South Carolina LPNs Arrested For Not Changing Wound Dressings

[SunCityInsPhysical, BSN, RN]

I'm having gruesome Flashbacks. Putting 2 and 2 together  I'm having Visions of decubitous ulcers gone really bad.   I put myself through nursing school days, working in nursing home 40 hr weekends.

Proud to say we had 104 yr old pt  on bed rest for 6plus years and NO decubitous. We turned her and massaged her and changed diapers every 2 hours. NO EXCUSES. Charge nurse kept a check list of rotations/positions and made rounds. 

As an OR nurse I've assisted plastic surgeons treating decubitous ulcers.  The worst one was unassuming on skin surface of gluteus maximus but had marsupialized under the skin to the bone and down to the knee.  

This patients grand daughter was being paid as a CNA to care for her at home.  

The surgeon had me call the police and the caregiver as arrested for criminal neglect and abuse. 

I would suspect that this is the tip of the iceberg for that facility and many others across the country. 

My suggestion would be surprise inspections and hold those who own the facilities accountable for adequate staffing. The state is also to blame. We're all in this together.

Not sure what is being taught in nursing schools these days, especially the illegal schools. Florence is turning over in her grave.

I was taught to date, time and sign dressings. We were also taught to restock supplies for the next dressing change, leave the area cleaner than we found it. To work as a team and care for each other as  we give our patients the care we would like to receive. To know and follow the law and good care practices medical, nursing, psych and spiritual. Now a days we need to add gender awareness and respect but I've always treated each with respect.

I'm retired now, but my thoughts and prayers are with those of you who are teaching the next generations.  Also for those working in these severely understaffed conditions. 

 

 

 

[LVN_Flower, LVN]

I worked in a SNF years ago, and as I was sitting at the nurses station when a family member (grand daughter) came to the nurses station crying and complaining that her grandmother told her she didn't get her morning medications.  And demanded to know who the nurse was that didn't give the medication.  At first, I was like what room is she in? and then when I realized she was my patient, I then said "I'm the nurse, and I gave the medication", so I was confused.  My charge nurse stepped in and said, "hold on, let's look at the MAR" which we all did, and saw that I had signed for the medication.  But I knew I had given the medication because I spoke to the patient at that time.  And the patient took the medication, I watched her take it. and I told the grand daughter this.  But the grand daughter was so sure that I did not medicate her that she was angry that I was "lying".  After the charge nurse did some digging, we found that the patient has Alzheimer and in fact "Forgot" that the medication was given to her.   That was my last day.  I never went back. NO MA'AM!

[MaxAttack, BSN, RN]

KathrynRNBSN said:

complaint 2.pdf  The facility was cited (attached) Without actually doing the investigation, which would be extensive, it is difficult to say although I think it's a very slippery slope. 

Thank you for finding and attaching this. It reads like a bad drama.

Quote

LPN4 revealed LPN3 presented a glove with a crumpled up old wound dressing and reported the dressing had an old date as proof wound care was not provided

The only thing criminal here is this sort of pettiness that exists in nursing.

This was an internal issue. The rest of it is fluff that a monkey could see through. This was some intense legal overreach that I can only assume can be attributed to politics like reelection and he's trying to look tough on elder abuse or some nonsense.

[nightwingcreations, CNA, LPN]

Res. Can and do refuses dressing changes ( or other things ) and will lie later and say they didn't. But...then you should document that, not sign you did it.  It sounds like on the first one she did document refused and now the res. Is saying they didn't. Unfortunately that's going to be a he said, she said thing. How to prove it? The way the rules are written a res. Has the right to refuse anything and you can't force them but.....you can also get in trouble for neglect if you can't get them to do it. Hence a no win situation. We currently have one at my nursing home that this is a major issue. Large wounds, refuses TX and cares, once to sit in w/c for extremely long periods (over24 hours), it's a very difficult situation. 

[RN_SummerSeas, MSN, APRN, NP]

I think anyone who feels the nurses were the only ones at fault here are off the mark. The fact that 4 nurses were involved and several patients points to a systemic and cultural issue. Also the wound doc should have made better orders. Daily dressings with set gauze, abd, etc allow opportunistic pathogens more chance to cause infection. Also staffing everywhere has been awful, SNF's especially. I have done consults in facilities where there was one LPN in charge of 2 carts and sometimes one on the desk but not always. That is 40-50 patients who are supposed to get all their care from this one human. Ridiculous. SNF staffing has been horrendous for years. That these nurses were all ratting on each other shows a toxic work environment. I would love to know how many nurses were working. This does not excuse the nurses for not providing care and false documentation but it is certainly indicative of concerns with the facility as a whole. I would also like to know where is the RN that delegated? Did they know this was happening? 
And those who say this would scare away only bad future nurses, false. It will scare away good and bad because we all know patients can and will make things up if they want to. If the nurse bears the sole blame and faculties are not accountable and arrests are made for things such as wound care not completed that had no negative outcome (yes, I'm aware it could have been worse but it wasn't) what's to keep this from becoming the norm? I don't like the arrest of nurses at all, unless they are setting out to commit crimes.

