Told to fake vital signs

[gypsierose]

This question is for LTC nurses: I took a summer CNA job at a local nursing home that is chronically understaffed and has no equipment for taking vital signs. Maybe there was once an oximeter but nobody knows where it is. The nurse gave me a list of residents to get vital signs on and no equipment to do so. When I pointed out that there was no equipment, I told "the other aides do it- make it happen". Turns out the other aides just write down numbers and don't actually take vital signs. I've worked in some real crappy SNFs before but never have I been asked to fake vital signs. As a nurse, wouldn't that worry you that your aides are blatantly lying to you? Is this common?? Some of the aides have bought their own equipment but for the pennies they are paying me I can't afford that. I'm told asking management for equipment is a losing battle.

[Kooky Korky, BSN, RN]

Other than the watch, this opens a whole other can of worms. Who maintains the equipment? Who verifies that it's reading accurately and is calibrated per the manufacturer's recommendations? And why on earth should someone spend their hard earned money on something the facility has a responsibility to provide?

I don't know who will maintain it, but it's only for the summer, so should be OK. I guess she could ask the facility maintenance personnel to check it out.

Why shouldn't she buy her own equipment? She says it's hard to find nearby work and she wants to work there. I know it's not that cheap, but it's also not all that costly. For about $100, she can have her own equipment that she will take with her wherever she goes.

I agree that providing her own equipment isn't ideal, but many of us carry our own wrist cuffs for BP's, so why not the other items? And she is going to need a stethoscope eventually anyway, so get it now.

[Rose_Queen, BSN, MSN, RN]

I don't know who will maintain it, but it's only for the summer, so should be OK. I guess she could ask the facility maintenance personnel to check it out.

Why shouldn't she buy her own equipment? She says it's hard to find nearby work and she wants to work there. I know it's not that cheap, but it's also not all that costly. For about $100, she can have her own equipment that she will take with her wherever she goes.

I agree that providing her own equipment isn't ideal, but many of us carry our own wrist cuffs for BP's, so why not the other items? And she is going to need a stethoscope eventually anyway, so get it now.

There is just so much wrong with this post. Maintenance of equipment requires approved channels and the appropriate tools and resources. Someone bringing in equipment they've purchased elsewhere will not meet this- and maintenance may well decline to service the equipment.

Why shouldn't she purchase her own equipment? Because the facility has an obligation to purchase and maintain equipment necessary to provide care, in this specific case, the equipment to take vitals. A stethoscope is a separate category.

$100 is a lot of money to lay out that shouldn't have to be spent. In fact, expecting it is a way for the facility to continue shirking its responsibility to provide necessary equipment maintained in working order. Oh, and I'll bet that if your facility found out you were using your own wrist cuff on patients, there would be a big issue, again got my back to approved equipment and proper maintenance.

[saraleal22]

I have had this happen to me when I was a CNA...we would bring in our own equipment...some people refused to share so one of the nurses would let

me borrow the equipment they brought in, but the electric no cuff aren't very accurate there needs to always be a manual available and most def a pulse ox and thermometer....I don't know how those nurses handled that or maybe they didn't know they were being faked?

[No Stars In My Eyes]

TessLJ is right, you can count pulse and resp; as far as temp, it used to be acceptable to write "afebrile to touch" as long as you wrote down real temps most of the time.

I have seen an aide pull up the vitals clipboard, say "Let's see..." and proceed to write a set of numbers for each pt, not the same as, but close to the numbers recorded previously. And then hand it to the nurse, who was supposed to record them in the patient's chart! Duh! But never mind the legality of the issue, my fear would be the patient going through something that nobody was aware of that could be fatal if not caught in enough time.

There's lots of things that folks lie about in some LTC's, so that it will look good on paper in chart reviews, to get or maintain a 'good grade'. If you were truly able to see the short-cuts and omissions in some LTC's, probably the only ones being straight-forward with their work and charting would be the PT and OT's.

Understaffing is no excuse for the pt getting short-shrift, but the why do the powers-that-be not see what a stretch it is to expect employees to do it all, every shift, every time.

The compliant liars are only making their growing responsibilities and assignments look possible. They enable the management, so the numbers continue to get crunched and shrunken, because they see...oh, well, if they can accomplish all that, why do we need to hire more help? Ethics be damned.

I'm surprised that not more organic effluvia has accelerated into the intake path of the directional air-flow regulator and come spewing out in all it's stink and glory.

I'm 68 and I don't foresee anything happening in the my lifetime, to improve the situation. I would rather live in a box under an Interstate bridge than be subjected to that kind of 'care'.

[gypsierose]

I don't know who will maintain it, but it's only for the summer, so should be OK. I guess she could ask the facility maintenance personnel to check it out.

Why shouldn't she buy her own equipment? She says it's hard to find nearby work and she wants to work there. I know it's not that cheap, but it's also not all that costly. For about $100, she can have her own equipment that she will take with her wherever she goes.

