Met with-the retirement home director about missing medications, and snotty nurse

TerryJ2

Well-Known Member
I actually went in with-the intent of simply writing down license #s, but just as I was walking out the door, she stopped me and asked what was going on. I told her I was filling out a complaint report. She saw the heading (the state of VA medication board) and said it was the wrong form--it should be soc. svcs. Plus, she had never met me b4 and I was supposed to go through her, first.
She called in the nursing mgr (yes, I have met with-her on more than 1 occasion) and we spent an hr and a half (sigh) going over the list of medications, who admint'd them etc. All but 2 days were accounted for. I told her that didn't mesh with-what I had observed and she told me the P is suffering from dementia. Twice (or was it 3X) I told her that *I* observed the pain levels and the outdated Fentanyl patch. I also was told by head nurses on more than one occasion that the medications hadn't been filled and that they had faxed the dr but the dr hadn't responded.
She kept bringing it back to P and then said that the only alternative is that someone deliberately initialed the file when there were no medications and that could be loss of job, license, etc.
I said, "I know. That's why I was filling out this complaint form."
"But that is very serious and very rare and we have all of the best people."
"I've seen it done before. I went to court when an employee I hired for P at ZZZ nursing ctr didn't even show up and billed for it. I've gone to court b4 and I can do it again."
She seemed unfazed but she did have one good idea--change doctors.
So I immediately authorized a new dr, on her recommendation, and that paperwork will go through Friday. I will call his ofc personally. I asked her if it was normal for family members to sit out in the car and call the dr to make sure that the faxes went through and the orders were filled and she said yes.
Sigh.
She suggested checking the medication file, notes, and packets herself, with-me at her side, every wk for the next mo while the new dr is writing scrips, and I said "I'm already doing that and I'm tired. I even called at midnight one night and bit the nurse's head off. I was out of town. I shouldn't have to be doing all of your jobs."

So for the time being, I will not send in THAT report.

However, she really stonewalled when I complained about the medication nurse who yelled at P last wk, so much that P threw up. "Oh, she's gotten nothing but good reports from all of the familes."
I said, "Not from this one."

I didn't mean to be snotty, but instead of immediately coming to her defense, why didn't she just LISTEN and shut up?

She told me I am not supposed to have the nurse's license #s so I dutifully crossed them out. I have no idea why she said that, but when it comes time to file the paperwork (and I can see, I will probably end up filing) I'll just get someone else to do that part for me. She said I'm only supposed to have her lic # and the bldg license.
And I was supposed to come to her.
I didn't know that. I thought I'd gone to the top. (I didn't know I had to take a test in order to pay over $4,300/mo so that my cousin could have a small apt, grilled cheese sandwiches, and Nurse Ratchet on call.)
So she gave me her cell ph # and is certainly on the ball now.

I also told her that the Visiting Angels caregiver had already written a report to her supervisor about P throwing up after she'd been yelled at, and the admin scoffed and said, "Oh, I'll call her. We're really good friends. Her name is ... what is her name?" :mornincoffee:

And so what if they're friends? What's that got to do with-the price of bread?

Lots more, but that's the gist of it.

by the way, I'm now wondering if I should have confronted Nurse Ratchet myself, but she's so unpredictable, I truly think it would have been a waste of time. She smiles and assures you that everything is fine and then stabs you in the back. What's the point?
I told the admin that she cannot be re-trained. It's not a training issue. It's an attitude.
I can guarantee you, that fell on deaf ears.

If you missed the backstory on this, I'm sure you can look up something like, "I'm getting a nurse fired," and "P's pain medications" and "Arrrrgh! Assisted Living and P" or something.
 

buddy

New Member
Are there any rules about nanny cam type things there?

oh wouldn't that be great? When I owned a daycare it was before computer cameras were common, if I had it now I would set them up everywhere. I think we should behave in human service jobs as if we are on camera and it is being broadcast in times square every second. (hard to pick your nose though...oh gross, I will go to bed now, sorry)
 

keista

New Member
Ah, Terry, this woman is lying to you and snowballing you. I'm not quite sure to what extent, BUT you absolutely can have the nurse's lic#s. You can get the lic# of ANY professional you have to come in contact with. As a matter of fact consumer protection boards encourage it. You have the legal right to investigate any professional's background. You have the right to VERIFY that they in fact have a valid license.

Healthcare Practitioner License Search

That website popped up 3rd when I searched "professional license Florida"

So anyway, that's the big lie that jumped out at me. I'm sure there are others as well. And honestly, I would not trust the Dr she recommended. I'd stay with the old Dr and check with him directly about rx requests and scripts.

Sorry, ((((HUGS))))
 

InsaneCdn

Well-Known Member
Is there any way to get in touch with other families?
"Good" nursing homes and extended care facilities often have - and encourage - family support groups.
If this home has that, its a good sign - and a way to cross-validate the reputatoin of the nurse in question.
If it doesn't... how would they react if you asked about the need for this and how to get it started?
I'm guessing... they'd be totally negative. They do not want families to cross-check and/or support each other.

There is a problem. How else to figure things out??? Hmmm...

And no - don't switch doctors without talking to the existing doctor first. Need to get THAT side of the story too.

