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.
However, it is also possible that deep down they know they are being unfair, they know you have saved their butts from here forward, and they know you are doing the job properly and will continue to do it properly (perhaps because they scared you into it-- not saying that's true, but they might think it is). Therefore all will be well from here on, at least if you continue to do your job, and they will turn their attention to the other folks who screwed up in due time, perhaps even now.
Another theory is that they noticed that it had not been done and did not want state surveyors to cite them. So by wiring you up it appears they took corrective action and all is well, in their minds.
Specializes in Clinical Documentation Specialist, LTC.
Thank you all for the great advice and support.
I may have shot myself in the foot today. The other MDS nurse was doing her usual griping about the dates not meshing when she tried to close the MDS's that are behind because I WASN'T THERE TO DO THEM. Anyway, at around 3:00pm she asked me if I needed any closed because she had to leave. I told her I had a few but wouldn't overwhelm her since she was in a hurry to leave. I was rewarded with "Well hurry up. I have to go." She came to one MDS that for some reason the software was putting some random date in section A (resident identification). When I tried to remove the date, it kept kicking me out out the MDS screen altogether, which in turn caused her to huff loudly and state "I don't have time for this. I have to go!" When I tried to defend myself she cut me off, then told me I was going to "have to put her charts up for her because she didn't have time." By that point my face was burning hot I was so mad. I had a talk with the Administrator and the DON. Turns out they thought she had been keeping the MDS's up to date. I had three pages full of them I had done since the 18th of February which I showed the Administrator.
So the Administrator calls the corporate MDS nurse and puts her on speaker. The corporate MDS nurse then tells me the BIMS (brief interview for mental status) cannot be dated later than the ARD date of the MDS, which I know, but since I had just started and so many were behind, I dated them for when I did them. Now I have to go back to the ones that are not closed and either put dashes in the cognitive section indicating a BIMS was not done, or back date them from the time I started, and I really don't like the idea of back dating at all. Bottom line, the corporate MDS nurse took up for the other MDS nurse who had not done anything but her 8 part A residents. The Administrator even asked what the heck she had been doing all this time, and I told the Administrator there was no reason for there to be 3 full pages of MDS's that needed to be done when they had someone who could at least do a few of them.
My worry is that now I will have problems. The Administrator and DON are going to talk to her tomorrow and I have to share a teeny, tiny office with her. I can't stand animosity, but I have been nothing but nice to her. Today was the last straw.
Know what would be so crappy? If I'm terminated for dating the BIMS late and labeled a trouble maker.
Specializes in school nursing, home health,rehab, long-.
Been submitting resume's for the past week. I don't have a good feeling about the place at all.
Hello LTCNS,
You have been having a time haven't you...You go with your gut and get on out of there. Don't back date anything for these people. I wouldn't trust them as far as I could throw them. I hope you can walk away from them and the sooner the better. I'm rooting for you.
Specializes in Clinical Documentation Specialist, LTC.
Hello LTCNS,
You have been having a time haven't you...You go with your gut and get on out of there. Don't back date anything for these people. I wouldn't trust them as far as I could throw them. I hope you can walk away from them and the sooner the better. I'm rooting for you.
Thank you. I really appreciate that.
I sorta' kinda' threw a fit today. I had had enough and well...I basically told them all I was done. Ended up sitting down with everyone and hashing things out. Later, the other MDS nurse told me to be careful how I'm dating the sections when I'm doing them, because they can tell the actual date the sections were done. I do know this and have not back dated anything so I'm not sure what she's talking about. She said she noticed, as she was closing them, that some of my dates don't match
I think, when called into the office, many employees fail to realize that not signing a write-up is even an option.
Employers are seen as holding all the cards, unfortunately. Employees feel obliged to sign anything put in front of them.
People need to realize that signing a write up is more or less an admission of guilt. If you don't agree that you are guilty of what the write up says you are, don't sign it!
Specializes in Clinical Documentation Specialist, LTC.
I think, when called into the office, many employees fail to realize that not signing a write-up is even an option.
Employers are seen as holding all the cards, unfortunately. Employees feel obliged to sign anything put in front of them.
People need to realize that signing a write up is more or less an admission of guilt. If you don't agree that you are guilty of what the write up says you are, don't sign it!
Yep. Exactly. After I signed it I thought "I really do look guilty now" but I felt like if I didn't sign it I would have an even bigger target on my back. A good many employers don't even tell employees they have the option of not signing. Appears my whole backside is covered with a bulls-eye anyway.
Specializes in Gerontology, Med surg, Home Health.
Why all the drama over a write up? I would have commented on the form that I had only been there for 3 weeks and hadn't been given the time to read EVERY care plan in the building. I've been the new kid more than once....I was a new DON at one building when a few of the corporate chickies came in to tell me it was MY responsibility to find a summary that had been missing for 9 months....what?!?! Y'all have had the opportunity to find it, I've been here 3 days and you tell me it's my responsibility?!?
It's a write up...you know you did nothing wrong. You can either stay and carry on or quit and have bills piling up.
In my opinion, signing a write up is not an admission of guilt but rather an acknowledgement of the write up. The employee should always have the option of writing a counter statement on the form and I would encourage the OP to do just that.
Specializes in LTC,Hospice/palliative care,acute care.
Why all the drama over a write up? /QUOTE]
Because a write up matters to the nurse who really cares. It stays in that file and puts a target on your back. Even if YOU feel you didn't do anything wrong the folks above you didn't agree, hence the write up. If your facility follows a progressive discipline protocol that write up is given for pretty serious scenarios and if you make a misstep in the next few months you can be in for serious consequences.
I was written up last summer due to my involvement in a pretty serious allegation a resident made against the cna's. Despite the fact that I followed the policy as IT WAS WRITTEN AT THAT TIME I ended up with a written warning. First time in 25 years-you think I shouldn't have been up set and "dramatized" over it?
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nurseprnRN, BSN, RN
1 Article; 5,116 Posts
However, it is also possible that deep down they know they are being unfair, they know you have saved their butts from here forward, and they know you are doing the job properly and will continue to do it properly (perhaps because they scared you into it-- not saying that's true, but they might think it is). Therefore all will be well from here on, at least if you continue to do your job, and they will turn their attention to the other folks who screwed up in due time, perhaps even now.