Reporting resident abuse to local office of aging....

RedZeppelinRN · Jun 7, 2007

I don't know what state you are in, but in my state, as part of our orientation they have an inservice called "Mandatory Reporting." If you don't report abuse, you could be in trouble. They say in the film that you can report anonamously. I think this is just LTCs. You might call around, like DHS or Department of Aging. Best of luck.

lindarn · Jun 7, 2007

There have been numerous episodes of resident abuse at the place where i work, they have all been reported to the NM and DON. The aides abusing the residents continue to be employed there. There is no documentation in the res. chart, all documents are written down and given to the NM and DON and I believe are easily "misplaced" or thrown away. The NM always seems to find some other reason for the bruises, or they get a psych consult so they can put an alert and oriented person on psych meds and have them diagnosed with some sort of disorder that could explain why her accusations aren't accurate. I think there is a lot of covering up going on and i don't know what else to do. Can i be fired if i turn them in to the office of aging?? I am afraid they will come in and do an investigation and not find anything because of all the "covering up" that the NM and DON are doing so they dont have to get rid of CNAs.
These aren't minor episodes of abuse either, resident's are being physically harmed, verbally and emotionally abused.
ANy advice greatly appreciated.

The first thing that needs to happen, is that when you write up incident reports of abuse make a copy of the document, who you gave the reports to. I don't care if you have always been told not to make copies of reports. They dissapear when they are inconvenient/incriminating to the hospital or nursing home. Is there any way you can take pictures of the bruises? Are any of the residents coheran enough that they can make a statement to you concerning the abuse that they experience, or observed on anothe patient/resident?

Nurses are Mandatory Reporters, and you could get in trouble with the BON, and be sued by the families, if you knew the abuse was going on, and did nothing to stop it and/or report it. Technically, this a whistleblower case, I would think, and you shoud be covered by the laws in your state, if they have them.

Document what you can, and talk to an Employment attorney, and get his/her advice is the best thing I can tell you. Yo alos mght start NOW looking for anothe job, because when the you know what hits the fan, you want to be able to work to support your self. You don't want to be left with no way to support yourself when the going get tough. And it will. Financial problems are the least of what you need to worry about. JMHO.

Lindarn, RN, BSN, CCRN

Spokane, Washington

tkhayman · Jun 7, 2007

HI,

There is usually in each nursing home posted the tel # for local ombudsman to report abuse. I understand it is completely anoynymous and you have to fill out some paper work. i have to do the same cos one of my students saw something too.

Nascar nurse, ASN, RN · Jun 7, 2007

You need to contact your department of health immediately and as someone has said, the phone number should be posted somewhere on the wall (this is a requirement). You also stated you have told NM and DON...keep going up the chain. Talk w/ adminstrator and then on past his/her boss if necessary. Abuse must be dealt with!

But on a side note, please remember that medications, such as coumadin often results in frequent bruising. I don't take any meds at all, but not unusual that I have some unexplainable bruise. This doesn't mean I am being abused, just that I bumped something somewhere along the way, probably yelped "ouch", then just forgot about it.

Daytonite, BSN, RN · Jun 7, 2007

believe me, i know how much this tears your heart up. whenever i wrote anybody or any incident up i always kept a copy of it for myself. you will often be told not to do this. however, over the many years i have been in nursing i have gone to a number of seminars on "nursing and the law" and this was mentioned in every one of them. you don't go around telling people that you have a personal file of documentation, but you do it. you never know when you're going to need to prove that you did document something. for this reason, whenever i wrote someone up i usually did it in the form of a memo that included dates, times and names and printed it out on my computer so i could spell check it, format it nicely and make a copy. i placed them in a #10 envelope and sealed it. i either hand delivered them to the don or made sure they were pushed well underneath her locked office door so no one else could get it. a write up like that which looks more formal is less likely to get thrown away than something that's been scribbled on the corner of a piece of scrap paper. when i was a supervisor i learned that beyond the regular facility disciplinary and incident forms, there was an administrative reporting form that we supervisors were to document the facts of events that we had been involved in. these went to the administrators. i was advised by a number of my supervisor peers to make copies of these for myself.

