one aide. Now, with all of that said, I work 7p-7a. I have many of times worked the unit with 21 residents by myself and have still been able to do ALL of my checks, my charting, pass linens/clothes, take residents who are able to the bathroom as needed and answer call lights.In addition, in the mornings.....bathe, dress, and provide care to eight or more residents within a 2 and a half hour time frame.... Sometimes I even do the I&O's for my nurse as well as her vitals.

Weird! We have to do all I&O's and vitals ourselves along with all of the above and then some. I wish the nurses could take a chunk of it though I understand that they have their work cut out for them as well. Sounds like you do a great job time managing. I hope I can get to that level as soon as I adjust to the newness of everything.

After much thought and reasoning and after talking with my husband about this and reading the good advice of all of you, I've decided I'm not lying. No way! I don't care if everyone does it. I don't care if they all hate my guts. I'm going to try my very best to get everything done and what I don't get done they can see me about. I am going to speak with the DON or the Administrator and express my concerns. If that doesn't go anywhere, you bet I'm going to report the facility. I care too much about these people to neglect them on paper like everyone else. If I have to take my certification and go elsewhere, so be it. At least I have my integrity.

I just want to thank everyone for your input and support. I'm no longer worried about what to do. I know exactly what I'll do. :)

Thanks so much!

Shel

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Specializes in Registered Nurse.

my opinion is that the cna assignments are impossible most of the time. i would not falsify the documentation. i would only write down what i really did. it's the facilities administrators/don that have the choice to staff properly and safely or not. you can only do what you can do.

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definitely true liza. if we only accurately document what was done, then mgmt. might just have to reassess staffing and expectations if indeed we do not get everything done.

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Falsify Documentation nah l can't do it. Have been hasseled to do so from time to time. If mamagement want lies in the documentation I simply tell them they can do it.

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Specializes in Registered Nurse.
definitely true liza. if we only accurately document what was done, then mgmt. might just have to reassess staffing and expectations if indeed we do not get everything done.

Exactly!...............

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Do you have restorative and ambulation exercises to do on your shift? I had 13 residents on 3-11 and if I were to do all the restorative and walking that are in the patients' ADL's, it would take me approximately 2 hours.

As it is, I already am busy toileting my continent/semi-continent residents and there's a couple of them that want to go every hour (and our restorative charge nurse says that that doesn't count toward walking) getting my residents ready for bed, dinner, dealing with families, getting the residents back and forth to evening activities. Without the restorative/ambulation exercises I finish up between 9:30 and 10. After they are in bed, I'm busy emptying hampers, taking dirty pad barrels downstairs to laundry and bringing back empties, neating up the rooms.

Then I have a break, then rounds and getting to bed another lady who likes to stay up till 11:00 and then finishing my paperwork till quitting time.

I do not have 2 hours to do complete restorative exercises as outlined in their ADL's. Were I or any other aids indicate that we weren't able to get restorative done on the ADL's, the restorative charge nurse has already told us that they will be done, end of story. No excuses.

So if we complete restorative as they are expected to be done, that means that there will be a few residents still up when the 11-7:30 shift arrives. I don't know about your night shift workers, but our's would scream bloody murder.

We have a restorative department. They work during the day individually with the residents. Our LTC is also a rehabilitation center that has its own therapy department at the facility. However, I work 7p-7a so I am one of those night shift ppl. There have been occasions where R have been left up. As long as they are dry or as dry as can be expected and dressed for bed, then no I don't scream bloody murder. I just think that its an issue of time management and learning the ropes. The things I do get p-o'd about is when ice doesn't get passed or residents are put in bed still dressed or bed check has not been done. There are certain things that can be overlooked (we all have good and bad days) however, letting R go thirsty or having them have their feet touching the edge of the bed and them lying completely on their back or them being a total bed change is something I don't tolerate and I let ppl know.

Julee

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Weird! We have to do all I&O's and vitals ourselves along with all of the above and then some. I wish the nurses could take a chunk of it though I understand that they have their work cut out for them as well. Sounds like you do a great job time managing. I hope I can get to that level as soon as I adjust to the newness of everything.

After much thought and reasoning and after talking with my husband about this and reading the good advice of all of you, I've decided I'm not lying. No way! I don't care if everyone does it. I don't care if they all hate my guts. I'm going to try my very best to get everything done and what I don't get done they can see me about. I am going to speak with the DON or the Administrator and express my concerns. If that doesn't go anywhere, you bet I'm going to report the facility. I care too much about these people to neglect them on paper like everyone else. If I have to take my certification and go elsewhere, so be it. At least I have my integrity.

I just want to thank everyone for your input and support. I'm no longer worried about what to do. I know exactly what I'll do. :)

Thanks so much!

Shel

We have our own I&0's and I do mine, however the nurses have to tally the totals and put them in their own charts. Sometimes, if I have time I will put the inputs in for them! :)

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