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Nurses Charged in Deaths of 12 Nursing Home Residents

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J.Adderton has 26 years experience as a BSN, MSN .

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What happened after hurricane Irma at the Rehabilitation Center at Hollywood Hills?

Three nurses have been charged with manslaughter and tampering with evidence in the deaths of 12 nursing home residents. The charges come after a 2 year criminal investigation and more arrests are expected. You are reading page 7 of Nurses Charged in Deaths of 12 Nursing Home Residents. If you want to start from the beginning Go to First Page.

KalipsoRed21 is a BSN and specializes in Currently: Home Health.

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More than 100 years ago, state and territorial governments established BONs to protect the public's health and welfare by overseeing and ensuring the safe practice of nursing. BONs achieve this mission by outlining the standards for safe nursing care and issuing licenses to practice nursing. Once a license is issued, the board's job continues by monitoring licensees' compliance to jurisdictional laws and taking action against the licenses of those nurses who have exhibited unsafe nursing practice.

Nurse to patient ratios sounds like part of “outlining the standards for safe nursing care” to me.

No not all errors are related to ratios. My point is there isn’t a good way to judge the error as a decisive act of the nurse (impaired judgement, unsafe, un ethical) when the ratios are not already in place. If you are going to work and it feels like Russian roulette as opposed to organized chaos, well then how can ANY error be appropriately analyzed if the situation was unsafe to start? And from judgements I’ve read the BON often judges in a manner that goes something like this, “It is the nurse’s duty to protect the patient and s/he should have recognized the unsafe situation and wrote it down on a piece of paper so we could tell that they knew it was dangerous and so that we know they said something to their manager. “ Giant eye roll here. 

It’s like signing up for karate tournament in one on one combat and then suddenly 5 opponents are in front of you. You say something about it and are told that this is what you signed up for by the coaches and then the judges (BON) tell you that you have poor execution of your skills because otherwise you would have beaten all your opponents when you were suppose to only have one.

 

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vintagemother specializes in Med-Surg, Psych, Geri, LTC,.

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On 8/30/2019 at 11:04 AM, The0Walrus said:

I know California has that mandated ratio for each nurse. They should do that for all states. Nurses are really held on so much responsibility sometimes too much than what they should.

The ratios don’t really have a meaningful impact in nursing homes - SNF or ALF. I’m in CA, have worked in these settings. The ratios allow for 1 nurse to up to 35/54 people. 

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Snatchedwig has 11 years experience as a ADN, CNA, LPN, RN and specializes in Medsurg.

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2 minutes ago, vintagemother said:

The ratios don’t really have a meaningful impact in nursing homes - SNF or ALF. I’m in CA, have worked in these settings. The ratios allow for 1 nurse to up to 35/54 people. 

54???????????????????????????? That's the most ridiculous thing I ever heard..any nurse that accepts that assignment needs a hug.

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vintagemother specializes in Med-Surg, Psych, Geri, LTC,.

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Just now, Snatchedwig said:

54???????????????????????????? That's the most ridiculous thing I ever heard..any nurse that accepts that assignment needs a hug.

I accept your hug. I worked in an ALF in CA with 54 residents in a locked dementia unit. The other side had 100 residents : 1 nurse. 

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Snatchedwig has 11 years experience as a ADN, CNA, LPN, RN and specializes in Medsurg.

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3 minutes ago, vintagemother said:

I accept your hug. I worked in an ALF in CA with 54 residents in a locked dementia unit. The other side had 100 residents : 1 nurse. 

Sweetheart I sincerely hope you don't accept those type of positions anymore. Your license........

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vintagemother specializes in Med-Surg, Psych, Geri, LTC,.

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Just now, Snatchedwig said:

Sweetheart I sincerely hope you don't accept those type of positions anymore. Your license........

I was an LVN then. I’m now an RN and work in a hospital...therefore the CA ratios law applies and I only have 5 pts max.

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Snatchedwig has 11 years experience as a ADN, CNA, LPN, RN and specializes in Medsurg.

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11 minutes ago, vintagemother said:

I was an LVN then. I’m now an RN and work in a hospital...therefore the CA ratios law applies and I only have 5 pts max.

If you worked in the same facility as a RN what will be the pay rate vs when you were a LPN. I would hope you were compensated a lot for all that liability

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vintagemother specializes in Med-Surg, Psych, Geri, LTC,.

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4 minutes ago, Snatchedwig said:

If you worked in the same facility as a RN what will be the pay rate vs when you were a LPN. I would hope you were compensated a lot for all that liability

Not same facility. As I said as an LVN I worked LTC settings. Now work Acute as an RN- pay is double to triple. Sad state of affairs, ALF/SNF Nurses make less with way more patients than in acute care.

