Reported Suspected Elder Abuse, now I'm terrified

[danvet]

I work in a California LTC facility. Supervisory responsibilities. I had a really bad weekend and it was extra busy. Patient had nurse send me into room where quite a few allegations of verbal abuse and withholding of pain medication were made.

Worse yet, it was substantiated in the chart. The nurse told patient to call for pain med change herself because she was busy so patient did. This resulted in a surgical MD giving an increase in frequency of pain med with acetaminophen product which resulted in >1000 mg of acetaminophen over 4000 mg max dose for more than 10 days.

I informed NHA because I couldn't reach DON and was told to begin investigative process. I found state required reporting forms and followed the directions and called/faxed state, and called ombudsman.

DON and NHA are infuriated with me. I've been pulled into 3 meetings and have been made to feel stupid, told I didn't follow p&p, and that I used "illegal documentation". Since then, I've been being tracked by individuals in management (you know, all whereabouts must be reported by other nurses as to where I am at all times).

I have lost pay which is attributed to an accounting error, and am looking at a demotion from weekend supervisor.

It's very difficult right now. I'm feeling awful. I looked at company policy and didn't see where it said to write it up seperately and submit it to management so they could decide. I followed the directions on the forms. Furthermore, the documentation in the chart was nothing more than exactly what the patient stated. No subjective info, no opinions, and no inferences. Simply what the patient stated. Further in the charting I of course had to reveal the discovery and disclosure of the tylenol error to family and on call MD.

I know it's retaliation and I'm actively trying to get a lawyer. I've got some concern that somehow they will go to the BRN and report me on frivilous charges. I did check the Nurse Practice Act for California and they say there will be no action taken on any licensee in connection with an abuse report.

I don't know what to do. Lawyers are slow to get back to me. I'm documenting what happens at work, but I am not a confrontational person. I'd have given anything in this world to have not come across this. I've never EVER been through an abuse reporting before.

Any comments, suggestions? I can't stop having anxiety attacks and they are about to paralyze my ability to fuction. All the upper management and DON suddenly got quiet my last day I worked and it was too quiet. Like they were totally ignoring me on purpose (which I was glad for).

Please help!!!! They are making me crazy at this point!!!!

[Liddle Noodnik]

Please help!!!! They are making me crazy at this point!!!!

Keep the "whistleblower's act" in mind, they are not allowed to intimidate or punish you like this!

[spaniel]

Hello- As I think I hinted in a previous post, the reason for the CEO's response is that legally/morally you were clearly in the right. But having been in your position, I very much hear you when you say your "spirit" is broken. I do believe it takes awhile to recover from these things. But I know, it can take a tremendous toll. I have had a case of abject retaliation for reporting things internally.I totally understand why nurses don't report internally sometimes.

On the side of the patient- I once had a surgical procedure with no pain relief forthcoming. I received no assistance from the nurse. Again in this case, there was no overt malintent. Hours went by. Forunately a friend called, who called her sister who was the CEO of the hospital where I worked. The CEO then called the hospital where I had the surgery (different hospital) and finally was able to get some attention. Can you believe that on the post op papers (discharge papers) they had the wrong surgery down!- And indeed the nurses probably couldn't figure out why I was in so much pain, and hence may have been dismissive. But it was a serious issue.

[danvet]

Just an update for everyone. Things are pretty much the same. I have taken another job, filed a greivance to the CEO and naturally, no response. State was in and apparently they are under scrutiny for failing to report a sentinel even...and finally, heard the words I longed to hear, and unfortunately they weren't "I'm sorry" but that they are in the proceess of becoming more aware of their abuse policies and procedures and they will need to follow taht. I am pursing legal action through governmental agencies. I just know that I have to stand up for the nurses behind me. Just think, if I hadn't reported that incident, what would I do? It'd be my license. I feel as though I have really done well, but I'm still sad for leaving my co-workers and residents. Though, where I am at now, they are like a breath of fresh air and are absoluely wonderful!

