Loyalty to the nursing home or the patients?

I think what’s going to happen is that once it’s put together in a nice PDF, a report about the health department’s wheelchair visit will go up on the Israeli health department website for all the world to see and it’s not going to look to good.

However this was really cutting corners too far in my opinion. I understand we all want a luxury car and vacations in Europe, however I think this manager needed a kick in the butt. Or a new career.

Well now you know they aren't anonymous as you thought. That sucks. Sorry that happened to you! That is basically getting workers in trouble for reporting, and furthermore not taking care of the problem. No one will ever call again knowing that! Dept of health doesn't have to do their job by getting workers in trouble. Problem solved, case closed. That person probably didnt want to do their job. Or manager found out thru phone records it was you. Or asked who said something about the wheel chair and someone told, or overheard you call.

You should not do the transfers, or say you cant bc you hurt your back and need help or use the Hoyer. Or what if you refuse on the grounds of safety?

Maintenance should be able to fix the wheel chairs to make it safe for staff. I dont know why they cant? I've seen them put wheel chairs out of commission and use others. I didnt see them fix it, but I know the wheel chairs came back fixed. Eventually. Might take a week. They should take care of that. Can you talk to the charge nurse, or call someone from maintenance? That's their job. It's usually not a hard fix either.

I can guarentee you if the elderly person falls you will be written up and responsible. And if they break anything bc their bones are like tissue paper, the families and bosses will blame you.

Tell the charge nurse/supervisor you cant bc there are no brakes on the wheel chair. Cant use it.
Usually nursing homes have rules about moving residents, and asking for help is allowed. Or chart pt is too unsteady and falls risk today. They have to report when a resident falls. They dont want falls.
I dont understand why they dont let you get help?
Ive had training where they tell you to slowly lower/brace the person to the ground. 100-150lbs of anything will fall quickly, not in sloooo-moooo. (Like they pretend) And then add in a tissue paper frail adult. I cant hold 100lbs up and guide it to the floor slowly as its falling away from me. Even with a gait belt. Try it sometime. Not as easy as it seems. This happens in a split second. Add in a person who has dementia. They could decide they are 6yrs old and going to go to the ice cream truck in their mind. You never know.
I also heard of a well respected PT dropping a very frail 93yr old while doing pt. That day she just collapsed. He had worked with her for weeks. Family was in an uproar. Like he did it on purpose? No. He was distraught over it as was everyone. People can get dizzy and faint. They can also get equilibrium /inner ear problems out of nowhere. She broke her hip. It was an accident. They do happen. I can guarentee you elderly pts get unpredictable.
I saw an elderly gent get up and lock himself in the bathroom and fell. They got a key after that. No one had ever done that b4! He was in PT/OT waiting for transport back to his rm. He could walk short distances.

My dad fell mult times out of bed. He forgot and thought he could walk. Muscles to frail to walk. He actually fractured his skull while in a very big hospital. They werent even going to tell me. No one was around when he did it. He also rolled out of bed sev times. It happens. Not everyone automatically at fault, or didnt care. I dont think nursing staff wants fractures and death on their conscience. Most people dont.

If they continue to hassle you about the quick transfers, refuse to fix the wheel chairs. I'd have to find a place that will help the workers and get the wheel chairs fixed. They should have extras on standbye. I dont know why they dont. Sometimes even PT or OT will fix if if they want to. Depends on how they are personally. They could make the phone call if you cant. You should be able to, but depends on the site culture. I could have told my boss in recreation svs and she would do it. I could pick up oh and call.

If your manager is that crappy and cant be concerned with safety issues, I'd RUN. Dont understand why they cant fix a wh. chair?

