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.
Specializes in Geriatrics/Oncology/Psych/College Health.
I'm flabbergasted. I would love to hear an update from the OP since it's been a couple of weeks. I certainly hope she has left this facility and reported this incident to the state.
Just think about an elderly loved one and ask yourself if you would feel ok with that person living in this facility knowing this sort of thing is "policy." Let your answer dictate your actions.
Specializes in Education, Acute, Med/Surg, Tele, etc.
I just attended a seminar about lawsuits with family members and LTC's and how there is a alarming trend of lawyers asking family members to actually wait their cases out for a few years so that nurses can't remember the specifics. They look at the charting and hold off if certain information isn't charted, like charting on the specific event, then hang the nurse involved for inadequate documentation (and since the nurse can't remember because it was a few years ago...ouch!!!)! Scary thing is, in my state, they can wait up to 7 years!!! I know I wouldn't remember things from a patient 7 years ago!
I document everything, because if anything goes wrong, it is me that has to defend myself. So if I document well, then I stand a better chance...and technically so does my employer!
We just had a case where a client was way out of line with one of our caregivers and yelled at her, calling her very inappropriate names. I had her document, and I followed up. One of the fellow nurses chewed her out for that, and I had to fight with her saying that his outburst is diagnostic for a change in mental status...and prompted me to do a CBG which was 389 and once his insulin was given he was back to his self again. That I used that information to fax his physician to show a difference from the norm for him, and it was what we are supose to do. She argued with me and said..."you should only chart the positive, not the negative or you will label your patient" and I repled with the arguement "if that is the case, then you just make everything you put into the chart bias from the start!! How will that help anyone???". I sat with the caregiver and we went though exactly what to say so that it was totally objective and using quotes...nothing subjective in either of our notations...there was absolutely nothing wrong with this! I couldn't believe she had a probelm with it, and wonder how much of her charting is her oppinon or missing entirely!!! (and my boss agreed! :) ).
It boils down to the old addage of nursing...if you didn't chart it..it never happened! And too bad that holds up in court in the lawyers side, and not yours!
As far as the threats and harassment, I agree with the majority and call your State Board of Nursing...they can help protect you and your rights, and help to stop this practice of just charting what looks good if they are to get an audit!
I agree. The state needs to be notified. From the sounds of the DON there are probably other things just waiting to be found out. I think I would look elsewhere for a job. Besides the fact it is not going to be a very pleasant place to work now, your DON obviously doesn't care if she puts your license in jeopardy and it may be a good idea to get out before the state makes its visit.
Report her and get out quick you cannot save every one. You have to be proactive and save your license. Do not be an awful lesson. Be a good example. You will have done your duty just by reporting them it sucks and is not fair but you need to find another job fast.
OMG! Talk about unethical! Where on gods green earth do they find these employees! Especially someone who's *supposed* to be a DON!!
You did exactly the right thing! Sounds like that DON needs to find employment elsewhere, and perhaps leave the medical field altogether. (For the sake & safetly of ANY patient. Imagine, that poor old lady could easily have been our grandmother.
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.
Specializes in LTC,Telemetry,Med/Surg,Psych, Alzheimers.
when i worked as a cna if anything ever happened to patient or staff we always made copies of notes and incident reports. like you said we did have one wacko of a don who tried that stuff luckily she wasn't there for long. try having your mother in alzheimers ward when she doesnt have alzheimers or any form of dementia. she just put her in there because she didn't want to fill out paperwork that day. patient wanted to make a phone call so i took her out. i was told not to take her out and did anyways. her daughter came up there and was enraged at don for not putting mother in the room she was supposed to be in. grant it she did need some assistance but there was no drs order to have her in unit. i did get in trouble but i did notify state of the situation and she had to throw out my write up. other than that i worked with a wonderful staff. nurses and cna's were wonderful to work with.
when i worked as a cna if anything ever happened to patient or staff we always made copies of notes and incident reports. like you said we did have one wacko of a don who tried that stuff luckily she wasn't there for long. try having your mother in alzheimers ward when she doesnt have alzheimers or any form of dementia. she just put her in there because she didn't want to fill out paperwork that day. patient wanted to make a phone call so i took her out. i was told not to take her out and did anyways. her daughter came up there and was enraged at don for not putting mother in the room she was supposed to be in. grant it she did need some assistance but there was no drs order to have her in unit. i did get in trouble but i did notify state of the situation and she had to throw out my write up. other than that i worked with a wonderful staff. nurses and cna's were wonderful to work with.
well, omg!!! i worked in ltc for 3 years and i am like you i would have documented everything! doesn't the nurse manager realize that state does look at a few closed charts? well, at least they do in ky! you should contact state, file a grievance and leave!!!!! i guess the don was going by the old saying "if you don't chart it, it didn't happen!" so unethical on her part!!!!
You poor dear: I was a nurse manager in a LTC facility for 12 years & there are a couple things you should be very careful about.
1st print off the string of these conversations to keep for your own records do not tell the state or the administration that you have them
2nd call the state asap, try to keep it general & annonymous but dont kid yourself they will figure out that you called.
3rd keep a journal, is your don on call all the time & really that accessible
4th the administrator is probably completely in line with the don, who is by the way a criminal & should loose her license
5th be very, very, careful they are likely plotting how they can write you up & fire you as we speak. They may even try to go after your license
6th You are in for the fight of your life. The national average for a don to stay in any one facility is 18 months how long has she been there?
7th You are right! Keep your charting about the facts do not imply anything & you will be alright.
I had a bad experience with a don that was crazy & had me write up some couseling for an employee that lost her job, when infact the nurse should have lost his job, but the nurse was a friend of the don & i was forced to do something i did not believe in. Long story short, the don left the woman filed a suit & the human resource director "lost" her employee file. the company was so afraid i would tell what i knew they made things very difficult for me so i left almost a year later when i figured out you can not work for decietful, lying managers who have no ones best interest at heart. It was the hardest decision I ever had to make but now 4 years later i am happy working in acute care & have managers who really care. It does not mean you are never reprimanded but atleast i feel it is honest & fair when i am talked to now.
after this incident I found out that the outlets in the building are very old and loose. According to the cna's this happens "all the time" and they just plug the things back in. An incident report was filled out and the md and family was notified.
The main reason she was so mad was because state was due to arrive any day. The woman ended up dying about a week later ( from totally unrelated problems - she has been bad for a long time ) and my nurse manager actually told me when she died "well, now at least we don't have to worry about state reading her chart" with a great big smile on her face.
I was so angry!!!! :angryfire The chart was filed away before the state arrived. This all happened about 6 weeks ago. The whole raise meeting was on monday. I just can't forget about this! It goes against all of my morals! 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"
This DON has no morals whatsoever!:angryfire
Any similar experiences out there, especially as far as documentation is concerned?
Being told to chart what someone else wants you to is not legal. Quit, report her to the State Board of Nursing, and the facility to the State. Back out of the facility slowly, quietly, and proudly displaying your middle finger during your escape.
Nurse Ratched, RN
2,149 Posts
I'm flabbergasted. I would love to hear an update from the OP since it's been a couple of weeks. I certainly hope she has left this facility and reported this incident to the state.
Just think about an elderly loved one and ask yourself if you would feel ok with that person living in this facility knowing this sort of thing is "policy." Let your answer dictate your actions.