We're supposed to take care of the pt 1st, right?

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Specializes in Ortho/Trauma, Oncology, Hospice, LTC,.

I have been reading alot of the discussions and can't seem to find someone with a similar situation. You see I was recently terminated from my employer at a nursing home for what I was told was "blame charting". In this instance, a woman was discharged before my shift that evening to home under the care of a home health agency. The woman was IDDM and had frontal lobe atrophy and was definately not able to care for herself. I recieved a phone call later eve (naturally 15min prior to 5pm on Fri eve) stating the home health agency had not been there to see her or had even checked in. We had known for 2 weeks that she would be leaving, and were not instructed to do any pt teaching, which made sense because of her memory. Of course the home health facility she was going to was did not provide the extensive care she required and happened to close at 5pm that day and did not open again untill mon. 9am. Long story not so long, her Dr. and I decided the best thing would be to bring her back and readmit her and then, with appropriate pt teaching to her husband and sending her medications, under facility policy we could allow her to go home. Which is what I did, all amazingly done within an hour and a half! She left smiling and thanking me (she very much wanted to go home) I contacted the facility administrator, and notified him of the decision-which he said was ok and then I requested an alternate phone # for my DON when she could not be reached on her home phone (of course there was not one, but we're supposed to call her for emergencies). At the end of the shift I did finally get a hold of her after and notified her as well. I expressed my concern that she was not contacted by her home health, and the DON stated that the social worker had told her that the resident was supposed to have set it all up because they would not let her (the Social worker) Which seems like a bogus excuse due to the fact we are transferring care. So I documented roughly a page and a half, including a complete reassessment with VS and details of the "transaction" complete with quoted statements from all parties involved. I also did enter the fact that no home health could be contacted and that assessment by the home health should be done to assess her needs before discharge.Figured I made everyone happy and still kept everything in the legal realm. Well apparently not because I recieved a call from the DON terminating me because I was deemed a "liability" by the corporate consultant reviewing the chart. I have worked there for 5 years and not once recieved any reprimands and had recieved outstanding evaluations. I know it's a right to work state but can they really terminate you for being honest? Another nurse I worked with stated a week before that they made her re-chart something 4 times to "get it right" And now I'm concerned because this goes on my employment record as a termination. I have never been terminated before ever in my entire life. What do I do? I am trying to find employment now and don't know if I should tell them if they ask why I was terminated.

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I wonder why your story sounds so familiar to me. You have been goated and must just move on. Think over how you will approach this at interviews and just go elsewhere. Do not make the same mistake as myself and spend too much time whipping yourself over the situation. You did your job as you saw it needed to be done and are paying the price. I for one commend your actions, however, I've no power to help you get employed elsewhere. Good luck in your job search.

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Specializes in LTC / SNF / Geriatrics.

From what you've described, it sounds like you did exactly what you needed to do for the resident and family. Discharges are supposed to include continuation of care and it sounds like that is what you did. Good Job! Unfortunately, something sounds fishy at the higher up level. ("recharting something to get it right?") Given your level of integrity, I don't think they deserve you.

There is something better out there for you. I agree with caliotter3. Don't beat yourself up over the problems of that facility. Find one where they appreciate honesty and integrity.

As far as what to say in interviews as to why you were terminated, that could be tough without finger pointing back at the other facility. As an interviewer, a red flag always goes up when an interviewee starts bashing a former employer. :lol_hitti Maybe start with all the things you loved :redpinkheabout your job for the time period that you were there and end with something to the effect that you were terminated due to a difference of opinion between yourself and the company. What do the rest of ya'll think?

Good luck and God Bless shug:icon_hug:

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I agree with Rizpah and was going to suggest that you state that there was a difference in opinion that led to your termination and to try not to go into too much detail. Again, good luck.

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Well apparently not because I recieved a call from the DON terminating me because I was deemed a "liability" by the corporate consultant reviewing the chart. I have worked there for 5 years and not once recieved any reprimands and had recieved outstanding evaluations. I know it's a right to work state but can they really terminate you for being honest? Another nurse I worked with stated a week before that they made her re-chart something 4 times to "get it right"

I think you should get a consultation with a lawyer who specializes in employment issues and then perhaps you should report this to the BON and the appropriate agency that oversees long-term facilities in your state. Sounds like they are engaged in some fraudulent activity here...

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Specializes in Urgent Care.

My guess is that someone higher up in your organization (DON or someone else?) is pals with the HHA. When the doc/family/whoever got on the HHA then sh*t rolled downhill to you.

