As I was reporting off the the next nurse at 10 pm the cna's told me they needed me in a room asap. An air mattress had somehow become unplugged and had deflated and the resident had fallen down under the mattress and it was over her head. When they found her she was cyanotic and I had my doubts if she would pull through. We put her on O2 and she pulled through ok. when I left she was back to baseline.
Here is my problem.
I was called into the DON's office a couple of days later and counseled and they really came down on me for making a nurses note about the situation. The DON said that I should've called her at home and asked her if she wanted that documented or not. The counseling is for not calling her. She said that it looks really bad and that a "seasoned nurse would've known not to write something like that".
I don't understand how you can not document something so serious. Since then they are on my case really bad for a lot of stupid things and the company just offered a raise for all nurses and they upped the shift differential for afternoon shift. She called my into her office on monday and said that she is with-holding both raises from me because of this counseling.
Ditto. And bravo for contacting the doc and the family. You are too good to be mixed up with that place. One day, it will be your license in jepordy if it isn't already. Not because of what you do or don't do, but because of your employer.
I believe that it's not only in the resident's best interest, but in your best interest as well to report the DON's criminal behavior.
missykalo - If you don't mind me asking, in what state did this incident take place?
I would shudder to think what other very shady things have been done by this DON, and if it was my relation in that facility I would be counting on someone with ethics and morals to notify the appropriate authorities.
I think it is absolutely disgusting, that a RN in a position of responsibility and trust is abusing it as she is. She should not be allowed to practice, and someone needs to be looking into the whole organisation because I feel that she wouldn't be able to get away with it without others aiding and abetting.
Then she won't give you a raise because you are doing your job to the level expected by the State Board and the public :angryfire . If it was me I would be handing in my notice and blowing the whistle as a farewell gesture. There has to be a job out there that will appreciate someone with your obvious good ethics and nursing ability!!!!
They called me into the office and handed me the chart and said "now you will make an addition to your note and you will write what we tell you to write"
What a horrific situation but sadly, not too surprising to me. What did they tell you write? What was your response? I had kind of a similar situation when I worked my last LTC job(I ran from there after 6 mos). I was treatment nurse 32 hr/wk until census dropped and they figured they'd drop my hours to 10/wk and put me on as charge nurse some other days. Well, before doing the charge nurse duties, I'd come back after a few days off and find this one tx that was supposed to be a b.i.d. to an amputee(NASTY wound) not done. How did I come to that conclusion? My initials and date and time were still on the bandage!!! But the TAR was signed as having been done by other nurses!
I took the DON into the room and showed her the bandage with my initials and date and time from several days earlier. We then walked out to the hall and she said" Well that's not good. But from now on, don't date and initial your tx bandages. Signing the TAR is sufficient evidence that the tx has been done. Signing the bandage isn't necessary." :angryfire (State survey was due any day in this case). I said "ok"(to avoid a lecture and return to getting my work done) but I continued to do AS I WAS TAUGHT--and that is to date, time(if more than once a day), and initial the tx. This was the same DON who got on my case for "using poor judgement" when I called the MD on this amputee to 1)clarify a former order for a foley cath(needed the size),2) to relate that the pt really wanted a foley due to skin breakdown on his coccyx and the fact that he had an edematous scotum and could not manage to get his member into a urinal without voiding all over himself. The DON said to me:" Don't you realize we are trying to get rid of the foleys in this building? Doctors will give you almost anything you ask for! We need to be doing bladder training on these pts!" (I felt I was being a pt advocate!!!!--does anyone disagree with this?) Well, I got away from your situation--just wanted to confirm that there are indeed other shady DONs out there. Keep us posted on what's happening!
Oh how many times I have heard this very thing. I have even been asked by a DON in a LTC facility to go back and rechart so that another nurse could "correct" something she (the DON) did not want charted in regards to fear over 'state' being due anytime. :angryfire Now this I thought was unethical too. There were 3 of us who were told that we must rechart. I have also been told by the DON to keep a resident in her room and not let her out on night shift because that resident was slipping into another resident of the opposite sex room to have sexual interactions. But the male resident was allowed to come out of his room. Imagine a DON telling you to falsely imprison someone, which is what she was asking of me. Did I keep her in her room? NO way! I monitored her closely and gave her towels to fold to occupy her. Did I report this? Heck yeah I did and I moved on fast. I think it's much more common that we may think especially in LTC.
In reply to your situation I have a few strong thoughts:
1. If you hadn't documented what you did not only could you have lost your license, you might have been party to a criminal act.
2. Are you sure her death a week or so later was not related? Hypoxia is not a good thing for ANY disease condition.
3. Besides, I wouldn't put anything including murder past people who would encourage you not to document something like what you experienced. Not that a corporation would kill someone to help ensure their profits were endangered (please). Just curious was there an autopsy?
4. If you don't resign they may "set you up" in a situation that makes you look bad and then terminate you.
I admit that I am probably being too cynical. However, people with the attitude that you describe in the person of your DON are but a step away from being sociopaths. I would submit that they are capable of more than you ( and most) good people would dare imagine.
Specializes in Gerontological Nursing, Acute Rehab.
Just agreeing with what everyone else said here.....quit and report everything that happened to the state. You did the right thing by filling out an IR and writing a nurses note....the only other thing I would have done is called the DON or manager on call just to cover your butt (there are certain things they must do and report when a sentinel event like this happened...but I'm sure they didn't do any of it).
While I work in an excellent facility now, LTC is notorious for being paranoid over documentation.....how to word things, etc etc. But I was never told to redocument or not document.....that's going too far.
As for what another poster asked about DON and bonuses.....you bet they get bonuses.....my last job the DON got a monthly bonus if she didn't use any agency........work us short every day.....just as long as you get that bonus!!!!
Most of the LTC facilities I have worked in are the same way as the OP describes.
Their main preoccupation is heading off a lawsuit.
IMO, the situation definitely called for an Incident Report; which would mean calling the DON anyway.
They instructed us to make incident reports but just to chart what happened in the nurses' notes - not mentioning that an Incident Report had been filed.
I would start looking for another job, pronto.
This sort of thing is what I don't like about LTC.
Don't be so sure that the state might not look into her death. Sometimes during survey they want to look at deaths within the last few months and discharges.
As far as the bed issue. We have an old building too..the plugs come loose and the beds defalte also defeating the purpose of the bed. I've never thought that they could pose an aspiration or entrapment risk before...something I will look into. As far as CYA...could you fill out a maintanance form for them to check the plugs??
But the TAR was signed as having been done by other nurses!
mscsrjhm
646 Posts
Don't just quit... RUN.
When someone tells you what (and what not) to chart... you know you got big problems.
Nursing homes like this are shut down one day, and opened the next with same owners, new name and new management.
(I have heard rumors that DONs receive bonus' after decent surveys... can anyone confirm or refute this?)
So sorry this is happening to you.