i also want you to know that from the perspective of a manager that it sometimes takes more than one write up to fire an employee. when there is only one witness and the perpetrator of the abuse, it's kind of a he said/she said situation, particularly if the patient is confused. unless there are stone cold objective facts that go along with the situation (like a bruise on the patient), a prudent manager has to have other similar documentation that shows a pattern of this behavior and it has to come from other employees. the very sad problem is that if one of these people is fired (which i know, and you know, is the right thing) they can go and file for unemployment insurance. the unemployment office is going to look at whether or not the facility followed its own rules and regulations regarding discipline and termination. the reason is because the state doesn't want to be burdened with having to pay out unemployment benefits for the wrong reasons. if the facility didn't follow their own rules, the person gets unemployment and the facility gets the bill from the state for it! in effect, the facility ends up paying this employee for work they aren't getting any benefit from. most facilities and managers are aware of this. if they've been stung once by this then they are very reticent to summarily fire someone without having concrete proof of wrongdoing. it is so very sad, especially when it involves patient abuse.

the agency to report to is the state agency who licenses your facility. which agency does your state surveys? usually, its your state department of public health. it's easy enough to find out by doing an internet search. some states will even have an online complaint form that you can download, fill out and mail in. but, i have to tell you that if you file any complaints they will want documentation. this is why having copies of all the write ups you made is helpful. if you have documentation of a cna doing abuse, you can also try to file a complaint against them with your state nurse aid registry. most have online websites and instructions on how to report complaints. where complaints involve the cna registries or the boards of nursing they will want documented proof. all complaints will get a response.

i was close to doing something like this because i felt the don and administration of a ltc i was working in were ignoring all the write ups and complaints i was making about another rn who i knew was not giving medication and was falsifying blood sugar results. before i was getting ready to call the state i told the don that if she didn't do something about this nurse i was notifying the board of nursing. within a week things were taken care of. i was told that a plan had been set in motion already and to just cool my jets and say nothing. we all have to realize that because of an employee's right to confidentiality (remember we all have that right) management cannot not disclose anything about another employee's performance or any discipline they might be receiving.

Jo Dirt · Jun 7, 2007

Adult Protective Services' main concern is financial, and ensuring the elderly's finances are in order BEFORE they have to go to a nursing home. If you suspect aduse and neglect of a noninstitutionalized aged person what APS does is go in and investigate, look for sign of abuse, see if they will be able to take guardianship of that individual, then they will check out the finances, property records, etc. to ensure their resources will be properly exhausted before they can apply for Medicaid, so I don't think calling them will be of much benefit.

What I would do is report them to the state regulatory board that inspects the nursing homes. I can't believe they would be able to cover up abuse to the point there would be no suspicion, especially with bruises. I would even sneak a camera and tape recorder in. Don't know what state you're in but in Tennessee all that is required to do this is to have the consent of one party (that would be yourself).

I'm sorry for this situation.

beachmom · Jun 7, 2007

Before you sneak in a camera and tape recorder, be sure of your laws. We aren't allowed to photograph patients. I think it's a HIPPA thing. The patient has to sign a permission slip to be photographed. In my state, tape recording without permission may be illegal, and I know it wouldn't be admissible in court.

Immediately after a conversation, you can write out as much as you remember and date it.

You can report abuse anonymously. I had to do this once, and the DHS person was very nice. No one ever knew it was me.

MrsMommaRN · Jun 7, 2007

you can not let this go on any longer. just knowing what is going on and seeing that nothing is being done is almost like condoning that behavior. that said do you really want to work for a facility that allows such admonishable things to happen to their residents.

it may be hard but stand up blow the whistle on this whole thing. think of it this way if it were your mother father or grandparent wouldn't you pray that someone would have the guts to stand up and say enough!!!

Nascar nurse, ASN, RN · Jun 7, 2007

Thread hijack... sorry

DAYTONITE - You always have such great responses! I read your profile. Why wouldn't you go into education. You would be great for that.

Again, sorry for thread hijack!

jojotoo, RN · Jun 8, 2007

If your facility has a policy that states incident reports are not to be copied, and you do copy them, you've probably given your employer grounds to dismiss you.

What I do, is write the "incident" up on plain paper and staple it to an incident report that says "SEE ATTACHED".

withasmilelpn · Jun 8, 2007

Thread hijack... sorry
DAYTONITE - You always have such great responses! I read your profile. Why wouldn't you go into education. You would be great for that.
Again, sorry for thread hijack!

I second that! Thanks!