resident abuse

[pooh]

I need info asap!

I work in Minnesota, long-term care. A couple of days ago a resident told me an aide had slapped her. I was livid. This resident is a severly dysphasic stroke pt who can move only her arms and head, both to a limited degree. Her mind, however, is clear. Although her speech is very garbled she can and does enunciate some words clearly and I could CLEARLY hear, "Aide, nasty, and mean" being spoken. The gist of it was that an aide (the resident also clearly spoke the aide's name) had "slapped my hands" during a care-giving session.

This particular aide is not one of my favorites. She's bossy and disrespectful to staff and residents alike. She's in instigator of dissent, always negative and bitchy. In short, a KnowItAll. On the plus side, she's a hard worker and very reliable but I've often wondered, if she's as tactless and harsh with the residents in front of the staff, what's she like when no one is around. Now I know.

I did not seek out the confidence from the resident, she freely volunteered, although if I'd suspected the aide was being physically abusive I would have started asking questions. As it was, I didn't need to.

I wrote a letter to the DON and quoted verbatim what I'd been told. The DON pulled the aide off that wing but she's still working here (as of last Friday) and I'm on again today, hoping like hell she won't be there. I understand that she put in her notice recently and hope she follows through.

What I'm wondering is, what are the legal repercussions of this? Is the DON (who went to the resident and verified what I'd been told) obligated to fire her?

I'd sure appreciate any info anyone has with an experience like this. I'm fairly new to this facility and the this scenario.

Feedback would sure be appreciated...

[Catsrule16, RN]

Get a copy of your facility's abuse policy. Read the regulations on Abuse. When in doubt, remember to keep the resident as your focus point. The resident is obviously upset by this person providing care. The facility should throughly investigate the allegations. Policies for what to do to the alleged perpetrator vary from facility to facility. There are certain items that must be in place according to the regulations. I have worked in facilities where the alleged is suspended pending the results of the investigation. If you feel that stongly, you can contact the local resident advocacy program (Ombudsman) and file an anonomous complaint. Hard to believe but the alleged has rights as well in this case.

Don't know about your area but new information concerning abuse is forth coming that the state surveying agencies should be giving to providers soon.

Good Luck!

Margaret

[2LTCnurses]

Not sure about your state, but most require the accused to be removed from the FACILITY until investigatin is comeplete, also a report must be filed with the state reporting the abuse. Believe it or not, some DON's don't know to or try not to report eveything they should. In my area, an administrator and DON were arrested and brought up on criminal charges for NOT reporting abuse in a timely manner. Find out the regs for your state and make sure they are being followed!

[peter73]

Federal regulations for long term care facilities are very clear on what is to be done in this type of situation.

#1 The alleged abuser (verbal, physical, emotional, or theft) must be immediatly removed from the facility and an investigation begun.

The facility may suspend with pay. If investigation disproves alligations the person may return to work as normal.

#2 If the alligations are founded the person MUST be terminated on the spot. There is also mention of reporting the incident to the board of nursing for an independent investigation (this includes nurses and CNA). It must also be reported to your states central reporting agency with in FIVE days.

#3 If the above is not done and the state/federal dept of health survey team or officials ever hear of it . . . very bad! Also, nurses are required to report by most state laws and most boards of nursing equate failure to report as the same as if you had been the abuser.

If the abuse occured WITH OUT malice or intent the DON and administrator may choose to suspend without pay, inservice on resident rights and abuse, put the employee on strick probation under supervision.

Also, you as a nurse with knowledge of the incident may also be held accountable by the MN board of nursing if the abuse occured and was not reported properly.

hope I helped with this sticky situation

Peter (former MN nurse now trapped in NC)

[OneThunder, BSN, RN]

Excellent description, Peter.

Although I have been on the investigating end of alleged abuse and we walk a thin line. I once spent hours on an investigation to find out it was a sqabble between two CNA's and one thought she could get the other in trouble by reporting "suspected" abuse that never occured. Needless to say, we had a full facility "come to Jesus" meeting about crying wolf!

[KRVRN, BSN, RN]

What did the aide claim happened? Did she deny the whole thing or did she give a reason/excuse/explanation?

[MaineNurse67]

Well, in Maine, you only have 24 hours to report the incident to the state, so this must vary from state to state.

Also, in a past situation, a CNA witnessed an RN inflicting abuse on a resident. The CNA reported the next morning. The facility received a deficiency because in the regulation it states that any suspected abuse must be reported "immediately" to the DON or Administrator. I will never forget that.

I make it clear to my staff that they are all mandatory reporters and that they must report "immediately" any suspected abuse. They can actually be held liable for NOT reporting, especially if an allegation of abuse comes up later on.

This is why every facility MUST have an explicit abuse policy and ALL employees need to be 100% familiar with it.

Great job, by the way, Peter... excellent response!!

Tim

[jkw]

First you did correct in notifying your DON. Our protocol, is to to contact immediate supervisor (house supervisor, DON) they should investigate the matter-self report to division of aging. If nothing gets done -report to division of aging yourself-anonymously if need be. Remember, keep a log book of anything unusual, time,dates-discussions. This holds up well, when Division of Aging come to investigate. Also proves you tried to prevent further abuse.

[debbyed]

Most importantly is that you can be held just as responsible as the DON if the case is not reported to the state. As far as I know this is a federal regulation. Make it your business to find out if the matter has been reported. It might be wise to check with the State agency rather than just ask your DON.