sd90mac

I can relate. As the risk manager, it is my job to do the investigation. 20 pages later, and statements from all staff involved, we have to determne if it is an adverse incident or not. That's the tricky part. We also have to determine if an employee is at fault or not. That is why all staff is required to check for all safety devices, alarms, etc. and make sure they are in place. I hate to have to talk to a nurse or CNA and question them about what happened. I always tell them to rreport any incident immediatlly and I'll fight for them, but if they don't and try to hide it, I cannot help them. Many are learning I mean what I say. They have stopped complaining about having to write statements and coming in to speak with us. I make sure Human Resources is involved in all discussions for the employees sake and mine. Our incident report is 3 pages, but the initial investigation I do is 3 pages or more. I am teaching the nurses to write everything they can think of, floor wet or dry, shoes on or barefoot, any obstructions, was the safety device on correctly or not on, anything that can help with the investigation. They are beginning to get the message. Marie

I didn't mean to insinuate the DON works the floor a lot, but she has worked a night shift on the weekend when were are really short. We are down 7 nurses right now. I worked 10 to 2 as the supervisor today, and may have to go in tommorrow. All administration nursing staff (MDS, Unit Managers, Infection control/restorative, and the weekend and evening supervisors) have to take turns being the on call nurse a week at a time, and this week is my turn. It's been horrible with so many nurses out. Any one want to work in Ft. Myers fl??? Sorry, couldn't resist. When we are on call, we have to find someone to work, or cover the shift ourselves. It really works most of the time. But there are times no one else is available and we have to do the shift. I don't mind, at least the residents get what they need. I can't believe the ratios of nurse to staff I am reading about on this thread. Florida must have stricter staffing standards. It's based on hours required for the nurses and CNA's to care for the residents. We have a 107 bed facility, and 4 nurses on days and 3-11 and 3 on 11-7. CNA's are 12 to 13 for 7-3 and 3-11 and 5-7 on nights. Plus on days we have unit managers, staff developement, and others who all pitch in to help. I feel real lucky now to be where I am. Marie

I realize this is an old thread, but a comment made by 2 posters caught my attention. In all the years I have worked in LTC in Florida, I have never seen or heard of the the surveyors calling ahead to tell the facility they are coming. I work in Fort Myers Fl, and we have the toughest district in the state. I worked for 25 years in Pinellas County and do not recall them calling first. I do agree with the statement that if we stay ready there is no need to scramble at the last minute. Retaleation (?sp) firings do happen, I do not agree with them, but they do. I have always felt nurses should tell it like it is to the administration, and darn the torpedoes. I have fought for years for resident rights, and fought against abuse, I've seen nurses fired unfairly,and seen some who should have been fired or never hired. Observations, not answers. Unions in Florida do not work for the CNA's or Nurses. They collect the dues, and that's about it. Not like thy are up North. Been there, done that, fired the CNA for abuse, and the union demanded she be rehired because I did not get a picture of the "aleged" red hand print on her face. Done Marie

Ok. I am the risk manager where I work. It is very important to do the incident reports. We had a resident show up with a fractured hip. I had to do an Adverse Incident with the state. On completion of the investigation, the nurse was terminated because she said she didn't think the resident was injured so she did not do one. This was not the first time she had done this. The resident was demented and could not verbalize pain. 2 shifts later, he developed what the nurse thought was belly pain because he cried when the CNA's got him up. A flat plate was negative. The next shift nurse whipped back the covers and found external rotation and shortening of the leg. Any questions? Always always always do an incident report. If something is found later, you have proof you checked the resident and doccumented for 72 hours. It could save your bacon! Do it for all skin tears, bruises, etc. Marie:nono:

Boy am I glad I work were I do. We have 2 nurses for 50 residents, and 6 CNA's. The unit managers help out on the floor, as do the MDS staff, and myself. I have seen our DON out passing meds, and she told the administrator to butt out or go get his nursing license. i sometimes feel as if I work in a zoo and the inmates are running it. But we all work together. Not a perfect paradise, we do have our problems, and we fight amongst ourselves, but heaven help the person who messes with one of us since we will all take him/her on!!! Marie:lol2:

Congratulations on your new career. As an LPN for 35 years, I hope all the best for you. Marie

Good heavens, what state was this? He or his family have the say, not social services or the doctor. The term is incapable in florida, not incompetent. The family of this man needs to meet with the administrator, social services and the director of nurses immediately, then they need to find another facility, and move him out. Then call the state, the ombudsman, and write a letter to the home office of the facility. The treatment of this man is intolerable!!!! The ombudsman is not the "state" that caused this mess, but they may be able to help get him taken care of. Most likely the hospital social worker called in the depatment of children and families, elder care section, and they made the decisions. I have been doing geriatrics, in LTC for 35 years, and have worked hard to change from chairs tied to the wall, activities consisting of a birthday party once a month and incompetent staff. This cases sounds like a "throwback to those days. Sorry, this realy upset me! Marie