LTC lack of reporting

[smorgan1228]

I work an a LTC facility where we just got a new DON. She had been the DON previously, but the position was taken away from her (and now we alllllll know why!) Since she took over she said that the facility, which is 2 skilled units and 1 residential, have been having too many falls, skin tears, and bruises of unknown origin... Well a resident fell the other day and the DON told a brand new RN not to report it. The nurse didn't report it or mention it to me on report or even just in passing so I would know. My CNA's told me and I was able to look out for any issues with my resident (thankfully he had no issues). The DON does stuff like this all the time, sometimes she asks us to give meds without orders or she makes up an order and wants us to sign off on it (we use the old school carbon copies to write out telephone and standing orders). Also, shes been super discriminatory to the LPN's (me and another girl). Shes been trying to shove us out the door since she took over. Apparently she thinks that when the state comes in for the survey that having LPN's are going to somehow make our survey bad.

[jadelpn, LPN, EMT-B]

What will make your survey bad is that there are medication orders that are not signed off by an MD within a time frame (if the DON is ordering meds herself as if they are phone orders) they are not too "into" verbal orders, as if the MD is "there" (or in this case, not there--YIKES) the thought process is that the MD in house can write the orders themselves.

Do you have a parent company? Is there a way to report ethical issues? Is there a parent quality assurance department?

Here's the thing--If you are taking over care of a patient with unexplained bruises and the like, and you do not document them, it can come back on you.

You know that the policy in your facility is what it is, and that you need to report what you need to report. That covers you. The DON can at any time state "why I would NEVER say that" regarding her unethical stance on reporting falls, or some such other nonesense, and it falls on you. If a fall goes unreported, and the patient suffers some sort of injury that is not discovered until well after the fact, who is to say that the care nurse (which could be you) didn't abuse this patient? Your DON is certainly keeping that option wide open. And that is wrong.

I agree there is a huge push for LPN's to get the heck outta Dodge. With that being said, if there is unethical stuff happening at the very top level of this facility, you may want to humor the DON and get your resume circulating now. We are talking about patient safety. We are talking about your practice being in question, which has no merit, and we are talking about a DON who for whatever motivates her wanting to "succeed" or get rid of LPN's or whatever posesses her to be unethical is putting patients at risk, putting your livelihood at risk, and when the chips are down, it can be all about you.

Because you know this is happening (and make sure that it is--he said that she said is not good enough) you have a duty to report this, you ethically should report this, and cover yourself always!!

[smorgan1228]

Thanks for your advice!!:) There is no parent company and from what I've heard from my co workers is that since we are a religious organization, we fall under different criteria. I do have resumes out because I am a brand new nurse (only 1 year licensed) and I have a baby I have to worry about. It just blows my mind how she's trying to run the home. Even HR listens to what she says! It's her way or the highway. It sucks because I do love my residents but I can't keep potentially being put in a situation where I could lose my license.

[Ruas61, BSN, RN]

Religious communities due not get a pass on regulations from the state or feds unless NJ is doing something the rest of the country isn't. Perhaps you should report to the OHC annousmously.

[smorgan1228]

I have been thinking about it lately...it puts me and the other nurses and even the CNA's at risk every time that she wants to turn a blind eye to things or do things we shouldn't be doing. Hopefully I get another job soon so I can leave there even though I love my residents:(

[amoLucia]

Another word of advice is that I hope you DO have your own malpractice insurance policy. This issue smacks closely to the realm of malpractice issues, and if there should come up a problem that could involve you, your DON will NOT be there supporting you. It sounds like there's some shady shenanigans going on there.

Protect yourself.

[smorgan1228]

That is one thing I will NEVER be without! My husband thought I was crazy at first but after his grandfather died at a nursing home from pure negligence he's in board...my DON would drop me like a hot potato if anything ever happened!

[SmilingBluEyes]

Sounds like the writing is on the wall. Put up with status quo or leave. I am sorry this is happening.

[smorgan1228]

I'm happy to say I interviewed and my references and jobs are being checked at another LTC place!!! :)

[Jillybean48]

Please report this woman to the State Board of Nursing, even if it's anonymous. Think of the other nurses she will be allowed to continue to do this too after you leave. Because of her negligence something very bad is bound to happen. Isn't there some statute that says we must report something like this.... it's considered negligence. What if something happens a year from now and someone brings your name into it, saying you knew this was going on and did nothing about it.... even then it could still come back and haunt you. Reporting her is not out of revenge or in any way spiteful, it's to protect patients and other staff members. This is just bad.

[kissbug26]

Please, please, please do not put yourself or your license in jeopardy to protect any other medical professional. I've been there and done that! You worked way too hard for your license. As they beat over our heads in nursing school..CYOA!!!