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.
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.
Gotta agree. I was once called by agency to return to a LTC facility and chart an incident report. Injury to resident's hand 2 days prior to my shift!!
(some "nurse" had heated washcloth in microwave--while it was in a plastic bag!!-- and placed on resident's hand--bingo... 2nd degree burns with blisters!!)
I had seen the injury, charted what the patient said, called Doc for orders, etc.
Apparently, the resident's family called state, so the facility tried to place blame on me.
They wanted me to "rechart" what they told me to on a clean nurses notes.
I said NO.
Then they said I should have written an incident report, so I agreed to fill one out. Lots of quoting the resident, "2 days ago", "I told the other nurse", "I have been telling them for 2 days" etc...
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!!!!
How big are those bonuses?? anyone have any idea??
(Not that I am interested...I try to stay away from the "dark side")
Facilities like this exist in every state. This place should be investigated by the State you are in, and not be allowed to take in any more residents until things are fixed. However, not ALL facilities are like this. I work at a facility that has never told me how or what to chart, except to "be thorough and always document your interventions". It's true, LTC is notorious for unethical treatment of staff and residents. But, there are those of us that try to always do the right thing, no matter wher we work. Don't get me started on some of the unethical, illegal things I've seen on a Med/Surg floor :angryfire
Do some more documentation in the the form of a diary. You will need this.
The DON is an RN what she has done violates every nurse practice act in the country. By law you are required to report her to the BON.
Next you will report to the state regulating body that oversees LTC facilities.
Since you likely have no witness you will have to carefully keep the journal I mentioned as this will be your evidence. Remember the old thing about using exact quotes, times, dates locations etc.
You might go to the labor board or to your local unemployment office and ask about wistleblower protection in your state and how it applies to you.
Specializes in LTC,Hospice/palliative care,acute care.
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.
what would you have done in the situation?
You did exactly what you should have done-did you also fill out an incident report? In my facility we do a 2 page incident investigation report -one whole page is for documenting the steps you will take to try to prevent the same type os thing from happening again...Our maintenance department would have replaced that outlet the next business day and started replacing any others that were also loose....Yesterday I had a resident sustain an injury while being transferred via the hoyer lift-within an hour I had the metal bars padded with pipe insulation and a new larger lift seat (thanks to the co-operation of 2 departments) I also updated the care-plan......and the supervisor THANKED me for acting promptly....You need to update your resume because they will look for any reason now to get rid of you.....I would make an anonymous call (LTC is notorius for getting whistle blowers blacklisted) to the dept of health right away.They have to follow up within 24 or 48 hours....good luck-I will be checking the outlets on my unit tomorrow..if I find any loose I will report it and I am betting they will be fixed by 3pm...I like me job..... :)
Specializes in jack of all trades, master of none.
Oh Heck NO!!!!! I hope to God you didn't chart what they told you to. I hope you reported the facility & that DON. Her actions were completely inappropriate.
Shaking my head...... unreal!
Get out while the getting is good & don't look back.......
Since you likely have no witness you will have to carefully keep the journal I mentioned as this will be your evidence. Remember the old thing about using exact quotes, times, dates locations etc.
No witness = NO CASE
Even if there were witnesses, more than likely they would stay with their employer's side.
If she carries this to the BON.....well let's say she'd better have a rich husband or another job to go to, because no one will ever hire her again.
OMG! That facility sounds like a veritable Cuckoo's Nest! By demanding that you make an addition to the chart and "write what they tell you to write", they are essentially having you falsify patient records, which is a flagrant violation of the Nurse Practice Act in ANY state. You can be held accountable if you do not bring this to the attention of the proper authorities. Please, take the advice of the posters here who are encouraging you to report this. Many states have laws to protect "whistleblowers". If you do nothing, and this incident ends up being investigated, you will go down with the rest of them. Don't let that happen to you. You sound like a truly conscientious nurse. Stick to your convictions and you will be a truly GREAT nurse!
[QUOTE=SunStreak]Since you likely have no witness you will have to carefully keep the journal I mentioned as this will be your evidence. Remember the old thing about using exact quotes, times, dates locations etc.
No witness = NO CASE
Even if there were witnesses, more than likely they would stay with their employer's side.
If she carries this to the BON.....well let's say she'd better have a rich husband or another job to go to, because no one will ever hire her again.
I totally agree with SunStreak. If there are witnesses, make sure that they document, sign, and date. This way they HAVE to back up their documentation later. Keep this documentation!! (Most people will do this while immediately after an incident, while they are emotional, later, they tend to back off later.)
your duty is to the patients in that ffacility...don't just quit [DO QUIT] follow advise of other posters and report all facts to management and to the state board...etc anyone with the authority to prevent a reoccurance..i hope that your next job is better
mscsrjhm
646 Posts
posting wrong, sorry