[FiremedicMike, RN, EMT-P]

RN_SummerSeas said:

I think anyone who feels the nurses were the only ones at fault here are off the mark. The fact that 4 nurses were involved and several patients points to a systemic and cultural issue. Also the wound doc should have made better orders. Daily dressings with set gauze, abd, etc allow opportunistic pathogens more chance to cause infection. Also staffing everywhere has been awful, SNF's especially. I have done consults in facilities where there was one LPN in charge of 2 carts and sometimes one on the desk but not always. That is 40-50 patients who are supposed to get all their care from this one human. Ridiculous. SNF staffing has been horrendous for years. That these nurses were all ratting on each other shows a toxic work environment. I would love to know how many nurses were working. This does not excuse the nurses for not providing care and false documentation but it is certainly indicative of concerns with the facility as a whole. I would also like to know where is the RN that delegated? Did they know this was happening? 
And those who say this would scare away only bad future nurses, false. It will scare away good and bad because we all know patients can and will make things up if they want to. If the nurse bears the sole blame and faculties are not accountable and arrests are made for things such as wound care not completed that had no negative outcome (yes, I'm aware it could have been worse but it wasn't) what's to keep this from becoming the norm? I don't like the arrest of nurses at all, unless they are setting out to commit crimes.

Conversely - there are definitely a group of posters here who think that nurses are only ever a product of their environment and never have any personal responsibility for their own actions. 

[RN_SummerSeas, MSN, APRN, NP]

FiremedicMike said:

Conversely - there are definitely a group of posters here who think that nurses are only ever a product of their environment and never have any personal responsibility for their own actions. 

When it is 4 nurses from the same facility shirking duties and playing the blame game and the administrator and DON are gone that points to an organizational problem. There are of crap nurses out there, I have had the displeasure of working with many, but do I think they should be going to jail for their transgressions?  Not for this. Should they be fired? Absolutely.  Poor leadership doesn't excuse poor nursing practice.  Not sure where you work, but these days but short staffing, purposefully in some instances, is driving people from this profession, both good and bad.  As far as organizational failure, there are piles of data from research that describe how when leadership fails it created a trickle down effect and that is present in many, many health care facilities. 

[FiremedicMike, RN, EMT-P]

RN_SummerSeas said:

When it is 4 nurses from the same facility shirking duties and playing the blame game and the administrator and DON are gone that points to an organizational problem. There are of crap nurses out there, I have had the displeasure of working with many, but do I think they should be going to jail for their transgressions?  Not for this. Should they be fired? Absolutely.  Poor leadership doesn't excuse poor nursing practice.  Not sure where you work, but these days but short staffing, purposefully in some instances, is driving people from this profession, both good and bad.  As far as organizational failure, there are piles of data from research that describe how when leadership fails it created a trickle down effect and that is present in many, many health care facilities. 

We only know the details from that short report that wasn't conducted by an agency that does criminal investigations.  I'll wait to see the affidavit before I truly pass judgement.

That report did mention that the DON had only been there a week, the revolving door of DONs is another notorious problem with SNFs these days.. 

[NutmeggeRN, BSN]

hppygr8ful said:

Maybe that's why cell phones aren't allowed in most facilities!

 

Do you really think the rule about no cell phones is protect those who don't do wound care as ordered? 

[hppygr8ful, ASN, RN, EMT-I]

NutmeggeRN said:

Do you really think the rule about no cell phones is protect those who don't do wound care as ordered? 

No I don't. I was being facetious.😄

[payitforward]

Seems a little harsh, but it appears we don't know the whole story. BUT! Why would they be documenting they did it when it wasn't done? That is an offense right there. I'm going with a disgruntled family member. Sad.

[Emergent, RN]

I remember working in a nursing home as my first job out of nursing school. We had some old school LPNs who were very meticulous, and made sure the CNAs did their job.

We had an old gal there who had fallen off of barstool while drunk, hit her head, and was in a persistent vegetative state. She got fed with a G tube and got her meds that way. She was turned Q2, and I never saw any breakdown on her. We took good care of our peeps.