Tech falsified vitals

[Presbynurse12345]

There was an incident at the hospital I work at where many nurses noticed that she wasn't getting up to do vitals after bringing it up to our director she investigated and the tech admitted that she did make up vitals. Our director suspended her for 3 days and when she came back she told the charge nurse she had only made up vitals for 2 weeks which is 6 shift at 12 patients a shift times 3 is 216 made up vitals .. I feel she has done this longer and don't want to work with her for fear of my patients.. can I go above my director and call our compliance line... not sure what steps I can take but I know I can't trust her to do her job. Not to mention all of the falsification on these charts. Any advice would be helpful

[parolang]

JKL33, I'll be honest, I never truly knew what the role of the RN's and LPN's were there in the nursing home. Things were in practice pretty compartmentalized, mostly because we were busy the entire time. It was hard for me to say I was "aiding the nurse" because we hardly communicated.

But I know this is very different from the nursing delegation model. But if nurses don't have real authority over the aides, then you can't be responsible for what they do to the extent that I claimed. But I was always under the impression that the nurses could at the very least get me written up if they saw I wasn't doing something right.

We have been told multiple times in recent years (as RNs on a staff) that we aren't there to "judge" others' work - we do ours, they do theirs.

If you find the term "supervise" in your job description anywhere, then "judging" is exactly what you are hired to do. Yet I understand that in practice a nurse's authority can often be undermined. Sometimes I really hate the health care system, mainly because it doesn't follow its own rules.

[Buckeye.nurse]

Just my 2 cents on delegation of vital signs. The PCA (patient care assistant/associate) is responsible for the *work* delegated. IE. they were checked off in central orientation on the actual task, then checked off again during orientation on the floor. False documentation is a fir-able offense, and I have seen it happen during my career. As someone else mentioned, obtaining vital signs (along with accurate daily weights and I & O's) is some of the most important work that PCAs do. Trends can't be measured if vital signs aren't timely and accurate.

As for the RN, we are responsible for the *results*, and any actions that need to be taken. We can't use "the PCA didn't notify me!" as an excuse for failing to manage a documented HR of 140, temp of 101.8, or B/P of 74/44 for example.

[Persephone Paige, ADN]

Because of this thread, I am now taking my own vitals from here on out. If the CNA is doing his/her job, great. The patient will have the most up to date vitals on the floor. I can't tell you how many times a day that I refer back to my vitals before medication administrations. This truly scares me and I don't know why I never thought about it before. Who would want to do 12 hour shifts without actually doing the work to pass the time? I would go crazy just sitting there. They are busy, but vitals wouldn't be my first choice of tasks to ditch. I guess you can't smell high blood pressure, but you can smell poop.

[Rnhopeful23]

On 11/8/2018 at 12:14 PM, parolang said:

I was a CNA for three and a half years. I do think a lot of readings were fudged/made up, but I also think that nurses are complicit with this. You are supposed to supervise. The job of nursing aides isn't just to do your work for you.

I say this because the perspective of the nursing aide is this: If there is no accountability for this kind of thing, then you are going to know which nursing aide is actually doing honest work. He or she will be the one who is behind schedule compared to the other aides, is having trouble finding an accurate BP monitor or is doing them all manually, and is getting chewed out by the next shift or the RN for not getting as much done.

I'm just a little surprised at how shocked the OP and many of you guys are about this, and now you want to get her fired? So no one has ever double checked her work until this time? I don't know how other facilities run, but as a nursing aide I was busy *all of the time*, and the time I spent doing vitals was precious time that I could have been doing something else, which the next shift would then quickly expect on a regular basis.

So here's the consequence: You don't supervise your aides, and so you end up rewarding the aides who aren't doing their jobs correctly, and punishing the ones who are trying to do it right.

I highly doubt that this is the only aide in your facility who is either making up vitals or fudging the numbers. This might be the only aide who is got caught, or the only aide who was honest about it.

My only thing is that if you want to fire this aide, I think a nurse needs to be fired with her. There is no authority without responsibility, and a nurse needs to be held responsible. If you are just accepting the vitals from your aides at face value without any supervision of the task, or at least the hard earned trust of these aides, then you are abdicating your responsibility for the work that was done on your behalf.

This is the only way to fix this perverse-incentive structure that I saw all the time at nursing homes. You are far more likely to get in trouble as an aide for doing your job right than for taking shortcuts, as long as no one finds out about it. Generally, the only thing people really cared about was the workload, and doing the job right takes longer than taking shortcuts, which means you had less time for doing other things. Everyone is greedy at a nursing home, and not just in a nursing home, and everyone expects more from you than what you have time for. So shortcuts are taken.

That's what I mean when I say that the nurse is complicit in this. Heads need to roll in pairs.

As a certified nursing assistant, I completely disagree with this. As a nursing assistant your job is to assist the nurse in basic patient care and that includes vitals signs. Per your job description you are expected to be able to do task independently with little to no supervision while upholding patient rights and safety all of which includes honesty. Staff nurses in the hospital that I work delegate task within their scope of practice to the aides and are not responsible for the aide but for their patients, the role of supervisor falls on the charge nurse and even then charge nurses run the flow of the unit and disciplinary authority is completely in the hands of the unit manager. I of course would expect nurses to get their own vitals at some point within the shift as they have to give meds and should have recent vital signs to rely on. I agree that aide should be fired because that was a complete violation of patient safety and right. But the nurses should be getting their own vitals at some point within the shift.

[Snatchedwig, BSN, CNA, LPN, RN]

I take my own vitals anyways.

[AMLPN90]

This is why I take my own vitals! I trust no one!!!

[NutmeggeRN, BSN]

On 6/23/2018 at 8:31 PM, Sour Lemon said:

Came back? Are you kidding???

Warm body...