I was asked by the marketing person in my mother's nursing home to post an evaluation of the home, because they "had received a few negative ones recently". I am willing to do so, but I asked why it would be assumed that one I wrote would necessarily be positive, and the answer was to the effect that I seem "easy-going" and friendly. However, just as I was when I was a graduate teaching assistant, I take any kind of grading task seriously. There are a few issues that bothered me, and she said "well, maybe you shouldn't write one". I have no grudge against them, but I won't just rubber stamp an "A" if I'm not convinced it is deserved. I told her I'm still thinking about what to say. Frankly, I don't know what the norm is among nursing homes--that is, are they normally very well run, or simply a couple steps away from a disaster--thus I'm not sure what would be considered "average". To her credit, she is being attentive to issues I present, one being that items my sister and I bring for my mother seem to disappear in spite of the fact they are well-labeled with her name.

Protecting the patient should always be your priority. Having said that, you should always try to follow your facilities chain of command first. There will be some exceptions to this rule. Also, always be professional in your interactions with facility management. Also, do not reach out to other pt family members unless your assistance is requested. It is never ok to discuss one patient with any other patients family. If they make a safety issue report to you, first ensure the patient is safe then direct the family to the person who can handle the issue. If possible walk them to that person. Make a note for yourself of date, time and your actions to protect or and assist family. You will need to decide the level of immediate or past danger based on the event. Report to the RN you are working with that day. Keep a personal log with dates and times and who you reported to. Keep specific patient identifiers to a bare minimum.
If your DON and facilities director do not appear to be working on the problem, report to the appropriate facilities outside your place of employment. Good record keeping of event, and person reported to will help with investigations and will help protect/prove retaliation from your employer if needed.
Good luck and always just do the right thing.

I could never leave these patients without fighting for thier safety, so I believe in documentation; a paper trail, beginning with your Supervisor and on up the chain, allowing them to fix the issue. This may be what is what is meant by loyalty. You would want someone to come to you if they had an issue with something you said or did, rather than report you, correct? Fix problems at the lowest level. If they are ignored, you'll have ammunition to send to all governing oversight agencies. A safety issue should be fixed soon (like same day!). If able, look for another job if you cant put your own safety the patients' wellbeing first. A call to the local news station just may light the fire and shed some light on the situation, prompting proper attention to the faults of the facility, for the residents sake.

Given that this is taking place in different country from where I am I can't speak to the proper "legal" steps but my basic approach in general would be, report the problem (dangerous wheelchairs) to my direct supervisor, if no response in a day or two even just taking the chair out of service or checking all chairs for issues and taking dangerous ones out of service until they are fixed reporting the situation to the director or whoever is ultimately in charge. In the meantime I would check each chair before thinking about using it and if the breaks don't work insist on a second person to help make any transfer to or from it. This way you have followed the proper channels, made the proper people aware of the issue and are taking care of the patient as well by making sure each transfer is as safe as possible. If the business hierarchy drags it's feet fixing the chairs maybe having 2 or more staff tied up each time doing these transfers (probably should anyway but...) will push them into fixing the equipment. I can't imagine how they could justify stopping you from insisting on help when you are using the broken equipment after all you are covering their butt's as well as keeping your patient safe and it would be hard to make a case for requiring you to stop the practice without fixing the chairs. Now if they do give you a hard time about this and don't fix the problem then they probably shouldn't be in business anyway and that's when I would go to oversight authority.

If you had dropped the patient, I fear that your manager's first action would be to fire you. However, there is an order to things. There should be a system in place to request a chair repair or replacement in writing. A copy should also go to the patient's social worker. Did you do that? I would always document the problem in writing (keeping a copy for yourself) and follow up on it. The safety of the patient comes first and foremost. If anything should happen to a patient, the facility may be ordered from the state to not take any new patients or possibly be shut down depending the severity of the violation or the number of violations. Functioning wheelchair brakes are incredibly important to patient safety. With written documentation, you are also protecting yourself.

Well, it's logical to start with the manager of the facility. How else will you get the situation fixed? Don't go over his head until you've given him a chance to fix it. If that doesn't help, is there a higher level supervisor or owner? Unless somethng "urgent" is happening, go through the line of command first. But make no promises of silence. You could be legally responsible if something happened as a result.

