False Documentation

[chicaloca006]

I am a part-time LPN at a LTC facility. My nurse manager is currently on maternity leave, so the full-time LPN is covering her office position and there is another temporary full-time LPN on the cart. I'm there two days a week, she works the other 5.

Anyways, I had been hearing a lot of things from the CNAs and the other full-time nurse on the floor that this nurse spends a lot of time sitting around doing nothing. She'll spend hours helping CNAs toilet or doing nails. Not that there's anything wrong with those things, but I am straight out on that cart all day and still don't get done until at least half an hour past the end of the shift. She leaves early every day. Also, the 2-10 nurse has told me that she finds most people's medication cards in the same order she left them in, or dressings not changed every day (she refuses to report this). I began to notice increasing behaviors and residents on the bowel protocol that aren't typically.

So I began paying attention and started noticing things like eyedrops put in the cart (the 10-6 nurse notes when she replaces eyedrops that are expired) and not opened for several days, as well as inhalers and nasal sprays. I reported this to our corporate compliance officer, and nothing happened. I told him all the other things and he said they couldn't do an investigation based on hearsay. So the next day I worked (Wednesday), I went through several peoples' meds and made a note of how many were left in some of the cards (mostly meds that are only given on days). I came back on Saturday and some had the SAME number left (some only one gone instead of two). I also put a new bottle of liquid enulose in the cart that was still sealed (Miralax as well). Again, went to the corporate compliance officer (put everything in writing). He will noHtell me what's being done...but here it is over two weeks after the initial report and nothing has happened. In fact they gave her an extra day today and bumped me to a different floor.

So, what do I do now? Do I call the DoH or wait it out? I'm appalled by the administration's apparent indifference. Family members are starting to notice things, and we even had a guy die of a sudden, massive heart attack...probably because he wasn't getting his meds. The CCO just keeps telling me he needs "verifiable evidence" and to tell the supervisor "as soon as I notice these things". Well, somebody else told my supervisor something and it got back to the LPN. So I told him, but it was promptly. How does the supervisor know I'm not lying about the number that was left? How can they really prove it unless they audit her, an why haven't they done so?

Sorry that was so long. I'm really sick over this.

[RN&mom]

It seems like you're doing all the right things. One thing I would suggest is do you initial the med cards next to where you have popped each pill? I know it takes extra time but I always do it for every med as an RN and also when I get put on the med cart (med tech call out), I have all my med techs and other RNs do it too. As charge nurse of my floor it makes it much easier to sort out any issues that come up and each person can always prove what they gave. Be persistent, your residents deserve for the truth to come out!