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I wonder why your story sounds so familiar to me. You have been goated and must just move on. Think over how you will approach this at interviews and just go elsewhere. Do not make the same mistake as myself and spend too much time whipping yourself over the situation. You did your job as you saw it needed to be done and are paying the price. I for one commend your actions, however, I've no power to help you get employed elsewhere. Good luck in your job search.

goated?:uhoh21:

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I don't know exactly what you wrote but you struck a nerve with someone.

No, do not go into detail when you apply for jobs now. Just say as little as possible, in charts and in interviews.

It's time for a change. I'm looking for a growth opportunity. I need to stretch my professional wings. Any type of BS like this. And it is all BS. Unfortunately, we have to work so we have to BS and do the dance.:monkeydance: Just relax a while before you resume the fight.:smiley_ab Your DON :jester: sounds dangerous. It would be nice if she would explain exactly why she is angry and what it is you wrote that made them get rid of you. Re-charting to get things right - I'd love to know what that nurse wrote, too.

Best wishes. You will find a nice new job. Apply now for Unemployment Compensation. Yes, you ARE entitled to it.

Are you sure you're in a right to work state? There are only 2, I think. Florida and _______.

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Specializes in I think I've done it all.

This is the only problem that I could see in your post:

""" I also did enter the fact that no home health could be contacted and that assessment by the home health should be done to assess her needs before discharge"""

You cannot chart what you think someone else should be doing, you can only chart what you see and what you do. You could chart for example "home health assessement not seen or found on chart" or something to that effect that states basically the same thing but you can't put it in your words of what you think should be done.

Having said that, it's small potatoes, really and I would be talking to an employment lawyer if only to get the termination label removed from your record. You did what you needed to do to see the patient safely taken care of, you informed the administrator, could not get ahold of the DON so you did follow the appropriate chain of command. I think you did a great job, and am so sorry you had such a terrible outcome.

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Specializes in Rehab, LTC, Peds, Hospice.

Basically they don't want you to chart anything a lawyer could use to blame the facility for. I do question the fact that no patient teaching was done for the family prior. Our home care nurses make 'visits' a few times a week, which has always concerned me when we d/c people home. Having worked as a private duty nurse that did do shift work, I still always make sure people are aware that they will not always have coverage and will need a 'back-up plan' ie: stay home and take care of grandma theirself.

I'm so sorry about you being fired! I'm pretty sure that it is illegal to alter the chart however; (as that other nurse did) and you may be better off working for a more ethical employer. Good luck to you!

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Specializes in Clinical Research, Outpt Women's Health.

Shug,

That totally sucks. What a system we have. I would call them back and tell them you want your record to reflect that you resigned. Just ask them. They may give that so you cannot get unemployment. At least that way nothing is on your record.

It is totally wrong what they did, but sometimes they hold all cards and you are just screwed.

Texas is also a "right to work" state, but unless you are in a union they all really are when you come down to it.

All the best,

Kim

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Specializes in er/icu/neuro/trauma/pacu.

Best of my recollection...HHA can't see pt on day of discharge-not billable, we always saw pt next day to do intake/admit. HHA can see and eval pt prior to discharge so to have everything in place. No patient should ever be discharged without instructions, and a pt is not transferred to HHA, they are discharged and HHA is providing some services to them, pt/family will need to give meds, transfer to toilet..whatever it takes. Nurse can set up med box and perhaps they qualify for an aide to bathe a couple times a week, but incontinence etc falls to the family caregiver--Hospice can provide some heavier care, but 24/7 care is self pay or back to the LTC.

Your charting was litigation fuel or at the least State survey ammo. Perhaps something along the lines of ..Pt returned for clarification of home regime, meds,wound care. Husband present, instructed and return demo given with good understanding verbalized. In a separate narrative or even a variance report I would of listed the rest of it. And verify when HHA will see a patient before thay are discharged so the family will not be frantic or confused.

You should not have been fired for this, you should have been counselled unless your charting has been questioned before. You could fight this, I am sure you have a mediation/greivance process in place at your facility, do not ask for your job back, instead ask to have your dismissal listed as voluntary and 2-4 weeks pay, since you should have been warned or placed on probation and that would have been 30 days. You don't need a lawyer for that, but if they are not providing you with some satisfaction by all means call one, and let them know that is your plan.

Good Luck

When applying for the new job, personal differences is acceptable as a reason. Don't give any administrative people as ref, and ask your charge nurse or house supervisor if they will give you a personal ref.

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