Having worked as a geriatric social worker for many years, I would say report to the ombudsmen for your state's department of aging as well was the administrator of the facility. If the problem is not resolved, I would report to the owners of the facility or the corporate office. I'd then report to the state department of health. Please use a mechanical lift with yourself and another person for safety.

Jacob,

Allow me to tell you what happened to me when I reported neglectful "care" of my Mom and harassment of my Dad and myself when we'd visit her.

I reported a gross event of neglect to the Department of Health and with the Office of Health Care Workers AFTER raising many concerns about my Mom's care, previously.
The nursing home staff LIED to the DOH nurse, who was investigating the case - said they had to call the police on me for disturbing the other residents. The DOH nurse dropped the case.
Also, the nursing home went to my sibling (who had health proxy), lied to him and got him to agree with the nursing him to ban me from the nursing home unless I signed an agreement which limited my visiting time with my Mom and that I could not take her off the floor. ( this sibling rarely visited and was resigned entrust Mom's care to this facility without question).
My Mom died July 15th. The nursing home staff did not alert my Dad she was in the last stages. We would have removed her into a hospice situation where she would be properly cared for and have family around her. She died in a hospital gown covered by a thin sheet and alone.
I had tried to contact grassroots organizations and legal services prior to this - but because I do not have POA - was told there was nothing they could do.

That is what happened, in my case. I've since heard of similar experiences.

If you have any suggestions of what I can do to effectively report the nursing facility, please let me know.

Thank You.

Personally, I would never work for anyone I couldn't respect.
While it's true that your manager might have been told the same thing you were told - I refuse to do the wrong thing. I reported when there was falsifying about the county monies and how they were being spent. I lost my job but I kept my integrity. Later the person who was lying lost her 43 yr old husband while we found the cancer in my 80 yr old husband and he lived another 26.5 years.

Lying and falsifying records is wrong. If you have no integrity, what is left?

However, be very aware that sometimes doing the right thing has bad consequences. Like losing your job. I was fired at Christmas but my then 75 yr old DH was wanting me to be home with him - so I quit working at the age of 45 to be with my hubby and never looked back. Not everyone can afford to do that.

Good luck to you.

My Daughter works in a rehabilitation hospital. When she sees problems she First tries to get it taken care of... if no results then she reports. You know if something happens they are going to blame you.... report in writing. And keep a record of it. Also.... as my Daughter says..... these peoples lives are in your hands.... it seems to me that you are a very careing and professional nurse..... like my Daughter is. Hang in there God bless you.... and thank you for all that you do

Contact the Department of Health again and ask why your boss was given your name. Tell them what you were told and ask them what sort of reprisal they think you would face if they violated your anonymity again. If the DoH isn't tattling, make your phone calls somewhere else and don't tell anyone. Your boss is, of course, wrong. The situation you saw could not have been new (your normal way of moving patients is long-standing and wrong); had he wanted to fix things, he would have. However, it's good to document problems. Every problem you see, email him and print a copy of the email and his response. If he does nothing, call the department of health again.

With any job you should do your best to have a problem corrected within first.
You contact your supervisor if there is a problem.
If the problem continues or gets worse then a call to the State Regulatory Agency or the Ombudsman would be the place to start. Local Health Departments do not typically inspect Nursing Homes other than inspections they would do for Kitchen and any Food Service area, Water testing if the facility is on a Well. the facility is licensed by the State and they would be the ones to follow up on any complaint. The only other time the Local or County Health Department might be involve is when there is and outbreak of a communicable disease TB, Scabies, Bed Bugs (I know they are not a communicable disease but they are a nuisance), Noro Virus or other Food Borne Illness.

