[nursechick]

I was given the option of resigning, going PRN or being fired. I have never, in 18 years of nursing been fired. I was told that if I chose one of the first 2 options that I would be "safe", but that if I chose to be fired every potential employer that called for a reference "would get an earfull." I was put in this situation because...well, here's the story, edited to comply with HIPPA and confidentiallity . An alert and oriented resident, early 30's, that had been verbally and physically abusive to staff and other residents the whole time he was at our facility, pulled up the shirt of a confused resident. (I was reprimanded for charting on him in the past, as well as other staff. We were told what we could chart and what we couldn't by our D.O.N. and Administrator.) I was not witness to the incident. The treatment nurse was the one who saw what happened, I was the charge nurse. She did not tell me about the incident until 2 hours later and it was non chalant, like there was nothing to it. I questioned her more and she said she told him to stop and he laughed at her, she also said the little lady had a T-Shirt on under her shirt and that he did not physically touch her. The confused resident didn't even know what happened. I asked her to chart the incident. At the end of the shift after 2 crashing residents and multiple urgent needs with my trach resident, I realize she did not chart before she left. I then made an entry in his chart that stated, "As reported by..." and charted breifly what was reported to me. I was forced to write an incident report on something I never saw, the treatment nurse didn't. I was given the above option due to this incident and failure to write a treatment order, again something the treatment nurse was supposed to do. She was not reprimanded at all. I don't understand how I could be terminated when I first did not realize it was considered sexual assault, no one did, and I was not the nurse who observed the incident, and there was a department head in the building who also thought nothing of it and did not call and report it. Now I am jobless and broke, with 2 kids to care for. This is a small town, it has already gotten all over town and I have been threatened by the offending resident at my home. They also refuse to give me my pesonal items from work. Any advice on what to do or what maybe I could have done differently? I may not be the best driver, the best cook, etc. But, although not perfect, I strive to be the best nurse I can be and this is killing me.

nursechick

[nurse4eva]

Nursechick I can relate ! I have also had the unpleasant experience of another nurse witnessing an incident and not documenting then being held responsible because I was " charge-nurse".I also have been repeatedly told what I 'should and should not document" by an Administrator or D.O.N. I have been an R.N. 15 years and know very well the "leagalease" neccessary for documentation...objective not subjective..what was "witnessed by me" or was "reported"...etc...etc...I have also been threatened or terminated for documenting or not documenting because an incident was witnessed by another nurse and documentation was not done or done but not according to what the facility wanted.It is very demeaning and I felt I was treated unfairly..My suggestion is this: 1) Always do an incident report according to facility policies 2) Always do an assessment on the resident/patient 3) NOTIFY the DON or administrator immediately 4) NOTIFY the physician 5) NOTIFY the resident/patient medical POA ...then chart objectively what was reported ( never never put staff names in pt record) CHART ONLY facts ....your assessment of the resident/patient...physical and cognitive status...complete the incident report and give it to the responsible administrative staff. They must also report an incident of this sort to State authorities.Anytime resident to resident physical contact is made it is imperiative that you as a professional nurse report the incident and follow the state requirements for reporting as you can be held legally responsible for neglect.I understand your point that you did not witness the incident however you were the "charge nurse" and ultimately responsible for implementing the appropriate documentation and notifying the appropriate persons.Protect yourself and your patients first and foremost.Also document what you did to prevent further contact between the residents...be specific and follow through to ensure no further contact is possible.We get overworked and overloaded but as you say you want to be the best possible nurse so to do so we have to be willing to take the time to follow a situation through.I hope I helped you and believe me I fully understand. The employer cannot disclose an "earful "of anything or they can suffer legal consequences and although you sign a release of information employers avoid giving detrimental information...they may simply say you are not eligible for rehire to a prospective employer.You will be able to work again so don't give up.My experience taught me a valuable lesson and I always document and follow through on any incident.

[MissPiggy]

.My suggestion is this: 1) Always do an incident report according to facility policies 2) Always do an assessment on the resident/patient 3) NOTIFY the DON or administrator immediately 4) NOTIFY the physician 5) NOTIFY the resident/patient medical POA ...then chart objectively what was reported ( never never put staff names in pt record) CHART ONLY facts


Excellent advice - I would add 2 things, though; 1) make a copy of the incident report for yourself, as they sometimes tend to disappear if they are not in keeping with how administration would like to appear, and 2) never never never mention one pt. by name in another pt.'s chart. I learned this the hard way after being fired because of an incident report I wrote that said that said that admin refused to give me adequate staffing for a shift in which a pt. fell and sustained an injury... Good luck and remember that nurses are always in demand elsewhere; at least you have a license to use.

[JOB]

I realize the original post is 10 months old, but it shouldn't be too late to contact an attorney that specializes in employment.

[starlingcv]

I just said a prayer for nursechick.