My Mother (an LPN) is in need of advice!

[Klaive]

Hi, everyone. I'm new here but I have a serious concern. Or rather, my family does.

My mother has been an LPN for 33 years and has never had a single blemish on her record or a complaint regarding her conduct. She's always worked hard to provide the best patient care she could.

Several months ago, she found herself swamped by workloads that were simply too much for a single nurse to complete in a single shift and they had cut everyone's overtime to ensure that no one stayed over unless it was at their own expense. She worked nights and there was always a lot of work to do. They rotated her halls randomly though, so there was no chance of her setting things up to make it easier on her the following night.

In order to make things easier for her, she made what she called "Cheat Sheets" for her patients. It was a nursing chart with their names and unchanging conditions pre-recorded. She would make copies of these, check the patients each night, fill in any changing conditions and sign the page. She'd also write a summary of the check on the back, as was standard procedure. In the event that an unchanging condition did change, she'd simply shred the documents and make new ones excluding that condition. Her signature was always in fresh ink, as were the summaries and changing conditions.

She kept these "cheat sheets" in her locker at work. This came to light and she was fired and her actions were reported to the board of nursing.

Her hearing was the other day and they gave her three choices: 1) Have a full formal hearing which may be better or worse for her, 2) Plead the Mercy of the Court (they never elaborated upon what this means) and 3) Sign a paper accepting an official reprimand for Nevada Revised Statues 632.320 (7) unprofessional conduct, and Nevada Administrative Code 632.890 (20) inaccurate recording, falsifying records and (27) failing to perform nursing functions in a manner consistent with established or customary standards.

The problem is with (20). She never falsified anything, nor did she inaccurately record anything. The case-manager insisted that her actions constitute this... but I don't see how. We're moving across the country in a year or so and she'll be looking for a job again. We don't want her record reflecting that she did something neglectful or malicious when she was, in fact, simply trying to save time to get all of her work done.

She hasn't signed the papers yet, as we're still weighing our options. I was hoping that perhaps some of you would have some insight that you could offer.

Thank you.

[sirI, MSN, APRN, NP]

she'd simply shred the documents

Unfortunately, if these "cheat sheets" were part of the medical record (and, it sounds as if they were since you pointed out about her signature), shredding documents falls under "falsifying documents and/or spoliation of the medical record". Both are considered against the Nurse Practice Act and have been singled out in Courts of Law during litigation.

[catshowlady]

Sounds like your best course of action would be to lawyer up.

:paw:

[lerabelle]

Sounds like to me she was pre-charting before seeing the patient, even though she thought the "condition" would be the same. It is illegal to pre-chart before doing an assessment on a patient. It would be ok if it were just her own "notes" on her clipboard or something, but not on the medical records that went on the chart.

[classicdame, MSN, EdD]

the reason it is not appropriate to make those type of cheat sheets is the nurse will then be tempted to not evaluate for any changes in condition and the patient could have serious outcomes. Also, if someone found that info there is always HIPAA violations to consider. I am sorry she is having this trouble.

[Klaive]

She never actually shredded any documents though. She stated that had any condition changed to render them inaccurate she would have shredded them, but over the course of the two weeks she had been doing it, none of the conditions changed in such a way.

She understands that what she did was a violation, however, as she never *actually* shredded any documents and no one happened to have their condition change... would it still count as falsifying?

Regarding the lawyer, unfortunately, we barely have enough money to make rent. Before she was fired, we had just purchased a new car and it consumed our savings in the time between her finding a new job.

[lerabelle]

Condition change or not, you must chart on a patient every shift.

[SuesquatchRN, BSN, RN]

Condition change or not, you must chart on a patient every shift.

Not in LTC.

Call Legal Aid.

[Ruthiegal]

I don't think I quite understand why she is in trouble if these were HER sheets to chart from? If she was making them part of the record, she would essentially be violating HIPAA if she kept PMI in her locker I suppose (of course if they were locked up...). So I remain confused about what she supposedly did wrong here. I would contact legal aid, they can help with a lawyer and advice, and it won't cost arms and legs.

[geekgolightly, BSN, RN]

Unfortunately, if these "cheat sheets" were part of the medical record (and, it sounds as if they were since you pointed out about her signature), shredding documents falls under "falsifying documents and/or spoliation of the medical record". Both are considered against the Nurse Practice Act and have been singled out in Courts of Law during litigation.

I think what she means is that basic information about the patient was on the top, and she filled in current physical assessment daily, and then signed the document.

[geekgolightly, BSN, RN]

I don't think I quite understand why she is in trouble if these were HER sheets to chart from? If she was making them part of the record, she would essentially be violating HIPAA if she kept PMI in her locker I suppose (of course if they were locked up...). So I remain confused about what she supposedly did wrong here. I would contact legal aid, they can help with a lawyer and advice, and it won't cost arms and legs.

This is what I was thinkin, too, but I might be misunderstanding. Please call legal aid and see if they can assist you in discovering if her actions were against the law.

[Klaive]

This is what I was thinkin, too, but I might be misunderstanding. Please call legal aid and see if they can assist you in discovering if her actions were against the law.

This may be just what we need! How can I get in contact with "legal aid?" Is it a state specific thing or is there a central number we can call?