I think it’s best to use lift machine..if they have stand assist lift or use 2 person assist transfer. Never transfer by yourself. If it was my mother & found out what happened...because I went every day & if I saw only one CNA come out of her room..I’d ask why. They always used they called it a Sirita lift ...& then later on hoyer. When I took her home, we use lift machine. She don’t walk or stand. However, If you’re an employee, you must follow rules on how to transfer what’s in their care plan. If unsure, ask at Nursing station or if they don’t want to tell you, ask Supervisor what is in care plan to transfer the patient. Also tell Nursing station about any broken equipment.

Get a new job at a better facility or in another profession.

It's generally best if one has a problem with anyone or anything to first approach directly to try to resolve it. But, if threatened, ignored, invalidated or blown off, not hesitate for a minute to report it to the Health Dept. Social Services, post it on social media and make it known on Yelp and Nextdoor.com. Nursing homes are notorious for subpar standards and over the top expense. As a caregiver, you can be injured, particularly with what you reported. You might want to look for another facility to work . Your first loyalty is to take care of yourself. Thank you for looking out for your patient's best interests, your facility sounds like it is in neglect and denial.

Always ( and I mean it!) make your complaints in written, and make a copy! This way you will have a chance to show your manager, that he is lying ( or forgetful) about not seeing previous complaints! And, by the way... not only patient could of suffered injuries in your case, but also your back!..... do not forget about your own safety!

You already know the answer to your question.  It is YOU that will pay the price if you "let it go".  If the manager "knows" you made the complaint, then there is no "anonymous" with the health department.  I doubt that was the case.  Someone else has laid the blame on you while they remain in the shadows.  If the Manager is TRULY the manager, then the manager ALSO knows the answer.  The answer is patient responsibility and patient safety and patient care.  Without the patients, there is NO facility.  They KNOW this.  They also know that a complaint to the authorities points out their weaknesses about them.  That is what they fear.  I would fear for my job and continuation of my licensure before I would fear for the facility.  There are TONS of facilities out there, not this single one.  Get a different job with a different facility--one who is loyal to the PATIENT who is first and foremost.

I would tell him first and if not taken care of / move it on up!

Jacob,
I know that ultimately no one has come up with the PERFECT answer, the one that will work now and in the future, but sure do appreciate the thread of this discussion with so many thoughts incoming. Hope you will keep posting to the forum things you see, things you think about, things that should be food for thought for those of us who have people we love in the care of others.

I'd play his game. Tell him first. However, give him only a week to correct things, only a day or two if patient safety is at risk. If he says anything, just tell him "I brought it up with you first and waited a reasonable amount of time for you to correct it, now I have no choice but to take the problem to someone who will handle it before an injury occurs." Document EVERYTHING and get pics if you can - that's job insurance.

You are to be appreciated for your work in a nursing home. You evidently care about your patients. Yes, first I would go to the manager to inform him/her of the issues with broken brakes on wheelchairs, BUT I would put it in writing, sign it and keep a copy of what I submitted. If you have a great manager, the problems will be resolved quickly. If they are not resolved, then you should consider your next course of action. Best to you for all you do.

a) Find another job, and having done so spend you last few days listing everything you can find wrong at the other place, type it up , print out and send to local inspectors. When applying for jobs make it clear that you are not willing to work in circumstances that put patients at risk and ask what their policy for problem reporting is. There is nothing wrong with a facility wanting problems reported to them first - in fact one would hope this would be the required process, the problem only arises if they do nothing about it. b) agree with your boss that you will do as he says ask him if he has any forms for reporting problems on as you are sure patient safety is paramount to him, and report anything that is not fixed in whatever policy says is the correct time.

You can always make a complaint to the state, remain anonoymous then deny, deny, DENY to the nursing home administration you made it. The state will not divulge you made it especially if you tell them you want to remain anonymous. Waiting for 6 months for an issue to be resolved is utterly ridiculous!!!!!!

