Potential neglect?

[Mayday83]

Hi everyone. I joined because I'm not sure where to turn at this point, and im hoping for some guidance.

I work at a SNF as a charge nurse on a dementia unit. There is a CNA here who is the worst of the worst you can imagine (lazy, sleeps during her shift, hides in the bathroom for nearly an hour at least once or twice a shift, is rude to the patients, disappears off the unit repeatedly, you get the picture). There have been numerous complaints by alert and oriented patients about how rough she is. There have also been complaints made and statements written by staff who saw her "yell" at an incontinent resident and refuse to clean her. Again, nothing ever seems to happen. Staff members alike do not like her. There have been more incidents than I can count, but I don't know how or even if they all were documented with management.

i was working the other day and heard a patient yelling for help. I came into the room to find he patient, who is on chair and bed alarms and one of our biggest fall risks, on the floor of her bathroom, sink running water (what our aides do to allow the water to warm up), and clean towels and brief on the sink. Clearly, someone had been preparing to do care, and she had clearly been on the toilet as evidenced by urine and TP in the toilet. I found this aide in the next room, with that door closed, giving care to another patient. I asked if she left this patient on the toilet. She said "yeah she said she wasn't done." I gathered myself and told her professionally, "ok, you NEVER leave alarmed residents alone on a toilet." Over the next hour or two, I started to gather my statements for the incident report and asked this CNA for her statement. She ignored me completely and refused. I got the supervisor, who she also ignored completely and refused to write a statement for. The next day, evidently she claimed she "heard another alarm" and left this patient on the toilet to go answer this other supposed alarm. She never told me this, and if that was the case and it was an honest mistake, why would you leave the alarmed resident on the toilet, go in another room and close the door, then refuse to write a statement?

Long story short - I am obviously really upset. This problem with this aide has been getting worse and worse, and I am worried for my patients safety. I can't say for sure that it is neglect, because I don't know the intent? Apparently corporate was involved with the decision not to terminate her, and I can't undwrstand why she still has a job.

I dont know if I should try and complain to corporate, or call the DOH and make a complaint? I'm so upset I can hardly work. I have to work with her again tonight and tomorrow and am dreading it. She knows she can do anything she wants and nothing ever seems to happen to her.

[canoehead, BSN, RN]

Write up your incident report, send it in, and be prepared for it to go nowhere. Keep a copy for yourself. Do the same thing every time you have an issue with her. If you have a good relationship with your boss, you could ask their advice on how to handle that CNA, and you might get some hints on whether they are covering for her, or waiting to amass a paper trail.

Keep in your own mind that you can't control other people, just yourself. If you try to force the issue, you will likely become a target. It's wise to do some reflection and decide if you can live with things the way they are, or you need to transfer elsewhere. You could report to the state, but without the facility backing you up, you'll look like a fool, so I wouldn't.

[Here.I.Stand, BSN, RN]

She sleeps on the job, goes AWOL, is verbally abusive/neglectful (yelling at the incontinent res and refusing to help her).......

Your residents are vulnerable adults, and you are a mandated reporter.

In addition to being the right thing to do, consider this: if she is as bad as you say, it's only a matter of time before a family reports her. When that happens, do you want to be among the ranks of the staff who allowed her access to these vulnerable adults? Or do you want to be the one who actually stepped up in defense of the residents?