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Asystole RN is a BSN, RN and specializes in Vascular Access, Infusion Therapy.

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20 hours ago, KalipsoRed21 said:

More than 100 years ago, state and territorial governments established BONs to protect the public's health and welfare by overseeing and ensuring the safe practice of nursing. BONs achieve this mission by outlining the standards for safe nursing care and issuing licenses to practice nursing. Once a license is issued, the board's job continues by monitoring licensees' compliance to jurisdictional laws and taking action against the licenses of those nurses who have exhibited unsafe nursing practice.

Nurse to patient ratios sounds like part of “outlining the standards for safe nursing care” to me.

No not all errors are related to ratios. My point is there isn’t a good way to judge the error as a decisive act of the nurse (impaired judgement, unsafe, un ethical) when the ratios are not already in place. If you are going to work and it feels like Russian roulette as opposed to organized chaos, well then how can ANY error be appropriately analyzed if the situation was unsafe to start? And from judgements I’ve read the BON often judges in a manner that goes something like this, “It is the nurse’s duty to protect the patient and s/he should have recognized the unsafe situation and wrote it down on a piece of paper so we could tell that they knew it was dangerous and so that we know they said something to their manager. “ Giant eye roll here. 

It’s like signing up for karate tournament in one on one combat and then suddenly 5 opponents are in front of you. You say something about it and are told that this is what you signed up for by the coaches and then the judges (BON) tell you that you have poor execution of your skills because otherwise you would have beaten all your opponents when you were suppose to only have one.

 

I understand your position but where your idea falls a part is that BONs control nurses and nurses are not the ones in control of staffing. 

Your local Department of Health and/or (actually even better), your local Medicaid program or CMS needs to step in and reimburse based upon the nursing ratio. 

Nurses are considered a part of the bed fee, the base DRG rate. Facilities are literally incentivized to control labor costs and that is primarily done by controlling nurse to patient ratios. 

If CMS included a nurse ratio accelerator or rate augmentation in their DRG reimbursement we would likely see much better staffing. 

Everyone complains that hospitals are looking for profit, yes well the government is the one who is providing the incentives to the hospital to reduce nursing headcount. The government is the real devil in this issue.

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Walti is a LPN, LVN, RN, EMT-I and specializes in ICU/ER mostley ER 25 years.

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I can't really say much about the situation but I do have to wonder about the ancillary staff. I worked very briefly as a LVN for a SNF in Southern California. Charge nurse trying to pass meds on 80 patients many of whom were demented. Four CNA's to do vital signs, pass trays do basic bedside care. On my first day I called the director and asked if I could fire people. A stooled patient needed cleaning and I asked his CNA to handle it. She looked at me and said "no". Then she explained that if she did it now he would stool himself again in a couple of hours and she would just have to do it again. It just made sense to her to wait until the end of the shift. I called the director and was told to send her home as off of the schedule until further notice, technically not fired.

Other concerns were finding patients with unstable vital signs that the CNA didn't report to me. Mr. Jones has a fever of 102, Mrs. Smith has a pulse of 140 but it didn't occur to them to tell me.

My heart goes out to SNF nurses, it is a very hard job and makes me really want to die at home in my own bed!

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Walti is a LPN, LVN, RN, EMT-I and specializes in ICU/ER mostley ER 25 years.

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Just remembered having to contact a facility from the ER I was working in. I was transferred to the charge nurse. When I said who I was I got back a Hi Waltie, it's Terry! Can you believe it. I'm the charge nurse! Terry was a work friend who had worked with me as a tech in the ER with CNA training. She had been going for her RN and has just passed her boards the week prior. Oh well, she was a very good ER tech.

Not related the to the above but have had more than a few seizing elders come in to the ER and when we checked the Phenytoin level, it was zero. Yet checking the MAR sent with the patient it was consistently charted by multiple nurses as having been administered.

After I retired I was contacted by the board to see if I would be interested n going to work as a "patient" in SNFs to check on the quality of the care being delivered to the patients. I declined. So maybe a caveat to the staff of some of those facilities. That cranky old codger might just be working for the BRN. Be nice to him.

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MrNurse(x2) has 28 years experience as a ADN and specializes in IMC, school nursing.

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This whole article reads as a biopic on why nursing homes have strict state oversight. From the never operational generator to the lack of administrative oversight, this seems like a small, mom and pop run facility that has been passed off by regulators because they serve a niche and run on a shoestring budget. The lack of mention regarding owners is downright scary.

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