If staff suffer an injury on the job, it is a worker's comp claim. If the resident is injured, it warrants an incident report to the state which can be turned into a complaint. The facilities don't like either of those, so why not fix the darn wheelchair and transfer residents according to their care plan. UGGGG!

Every facility must have on staff maintenance workers. Contact one of them and demand the items be fixed at once. And do this in writing and keep copies. You might consider giving one to the management. This is totally unacceptable and I think highly illegal as well. Give the manager the facts and ask that things be fixed. Do this verbally and then hand him the same request in writing. Tell him you made a copy for your legal file. I have done this and boy, everything gets fixed at once. Apparently the bosses of the manager don't like it when they are given complaints - makes them look bad. Your manager is protecting himself. Give him a chance to make things right and tell him if he does not do that, you will go higher. Keep detailed records of everything going on.

Could be way to sweep it under the rug or actually get it done - who knows? I made friends with the maintenance person and he always addressed my Mom's needs, so good practice!

As far as the danger: I know that there is a lot of danger at nursing homes - especially to patients who do not get visitors often - and even with that (I went every single day), my mother was severely injured. I kept telling the nursing staff and hospice that Mom was not connecting with me - that she had changed. I asked for a UTI test for 4 days and they refused to do it - I should have been more persistent. They didn't notice the change, but I did! It wasn't a UTI (found that out in the ER), but her dementia had worsened. She attempted to get up in the middle of the night without her walker - she used to know better than that - anyway, she fell and got a 2" gash on her forehead, all the skin ripped off her left shoulder, broke her right hand and skinned both knees. This was at 2:30 in the morning according to her roommate (who had a stroke, partially paralyzed but mental capacity is there). The roommate yelled for help & turned her light on - no one came. The resident across the hall heard the commotion so called the nursing home on their outside line and tried nursing station to nursing station until she got someone to answer. My Mom laid there bleeding for an hour before anyone responded. Where was the 24 hour care? I was told to call our ombudsman and they would address the problem. I moved Mom to another home. The ombudsman said they couldn't do anything because I had moved Mom and she was no longer there. So I went to the head of the resident counsel (the same one who called the nursing home to help Mom in the middle of the night) and she was going to talk to the ombudsman about it. My Mom never recovered from that fall - it was too much for her and she passed within six months. Probably should have called an attorney.

Keep in mind that many nursing homes are getting sold to large corporations who cut the staff to a minimum for the mighty profit dollar - there's big money to be made from the baby boomers coming to those homes...

I do realize that the nurses aides are overwhelmed - always too many patients and most nurses will not assist them - they stand and stare at their computer most of the day, some working and some not. But where were they for an hour?

its obvious that the nursing home wants to keep any and all issues that are illegal, dangerous and or harmful quiet and away from authority figures that can discipline and or shut down the nursing home if the complaints are serious enough.
the way I see it is if you decide to go the route of the nursing homes request, that you not call anyone on any patient issues, or patients concerns, just bring the issue to them directly, you are agreeing to keep any and all illegal and possibly life threatening issues that could have a horrible outcome if not reported.
maybe I am wrong but to me that makes you a partner in crime with the nursing home.
you sound like a caring person who only wants the best for the patients but the nursing home rules is to keep it within the nursing home only. I would look for a new job. check out the homes and find one that you feel comfortable with to work in.
better to be safe than sorry if something goes wrong.....

I suspect the manager has NOT been given the staffer's name, but is saying he "knows it was you" to all staff to see what their reaction is. And he presumes he will KNOW who made the complaint based on the reaction he gets. Follow the good advice on this forum and document photograph and sign, again and again as necessary. Thank you for doing such a great job and caring! Best wishes to you and all the best for your future.

Thank you for protecting your resident. Yes. We are to look out for vulnerable people. The manager already knew about the unsafe equipment. Moreover, your loyalty to the business kept them from being sued to west hell... You are always protected when you do what's right for people. Let the devil be a liar... Keep up the good work! 🤗
My Mom is in nursing care. I appreciate your sharing....