I agree that providing her own equipment isn't ideal, but many of us carry our own wrist cuffs for BP's, so why not the other items? And she is going to need a stethoscope eventually anyway, so get it now.

I think you have no idea how little money I make. 100$ is more than a day's pay. No way no how. I've just been saying I can't do what there isn't equipment for. Its been working out for most nurses. I put my foot down and it worked. Asking CNAs to buy their own equipment is ludicrous when the company makes a profit off the residents and has been contracted by all of us to perform the duty of providing NURSING care to the residents.

[cjprenurse]

I'd report it because it's medical negligence.

[Kooky Korky, BSN, RN]

There is just so much wrong with this post. Maintenance of equipment requires approved channels and the appropriate tools and resources. Someone bringing in equipment they've purchased elsewhere will not meet this- and maintenance may well decline to service the equipment.

Why shouldn't she purchase her own equipment? Because the facility has an obligation to purchase and maintain equipment necessary to provide care, in this specific case, the equipment to take vitals. A stethoscope is a separate category.

$100 is a lot of money to lay out that shouldn't have to be spent. In fact, expecting it is a way for the facility to continue shirking its responsibility to provide necessary equipment maintained in working order. Oh, and I'll bet that if your facility found out you were using your own wrist cuff on patients, there would be a big issue, again got my back to approved equipment and proper maintenance.

$100 today is nothing. Maybe to a low-paid worker it is, but not in general today. Every item in the grocery is at least $3 - bread, milk. Do you remember when a 2 scoop ice cream cone was a dime? Chicken 29 cents per pound, gas 25 cents per gallon? First class postage 5 cents, air mail 15 cents? A pay phone local call 10 cents? Just saying.

Our aides take VS on everyone at the start of the shift. But by the time I give some of my meds, those VS are a few hours old. So I take a wrist BP and pulse with my own wrist cuff. It never occurred to me that the house Biomed folks should be maintaining my machine. I am rethinking the matter after reading this thread. My boss knows that a number of us nurses use a wrist cuff and has commended us. I do understand where you're coming from though.

What you say about the facility being obligated to provide equipment makes me wonder. I guess it does but I am wondering if there is a state or federal law about who has to provide equipment. True life is stranger than fiction.

[Kooky Korky, BSN, RN]

I think you have no idea how little money I make. 100$ is more than a day's pay. No way no how. I've just been saying I can't do what there isn't equipment for. Its been working out for most nurses. I put my foot down and it worked. Asking CNAs to buy their own equipment is ludicrous when the company makes a profit off the residents and has been contracted by all of us to perform the duty of providing NURSING care to the residents.

I understand your position. Congrats that you already have solved the problem. Sort of. So if you don't get VS, who does? Do you ever see nurses do them? Have you spoken to Management about this lack of equipment and the suspected faking of VS? You do still have an obligation to report.

You could still buy some equipment for yourself. You don't have to buy it all at once. Someone else posted that a BP cuff at the drug store can be as little as $20. They also sell cheap stethoscopes. And thermometers are probably fairly cheap, too. Perhaps my $100 estimate was high. And, as stated, buy 1 thing at a time. Or ask for them as BD or Christmas or other gifts from those who give you gifts.

[Rose_Queen, BSN, MSN, RN]

Kooky Korky, I really think you just don't get it. Lack of functional equipment should not become the financial burden of the staff. And I also don't think you understand that staff doesn't have the money to drop on things the facility should provide. With a nurse's salary, I don't have $100 to be spending on equipment to care for patients of the facility I work for. Is there a legal obligation? I bet if you went through all of JC and CMS regulations, you'd find plenty. And that doesn't even touch individual state DOH requirements. Your DON's commending staff for providing their own equipment that is not certified by the facility or properly maintained is mind boggling. Residents and patients deserve accurate assessments- including vitals taken by properly evaluated, calibrated, and maintained equipment.

[Annielpn2002]

This faking VS thing is wrong on so many levels- the nurse / nursing home should by law be required to give you the proper tools to do your job...this is dangerous because if you as an STNA at the time...were caught making up VS serious problems arise from that- no pt. Deserves that and no nurse should ever ignore that or ask you to do that! Report up the chain until it's fixed.

[CrunchRN, ADN, RN]

This whole thread just blows my mind. No way in *&^* should the CNA's have to buy their own equipment to take vital signs. I am very surprised that people are suggesting that. And faking it is just unacceptable on any level.

The administration needs to be held accountable to provide the services they are being paid for and part of that is having the needed equipment.

I would definitely report this place to the agency on aging, ombudsman, and whatever entity regulates this type of facility.

[bgxyrnf, MSN, RN]

As a nurse, wouldn't that worry you that your aides are blatantly lying to you?

Of course.

This nurse, though, has vacated her nursing ethics... and, when the inevitable bad outcome follows, will hang y'all out to dry for falsifying the medical records.

Were I in your place, I'd buy my own BP and SPO2 devices and use those.