Thank you all for your responses. This has truly taught me allot. I feel as though I had made an honest mistake, and it has turned into a huge issue. I absolutely see now why new grads should not do home health or PD nursing. I fully take responsibility for my actions and honestly want to be the best nurse I can be, and live up to my full potential. I am very passionate about my career and my patients and became a nurse because this is the only thing I have ever been so passionate about and wanted so much.
I have looked and looked online and in public libraries for utd information on the laws & rules for my state on nursing in home care but have been unsuccessful in finding anything out. That is why I resorted to asking all of you. I am not asking for legal advice but at least advice on what steps I should take to protect the patients this company cares for, as well as my nursing license, in addition to I want to be a more knowledgeable, competent and safe nurse.
There are a few things I want to address to your responses and ask as well.
1. I believe I may have been unclear in my initial post, but the company received payment from Medicaid for the hours i "took a lunch" as well as for the two shifts they never paid me for.
The hours that they owed me pay for were for a completely separate issue unrelated to the "lunch issue". In fact, I did not even take a lunch on the two shifts that I have not been paid for. The system I use to clock in and out is called Care Call where you clock in and out using the clients phone. Maybe some off you are familiar with this system?
There were two occasions where at the end of myshift the client phone was unavailable. And, as instructed via email by my company, if the patient phone is unavailable to clock in or out, we are to call the owner of the company or the nursing supervisor, and they will call Care Call to clock us in/out. However, I was notified by the companies main office the day after each occasion that neither of them had clocked me out, even though I spoke with BOTH the owner AND nursing supervisor on BOTH occasions. The owner told me I would be paid for the hours on my next check.
The first instance occurred this past August and the second was in September. On both occasions, and weekly since then, the owner has verbally told me of some mishap as to why the money had not been paid and promised it on my next check. To this day I have not received payment for either shift.
It was not until October that I was suddenly informed by the owner we were not allowed to take a lunch (I explain "taking a lunch" in #2). I was told at this time by the owner that she was not going to pay me for those 2 shifts where administration failed to clock me out because of the lunch breaks I had taken. She said she was going to just "call it even". Feeling timid being a new grad, unsure of my responsibilities/rights and shocked to what I had just heard, I simply replied with a "yes ma'am" and the phone conversation ended.
I actually spoke with the Medicaid case manager of this case regarding everything and she told me she's had a number of problems with this company. She also looked up the two days I worked and said the company WAS indeed paid for both of the days as well as for the "lunch breaks" I had taken. She made a complaint against them for Medicaid fraud.
On a follow up conversation with the Medicaid case manager, she asked about the pay and was shocked when I told her I had not received payment as she was told by the company I had been paid after the complaint was filed.
SO TO RECAP: I was not paid for two shifts I worked because my administrators did not clock me out like they were supposed to do when I called them.
Three months pass, where I am constantly lied to being told the pay will be on my next check. Suddenly in the latter part of October I get a call from the owner of the company asking about a few occasions where I had left the pt home to take a lunch (as my head nurse told me this was allowed and not to clock out during lunch breaks). When I informed her of the ten or so occasions where this had happened, she replied telling me she was just going to call it even and not pay me for the two shifts she owed me for because of the lunch breaks I had taken. She also said that if I pushed the issue, "someone" might turn me into the nursing board for pt abandonment.
The company received payment for every lunch break I took as I did not clock out for them and the company also received payment for the two shifts I worked, however I was not paid for the shifts.
2. I am at all times in the same room as the pt with the exception of when I use the restroom and approximately 10 instances where I left the pt home to get lunch. I know and completely understand now why new grads should not do PD nursing. In my defense, being a new grad I was unaware of numerous things. Also, on the days where I took lunch it was on days where the mother approached me saying if I wanted to go to lunch she was staying right there by the pt, and these were also days where I was working 16 hour shifts, from 7am to 11pm. I asked my head nurse for this case how to go about clocking out (as I was not very familiar with Care Call) and she told me not to clock out for lunches regardless of if you left or stayed and she also told me it was fine to leave for lunch. I realize now I should not have taken her word for it and I should have had something in writing from the company regarding lunch breaks, which to this day I have not been given. I assumed with her 15 years of experience and10 years of that in home health and PD nursing, in addition to her being the head nurse of the 4 nurses on this case, that she knew what she was talking about.
3. My pt is an infant and her mother does not work. The mother is in the home with the client and myself 90% of the time, with the occasional grocery shopping trip or doctors appointment for herself. I would NEVER EVER NEVER leave a pt in a home completely alone. Knowing what I know now, I will never leave the pts home again without clocking out, if I ever leave at all.
4. With the exception of those ten or so occasions, I have never even left the pts room to eat. I have always eaten at the pts side, if I have eaten at all. And the few times that I did leave for lunch, I was never gone for an hour. I was gone for somewhere between 20-45 minutes. But again, only left for lunch ten times in 7 months and I work anywhere from 4 to 7 days per week. There actually was a 12 day stretch where I had no shifts off and then finally had off one day followed by another 10 shifts (this was due to nurses calling in sick and quitting without notice).
5. I was hired fresh out of college for this case by my company. They had me complete two CEU's prior to my first day of working. I was completely unaware and blind that I need a year of experience to work this position. I do have my bachelor's degree, although I wouldn't think so, could this possibly make a difference as to experience needed prior to working PD nursing? Or does it possibly vary by state? I live in South Carolina if anyone knows of some online literature regarding the state rules to nursing in home care. I am worried now... Do I need to resign from this position first thing Monday morning?
6. When the owner called and told me she was going to "call it even", she threatened me by stating if I pushed the issue that "someone" might turn me into the nursing board for pt abandonment. Can she do that? I understand now that I cannot leave the pt home for lunch or breaks and will not. But can she turn me into the nursing board when there is no proof that I ever left and no harm has come to the pt and the patients family is very happy with my performance and were the ones suggesting I take a lunch?
7. Is there a limit on the number of hours an RN can work during a shift? Because at the beginning of the case I was working several 16 hour shifts.
8. I have never been supplied with a company manual or company policy handbook, despite that I have asked for one several times. Is this something I should have been provided with at hire?
I have a copy of my contract and all forms signed with the company at my hire date, but none of it provides any information that relates to the care be provided by the RN.
9. A few weeks after getting hired the company had the nurses sign and return a "contract" stating if a nurse quits without giving a two weeks notice, they will only receive minimum wage ($7.25) per hour for their last paycheck instead of our normal pay. Is this legal?
Again, thank you all for all of your help and replies. Any advice or suggestions is greatly appreciated. And please realize this is for me not only embarrassing but has been an honest mistake. I am truly wanting to do the right things I just don't feel I have the resources.