[PMHNP10]

Just an update for everyone. Things are pretty much the same. I have taken another job, filed a greivance to the CEO and naturally, no response. State was in and apparently they are under scrutiny for failing to report a sentinel even...and finally, heard the words I longed to hear, and unfortunately they weren't "I'm sorry" but that they are in the proceess of becoming more aware of their abuse policies and procedures and they will need to follow taht. I am pursing legal action through governmental agencies. I just know that I have to stand up for the nurses behind me. Just think, if I hadn't reported that incident, what would I do? It'd be my license. I feel as though I have really done well, but I'm still sad for leaving my co-workers and residents. Though, where I am at now, they are like a breath of fresh air and are absoluely wonderful!

I'm glad that you are doing well. I think it was inevitable that you were going to have to find another job. I don't know if I was sleepy or what when I read your original post, but I do know that what you did seemed perfectly reasonable. I may be wrong but I suspect that had you been able to contact the DON, the incident would have not gone any further--call it a hunch. Thanks to you doing what you felt was the correct thing to do, maybe those residents will have a little better life while they are there. For that you certainly should be proud. Good luck to you

[CrunchRN, ADN, RN]

Thanks for the update. I think you did a great job and were a true patient advocate. I am very glad that you found a new job and that it is a good one. You were very brave and i hope you are never put in that position again.

[a21chdchic]

In my state, we are required by law to report suspected abuse. She did the right thing, but I also would have notified the DON or ADON as a courtesy, so they could initiate the in house investigation. When they chose to do that, is entirely up to them. But if they reported it and I didn't, it would be my *** in the sling for not doing my duty as a reasonably prudent nurse. I'm not putting my license on the line for anyone! I've worked hard through the years and am not going to lose my license for the sake of an organization.

I would fully be watching for actions of retaliation - this is all to common, and if you rely on your paycheck to live like the rest of us, I would suggest lining up a new job ASAP, for back up. They can make it very uncomfortable and stressful to be there. And undue stress is not healthy to put up with for an extended period of time.

[prmenrs, RN]

NOTE: the thread is 2 years old.

[treysdaddy08]

My "what were you thinking comment" was at the entire post. I don't think she did anything illegal. I haven't read the charting so I can't comment on the unethical part.

From the OP, I just got the feeling that she didn't think through the whole situation to the end.

Since when do we take it upon ourselves to report med errors to the state on a weekend?

I believe in the chain of command and following policy & procedure. They are in place for a reason. Once that is properly followed, THEN if I feel it was "covered" up, I would feel justified to report it to the state myself.

At NO time do I feel resident abuse is acceptable!! But there are mistakes and then there are reportable mistakes. P&P helps management determine the difference. I don't feel from the OP that she thought thru the situation.

If I did something like that on my shift, I would fully expect to be reprimanded for not following facility protocol and would probably lose my job.

As the nursing supervisor, it is my job to do that. That is all I am saying.

And that's the most retarded comment I've ever heard. Someone, especially a supervisor, expect neglect but shouldn't call the state to report it because it's "against policy"? She'd lose her license! P&P are there so they can cover their own ass, not for the safety of the patient. It's better to report suspected neglect/abuse and be wrong, then not report it and be right.

[kanzi monkey]

I don't agree.

That is what policy and procedures are in place for. She didn't follow them. I believe you should follow your p&p first. Had she done that and then they STILL didn't report it...now thats another story. In that case, yes she SHOULD report it. But she never even gave her administration a chance to do an investigation, which should be the first thing done internally. That is what I was referring to. Any of us can lose our job at any time for not properly following policy and procedure. Had she done that and then still felt the need to call the state in instead of calling the state BEFORE she even reported it to her supervisor, then I think she would have a case. As I see it now, she didnt follow her p&p at all.

Following this protocol is NOT not reporting abuse. Of couse we have to report abuse! But we need to do it properly.

That's all I am saying.

Hi, I'm not sure I understand all the details of this situation, but from I know that when I was studying for the NCLEX last January I was informed that the reporting of suspected abuse was to go directly from the nurse to an authority--social services, police etc. This was an exception to any other situation where a nurse needed to report something, where the proper protocol would be to follow the chain of command.

[kanzi monkey]

NOTE: the thread is 2 years old.

Maybe it's outdated, but I think this is a valuable discussion for RN's to have--this situation could have been theoretical, and it would still be important!

Cheers!

[prmenrs, RN]

OK, enjoy!