Written warning for a care plan written prior to my employment

Published

Specializes in Clinical Documentation Specialist, LTC.

I just started my new job as a MDS nurse with this facility 3 weeks ago (Have 15 years MDS experience) and this morning I was called into the DON's office and given a written warning over a care plan that had not been changed to reflect this particular patient had had both legs amuptated back in September, so another MDS had been done since then AND another care plan, but was not updated to reflect this change, nor was a significant change in status done.

I signed it, stated I understood, and just went back to the office and cried. Maybe I'm making too much out of it, but I fail to see why it is my fault that this care plan had not been updated for 5 months.

I guess I just needed to vent. Moving on and trying to stay out of trouble.

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Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.

You got called to the DON office after 3 weeks over a care plan that was unchanged for 5 months? I'd be REALLY angry....actually I'd be $$$$$$ off.

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Why did you sign this???

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Was this an actual CP/MDS reviewed by you (in your first three weeks), or had you not even seen it yet?

If you yourself have not even reviewed it yet-- being so new-- I can not see why you are being held responsible.

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Specializes in MDS/ UR.

If it went through schedule rotation in the last 3 weeks and you missed it than I would agree.

However, it sounds like it has not.

I would protest that write up.

It sounds way screwy to me.

Do you have a consultant you can speak with?

I would walk out the door if they did that me.

Good luck,

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Specializes in Emergency & Trauma/Adult ICU.
Why did you sign this???

Agree -- why on earth would you sign this and go back to the office and cry?

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Specializes in Pediatrics, Emergency, Trauma.

I am curious as well. :specs:

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Specializes in Clinical Documentation Specialist, LTC.

Yes, I signed it like an idiot. I was basically told "It's your problem now. You inherited it." I do understand their logic. I really do. I just don't understand why it's just now an issue when it should have been addressed over 5 months ago.

They were two months behind when I started, and this particular MDS is just now due, so although I have only skimmed through the care plan, I have opened the MDS in the system and have interviewed the resident. I just don't understand how it wasn't care planned the day he came back from the hospital after having both legs amputated. The nurse who had him, the DON, the Unit Manager? Why wasn't a significant change done then by the other MDS nurse? Why wait all these months? I'm just trying to wrap my head around the reasoning.

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Specializes in Clinical Documentation Specialist, LTC.
You got called to the DON office after 3 weeks over a care plan that was unchanged for 5 months? I'd be REALLY angry....actually I'd be $$$$$$ off.

I was quite $$$$$$ after I stopped crying and it really hit me as to what had just happened.

I wanted so badly to just get my stuff and go to the house, but I just can't leave right now. Too many bills unfortunately.

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Specializes in Med/Surg, Ortho, ASC.
Yes, I signed it like an idiot. I was basically told "It's your problem now. You inherited it." I do understand their logic. I really do. I just don't understand why it's just now an issue when it should have been addressed over 5 months ago.

They were two months behind when I started, and this particular MDS is just now due, so although I have only skimmed through the care plan, I have opened the MDS in the system and have interviewed the resident. I just don't understand how it wasn't care planned the day he came back from the hospital after having both legs amputated. The nurse who had him, the DON, the Unit Manager? Why wasn't a significant change done then by the other MDS nurse? Why wait all these months? I'm just trying to wrap my head around the reasoning.

In my opinion, you're trying to get your head around the wrong issue. What transpired to allow this situation is their issue, not yours. The only way it is your issue is in going forward and preventing a recurrence.

If I were you, I would revisit the issue of your signature. State that you felt unprepared and under significant duress and signed under those circumstances. At the very least, fight for an addendum to the file AND to your personnel chart, outlining the timeframe of the mistakes and your acceptance of responsibility.

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Specializes in Clinical Documentation Specialist, LTC.
In my opinion, you're trying to get your head around the wrong issue. What transpired to allow this situation is their issue, not yours. The only way it is your issue is in going forward and preventing a recurrence.

If I were you, I would revisit the issue of your signature. State that you felt unprepared and under significant duress and signed under those circumstances. At the very least, fight for an addendum to the file AND to your personnel chart, outlining the timeframe of the mistakes and your acceptance of responsibility.

This is great. Why couldn't I think of that when I was handed the write up? :o

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Specializes in Med/Surg, Ortho, ASC.
This is great. Why couldn't I think of that when I was handed the write up? :o

Because you were under duress :sour:

This is why you came to us - to help re-orient you to the appropriate action.

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