serious question, need reply: policy on rape

[noctanol]

I work in a long term care facility, to cut story short, a female resident, about 80 yrs claimed she was sexually assaulted at night, thrown to ground, clothes teared and fingered (sorry for being explicit) by male CNA and pts own brother at night. OK, heard this when i got to work and was like, nothing happened on my shift or any other shift that was reported to us (nurses), she slept OK and had breakfast, lunch and brought this up at shift change (2 PM). Police called, social worker, room mate interviewed and statement recorded, of which she says she didn't hear anything, she is alert and oriented. No bruises no scratch marks no torn clothes on resident with assault claim. After all was done, police left stating there was nothing they could do. however ALL male CNA's were sent home/suspended for 2 days without pay pending investigation by administration. QUESTION: has this ever happened in you workplace, what is to deter residents from making such allegations if pple are suspended, fired or even taken to jail. WHAT IS YOUR WORKPLACE POLICY.

[TheCommuter, BSN, RN]

A demented resident made a sexual assault allegation at one of my previous workplaces. The "involved" employees were suspended for three days pending an investigation by the facility administrator, who also functioned as the abuse coordinator. Once they were cleared, the employees returned to work.

The policy at my previous place of employment was to suspend the employee if any allegation of abuse was made. During the suspension, administration conducted their investigation. If the claim was unsubstantiated, the employee could return to work.

[CapeCodMermaid, RN]

Allegations of abuse whether made by a demented resident or an alert, oriented one must be taken seriously and investigated. Our policy states that if an allegation of abuse is made, the person who was accused will be suspended pending the outcome of the investigation. If we find there is no fault they come back and get paid for the days they were off. If we find there was abuse, they are immediately terminated. Either way a report is made to the DPH.

[ValerieAnn21486]

An ordeal where I once worked had happened once as well. A male pt accused a male CNA of putting his finger up his rectum. The CNA was suspended and an investigation was conducted. Of course it was unfounded because the CNA did in fact put his finger up his rectum to administer a suppository, the resident had occassional dementia, and forgot things often, and had forgot that the CNA had told him what he was doing. Needless to say the CNA returned to work within one week. But of course this stays on his record but is recorded unfounded.

[CapeCodMermaid, RN]

So MY question is 'why was a CNA administering a suppository?'. I've never worked in a place where CNAs could do this.

[cslxagRN]

So MY question is 'why was a CNA administering a suppository?'. I've never worked in a place where CNAs could do this.

I have the same question as well.

[Not_A_Hat_Person, RN]

At the LTC where I worked, allegations against employees were always investigated, however small. Accused employees were suspended with pay pending investigation. If you were cleared, you went back to work.

So MY question is 'why was a CNA administering a suppository?'. I've never worked in a place where CNAs could do this.

In my state, med techs can administer suppositories. If a male med tech was doing patient care, he could very well end up inserting a suppository during his shift.

[debRN0417]

The facility's first responsibility is to protect the resident. Any person who is suspect must be "suspended" or "removed" from where the resident is in order to protect them. It is also for the employees benefit as well, so that no other allegations can be made against them while the investigation is underway.

I know you all know what the regulations say about abuse/and reporting so I won't go through all of that (just in case- State Operations Manual F 223-226). A facility MUST have a policy in place for abuse prevention. This includes: Screening of employees, training of employees, prevention of abuse (providing residents and families witn information on reporting) Identification, Investigation, Protection, and Reporting. All allegations of a rape/sexual abuse must be reported immediately and immediate action taken to protect the resident. This includes reporting to the police, ombudsman, APS, and the state agency and if the allegation is substantiated- reporting to the DHP.

Even if a resident is demented (or not), any allegation must be investigated thoroughly. There are times when we all know a resident can confuse events- thinking a suppository is rape, or a catheterization, or even bathing. But what if it wasn't a procedure? I mean there have been cases when the elderly demented resident has been sexually assaulted. There are many times when a resident, although confused, can tell you that something happened to them. It is up to us to protect them while we figure out what it was.

It is hard to have a finger pointed at you, however if you are not guilty then it should be no problem. Where I used to work if an employee was suspended pending an investigation and the allegation unsubstantiated, then we would back pay them for their time off. Allegations of ANY type of abuse, verbal, sexual, physical, mistreatment, neglect...all this must be immediately reported and thoroughly investigated and every facility has to have a policy that follows the guidelines in the federal regulations. Even if the resident is confused...we all are mandated reporters.

[ValerieAnn21486]

So MY question is 'why was a CNA administering a suppository?'. I've never worked in a place where CNAs could do this.

Good question. The place where I was working at, in the beginning of when I had started there, CNAs were allowed to do suppositories, fleet enemas, and even digitally check a patient for impaction. It wasn't until a year before I left that they had changed the policy that ONLY LPNs and RNd could do it, and how they got away with it is beyond me, because CNAs weren't trained to do it, although it is common sense.

[CoffeeRTC, BSN, RN]

Yeah, I can see the suspension.

How about this story...a nursing home in Pa had a resident with a history of rape or assult (was on the sex offender list) on a minor. Facility knew this and had him "care planned". Man ended up assulting a demented female resident.

What type of care plan did they have? I know most of the LTCs I have worked at the staff is always short. I would assume you would have to monitor the resident and make sure he wasn't left alone with other female pts???

So...if you have a know sex offender, how are you keeping the other residents safe??

[lylenrn]

Here's an incident that happened at a snf near me recently.....CNA caught having sex with demented pt. Pt was so confused she couldnt have possibly reported it and even after proper authorities alerted pt was no help in giving information about incident. My point? while this population may have issues with confusion and report incidents that never occured. What about the rare occassion when sexual assault actually does occur. These reports all have to be taken seriously. There are some sick people in the world, unfortunately, some of them are in healthcare too.

[CapeCodMermaid, RN]

We check the sex offenders registry before we accept someone for admission. It certainly isn't foolproof since many sex offences are not reported but at least it's a start. My medical director told me I didn't have the right to refuse anyone simply because they were sex offenders....I can refuse anyone I think is going to put my residents (or my license) at risk.