Mandatory Reporting

There has been a few posts on some horrible incidents that have happened in the LTC stettings. Most of them abuse or neglect either from withholding things, actuall physical abuse or neglecting residents basic care needs.

As nurses, we are mandatory reporters? Where is it written (I'd love to actually have it in print). Aside from that....how do you/ we sleep at night, if not reporting abuses to higher ups? What holds you back?

I've done it before. Not at my current place, but yep it was difficult but the heads did roll.

Go online and read your state's Nurse Practice Act. Also, I recall when I lived in PA, I would receive a pamphlet with my license renewal notice outlining mandatory reporting situations such as child and elder abuse.

I was irritated last night when I got to work. I do not work full time. But I do get called in on occasion. I worked 7p-11p yesterday. Nothing was wrong at work except for our lack of nurses. Since our administration has changed almost a year ago, we have lost several nurses on the afternoon shift. And as if it were the fault of the rest of afternoon shift, they will not even try to hire other nurses. Our pay is not competitive, and we can't keep any nurse we do get. That said I come in last night to One RN in the skilled unit (60 beds) and an lpn. The DON was there with a CMA in one intermediate care (48 beds) and 2 cmas in another intermediate care (58 beds) there was one nurse that was going between the intermediate care sections. The DON was doing more of "her" work than actually being an acting nurse on that floor and the other nurse as good as she is, was dealing with 2 readmits and one admit and a fall so she wasn't concentrated on the floor. I trust the one cma as she has several years experience as a CMA in our facility and she has been with this company for 32 years. The other 2 cma's are young, one just out of high school and fairly "ditzy" and the other is ok but lacks experience period. I thought to my self, I would not want my mother in the care of the young cma's especially when there were only three nurses in the whole building after 7pm. I am a cna going to nursing school and have read many threads in here about nurses not wanting CMA's under them for fear of their license. I had never thought about it like that when we first sent our girls to CMA school all were CNA's and now the problem is that they will not work unless they are passing pills. We are so short all of the time that the managment allows them to get away with it. One time they even pulled a nurse to the floor to be a CNA in order to get a CMA to come in. She would only pass pills. Well that nurse is one of the ones we have lost. she didn't just abandon us but she put in her two week notice. I can't say that I blame her. I want to call state on this practice but I would like state to walk in and find the facility operating like that. I don't want the facility to be able to cover it up and make it look better, when state is there. We are about due any time now for our annual state inspection, but I know the floor will be covered while they are there.

I have heard of times that some one called state for one reason or other and everytime word got out and everytime our administration was waiting on them!!!!

Venting more than anything. I do want something done about this and I cant go to management they ARE the problem.

Sue

Yes, we as nurses are mandated reporters. We had to fire 4 people for not reporting abuse. 3 CNA's and an RN. The RN was told about the abuse, but instead of following the written policy, she did nothing.

Sorry folks. I may be a nurse, I do not work in long term settings. But I am a human being. I will report anything I see out of sorts based on that. Based on my being a nurse, I guess I have an educated eye. Anyone who slides on their duties should be ashamed..

And reported to the end.... sorry, hit send before I meant to....

I have reported a few things I have seen, if I have seen them first hand. That is actually the trick...I work in assisted living where people live behind closed doors in their own apartments, and I have to go on what a CNA tells me, then I have to investigate (which can take a while since I am part time, but I have the heads up for other nurses to help me...they for some reason don't tend to report things as much as I would).

I remind my CNA's that in my state...all certified or licensed medical personal are mandatory reporters! That if they see something they don't have to wait for a nurse to actually see what they are worried about...that they can report it immediately to the appropriate authorities. BUT...which agency to report it too is something that must become more clear and posted in our facility (another project of mine getting flack! The admin wants it reported to them and they will report it to the proper authorities...which sometimes..not all...winds up going no where).

However, I am pretty agressive on reporting things...and the admin knows it! I give them a timeline to investigate (dependant on circumstance) before I will report it and I MUST see what they did or their conclusions or I will consider it not investigated. They know I am very conscious of mandatory reporting and I will do it!

The times, thank goodness only two, where it was an immediate report...we got the police involved straight away..both nursing staff and admin! It is the hearsay items that get a bit more tricky...

The incident I told on here about the women and their personal vibration devices..that happened before I worked there, so I have an eagle eye on the woman that have these and if one turns up 'missing' or is taken...report city!!!!!!! (and the CNA's are 100% behind me!!!!!!).

all peole should report abuse to proper authorities...but if you are in a situation such as a family member or cna, nurse or any one who would be cosidered a 'person of trust' then you can be held accontable for your failure to report

this means that you can be brought to court on criminal charges and that you can be sued

mandated reporting is exactly what it means...if you feel that your immediate superiors are not going to address the issure then you may need to go ove their heads or if it is serious enough you can report to state inspectors or oomudsman

ask for a code word when you report so you can later be identified as the reporter..if you do this completely anonaymous you might get caught up in the net if state takes action

I find it is really helpful to document document document and put WHO you told it to!!!!!!!! Be it anyone or any situation! It is not only CYA, but helps the patient! And have the heart to follow up...doesn't matter your title, do it! (and document document document or did I say that already!).

SOAP is awesome at covering this type of charting...subjective "I did not witness said yelling, but the patient told me the following"...objective "I hate it when he yells at me, I feel like I want to die and be done with this"...action "told my administration and informed her PCP about the situation by phone at 1330...Plan, "will follow PCP orders to have a geri psych eval done tomorrow to investigate the depression scale and family dynamics unless said patient is persived to be a threat to self and others, then I will call 9-11 for immediate help".

:) Very helpful!

I have no problem reporting any incident that is abusive, neglectful, illegal, inhumane, dangerous or potentionally dangerous and so on. As nurses ,we are the patients advocate and mandated to report any abuse. As a human being, I believe that we should report the same.

What I have a problem with is when a coworker tells you about such an incident and you ask what happened and they tell you that they didn't do anything about it. Now what? This has happened to me several times and thankfully nobody was seriousely hurt, but.............I just didn't feel right. One time, I told our supervisor about an incident with one of our pts and a cna............what was I told?? :angryfire Did I see this for myself? No, I did not, but so and so told me. Ended up with the person who told me this being mad at me and with the sup doing nothing. I did tell my coworker that if they didn't report the incident that I was going to, so therefore, I could care less that she got mad at me. Other than making it a somewhat hostile atmosphere for a while, she got over it. She actually ended up leaving the facility for another job.

Another coworker told me that I shouldn't of gotten involved with that situation but I feel that if somebody knows of abuse/neglect etc...and does nothing then they are just as guilty as the person who commited the abuse. What do others think about this? Have you ever been in such a situation and if so, how did you handle it??

JUDE :Melody: