What do I do now?

[Bellalynn]

Okay, this is my first time "posting" so please bear with me. I have a couple of issues and questions that I'm concerned about.

I work in a LTC facility, and I have had some issues with the quality of care the residents have been receiving i.e. briefs left behind beds, residents left up after meals sleeping in their wheelchairs, beds being made even though the sheets are dried in urine, hands not getting washed prior to serving meals, residents that smoke being taken out to the smoking area and smoking a cigarette while wearing their oxygen or having it placed to the side, narcotics coming up missing, residents complaining because of this or that, pills not being gave, etc. I spoke with all of the management including administrator, don, adon, etc. They say action will be taken or make an excuse for any issue that "arises". I feel like all of these problems are being pushed under the rug, so I called the state inspectors. They asked for my name, which I gave to them. They also asked about any specific residents, and I did give them one residents name...(first question) IS THIS A HIPPA VIOLATION? I asked if it was prior to giving the resident's name & the lady told me it was not so I proceeded. I am now feeling somewhat guilty for calling the state rather than the obundsman or corporate first. However, I want people to have repurcussions (sp?) for how they are providing care to the residents, and that is not happening. I was at a dead end, and I feel I did the right thing in my heart. But now I'm worried. Will I get into trouble for waiting to see if the administrator or don would take action before I called state? Will I get reported to TBON? Also, do you think anything will happen when state investigates? It seems like the facility was on their best behavior when they were expecting survey, but after the surveyors left, they stopped doing their jobs. That is how I feel.

[NurseNightOwl, BSN, RN]

Based on what I have heard from others, the main repercussion is the fallout at your facility, because I *think* the facility has access to an official report when state comes to investigate, and that includes the name of the person who provided them the information that caused them to investigate. Although those conditions sound awful, it's an unfortunate fact that, especially in smaller areas, word gets around and employees who "call state" are seen in a bad light not only by the admin of the current facility, but others nearby as well when you go to try and work somewhere else. For example, there is an LPN who works at my facility now who called state about the last place she worked (which is now closed, btw) and she is seen in a negative way by many because of this, and likely she would not be working here except the need for staff is so bad right now.

[LadyFree28, BSN, LPN, RN]

* I spoke with all of the management including administrator, don, adon, etc. They say action will be taken or make an excuse for any issue that "arises".*

I am confused, what did management mean by this??

I feel like all of these problems are being pushed under the rug, so I called the state inspectors. They asked for my name, which I gave to them. They also asked about any specific residents, and I did give them one residents name...(first question) IS THIS A HIPPA VIOLATION? I asked if it was prior to giving the resident's name & the lady told me it was not so I proceeded. I am now feeling somewhat guilty for calling the state rather than the obundsman or corporate first. However, I want people to have repurcussions (sp?) for how they are providing care to the residents, and that is not happening. I was at a dead end, and I feel I did the right thing in my heart. But now I'm worried. Will I get into trouble for waiting to see if the administrator or don would take action before I called state? Will I get reported to TBON? Also, do you think anything will happen when state investigates? It seems like the facility was on their best behavior when they were expecting survey, but after the surveyors left, they stopped doing their jobs. That is how I feel.

Anyone can make a report to the state, and yes, they have to take a name to make sure that there is a founded concern; it's a SERIOUS issue to report to the state, and they need the patient's name. I'm not sure if you have anonymous corporate reporting, if you wanted to report it anonymously, that would've been an option, as well as the ombudsman; however, is there a reason why you decided not to go through those channels-was it neglect or abuse that you suspected?

You state that you should've given your management time to handle the issues-my question was how long from the time you reported your concerns to management that you called the state?

I'm just trying to understand where you are coming from in terms of reporting to the state, the timeliness in where there wasn't action in addressing your concerns.

Residents sometimes bypass management and call the state; sometimes for billing issues or not getting cranberry juice (TRUE story ), they even call the cops. The possibilities are your issues getting addressed to another talk with management and some action against you happening; they can't report you to the BON for wanting issues to be addressed; if they tried, the BON would be looking into the intent on the person reporting it.

[KRSLPN, LPN]

In your post you don't mention the length of time between the time you spoke with mgt and when you made your report to the state. If it were only a matter of days, I would think you should have given them a little more time to attempt to resolve the issues you spoke of.

As far as what will happen when the state investigator arrives and makes it known to mgt that there was a complaint and IF it is revealed who made the report, in my opinion I would say, putting it simply, mgt is NOT going to view you in a positive light.

[CapeCodMermaid, RN]

How do you know management wasn't in the process of correcting these issues? I have staff come to me with issues...sometimes it's about writing someone up. I always tell them that I am not obliged to discuss anyone else's discipline with them.

If you reported something on a Tuesday and it wasn't fixed by Wednesday, you shouldn't have called the state. That is really an over reaction and doesn't inspire good feelings about you.

[LaRN]

some of the issues you mention are serious, such as the oxygen in use while smoking (if I understood correctly), and the unsanitary conditions, geesh !

Dept of Health only informs the facility of what the complaint is about, they are not supposed to reveal your identity. but that doesn't mean they won't find out or suspect that it is you, especially since you've made the same complaints to management already. supposedly you are protected from retaliation for up to 180 days after the complaint. just never admit or tell anyone (at all) that it was you.

your facility should have reacted to your complaints with an investigation and facility wide education, (esp the 02) and I hardly think a few write ups would've resolved anything. If a fire ignites due to a patient smoking with 02 going, it will be the NURSE that the state points the finger at, and your facility will join in on that finger pointing. I've seen things very similar to this play out exactly like that, such as being forced to work shorthanded with new cna's and cna's who didn't do their jobs which directly resulted in a serious injury to a patient. Nurse fired right away, no questions asked.

[Bellalynn]

I gave the facility over a month to fix the issues, the issues just kept getting worse. They had over four weeks to fix things that needed fixing & I never saw any positive progression, so I called state. I was terminated the day after state came into our building. I was told that they no longer needed me because my position wasn't necessary. State has yet to call me with a follow up related to the results of the investigation, so. As for me calling state and other facilities looking down upon that when word gets around...I beg to differ because I know work right down the street & I feel by calling state it will at least earn them a poor reputation so people will be hesitant to admit their loved ones to a neglectfully ran facility when there's a five star one right down the road. I feel in my heart what I did was the right thing because every resident deserves a decent quality of care.