Is there a medical ombudsman or equivalent? They usually have powers to investigate... and will help you get the ducks lined up BEFORE you start paperwork...
 

keista

New Member
Haozi, true, but licensing of any type is generally a matter of public record. It's the whole point of anyone getting a license for anything. For others to be able to keep track. Most practitioners are required to display their license in their place of business. I don't care what state I'm living in, if I ask a professional for their license# and they refuse to give it to me? I am NOT doing business with them.

Here's the lookup for VA https://secure01.virginiainteractive.org/dhp/cgi-bin/search_publicdb.cgi

Terry, you went in with VERY SERIOUS accusations, and this woman is like......whatever, I'll deal with it...... Oh, it's P's dementia. NOT.

Sorry, this is really bugging me. It smells like last week's fish!
 

Marcie Mac

Just Plain Ole Tired
Jo, I just hate hate hate when you bring problems to someones attention, and they blow you off or blame the patient. You should be able to check the nursing home out on line to see problems and conditions - I know I did that for my mom when my relatives were trying to find a place for her.

SO's mom fell yesterday - home didn't call, but her room mate did, telling us she fell. When SO called, they said she had lost her balance in the bathroom, but the aide was there and gently took her down to the floor. That was NOT what her room mate said, so we went up. Mom confirmed she told the aide, who only had a hold on the back of her nightgown, she was going down, and hit both knees. There was no "gently" being let down. Her poor knees were swollen to the size of grapefruits, and she was badly bruised. They were insisting on their side of the story and maybe Mom was confused. SO made the head nurse go and look at her knees, and stood there while she did it. Thankfully they did an X ray today, and they were not broken. But he has to go up there every day to check on her - she either doesn't get her medications, or has wet herself and was ringing for the nurse for over an hour just to get a bed pan and no one answered her call. He has to go over her chart every day to see what they did or didn't give her. And if you ask why she is not getting one medication or another, they were blaming the doctor for not calling back (they now know that our doctor is also a long time family friend, and we have his personal cell phone number. I really really feel sorry for the elderly there who have no one to go to bat for them.

And I don't know if formal complaints really go anywhere, but maybe enough of them leaves a papertrail. I was in the hospital last month for a week with a severe case of diverticulitis. When Jamie and SO came to visit me that night, he became unglued that the room was absolutely filthy - dirty needles on the floor, bathroom had not been cleaned in days, trash under the beds. He took photo's, came home, called my medical insurer, and filed a report with them and the state, and sent them the photos. Next day the head of nursing was in my room so irate, yelling at me and pointing to a phone number on the wall and said I should have called that number for housekeeping if there was a problem, and not gone to the insurance company. I did get a letter last week from the company saying they received my report, and was waiting for the hospital to respond, but due to confidentiality, they could not tell me if any actions were taken. We did later find out it was rated as a "one star" hospital, and were cited numerous times - ER doctors operating on patients and were not certified to do surgery, someone went in to have his bad kidney removed, and they took out the good one instead, scads of complaints of infections from being in there. Am not sure how I even ended up there as it is in Riverside, which is about 45 minutes from my house - there are three hospitals I could go to within miles of where I live.

Anyway, didn't mean to rant on your thread - but it is absolutely appaling the shoddy treatment one has to put up with, especially if you happen to be elderly and defenseless. I think every state has a rating for care homes and hospitals-might be interesting to see what kind of complaints the one that P is in has.

Marcie
 

JJJ

Active Member
I'd file the complaint anyway. It will take the appropriate people a while to get around to acting on it. Plus you know that she lied to you (I agree with Keista - nurse's license numbers are public record) and she discounted your concerns. She may just try and stall you from filing the report and then when you finally get sick and tired of it and file, she will claim that you must not have thought it such a big deal to wait so long to file.
 

TerryJ2

Well-Known Member
First of all, I could have sworn I typed this on the watercooler. :twister2:

Anyway, yes, I will pursue all of this tomorrow. I am going to call the ombudman first, then the state, and ask basic questions such as the right to have lic #s.

The more I thought about it last night and this a.m., the angrier it all made me.

Thank you for your support.
 

mstang67chic

Going Green
I don't know if it's a state thing or not but I know that when I get a prescription from my doctor, especially one for a controlled substance, the doctor's license number is right there on the script. So why is having a nurses number such a no no????

I agree also about not changing the doctor right away without talking to the doctor's office. Actually, I might try to do that in person or at least make arrangements in person. My reasoning is that if you bring up the subject of issues with the nursing home in front of the office staff....their reactions will tell you a LOT. They may not be able to actually tell you anything but they can say a lot with their reactions.

I would also try to get this woman's "promises" in writing, in an email or on a voice mail. Something that can be produced if need be so she can't deny everything. Maybe send her an email following up on your concerns. "As I understand it, you will talk to Ms. XYZ about my concern with the ABC issue. Am I correct?"

Good luck!
 

susiestar

Roll With It
The admin is lying to you. FLAT OUT LYING. Little lie, big lie.

It is CLEAR she did NOT know the name of the Visiting Angel person who was reporting to the supervisor, as she claimed to but then asked you what her name was. Little lie.

WHen you find a lie like that, you are going to find bigger lies, esp if you ahve already had them from most other staff people, as you have.

the bit about not having license #'s is pure lying. SHE may not want you to have them, but you have a right to have them.

She is trying, quite desperately, to get you to not file that complaint. She also doesn't want you to use those license #'s to look up the records of her staff and see what problems she is hiding. Cause with her attitude and lies she is surely hiding something.

My gut feeling is that the fentanyl is left on too long because someone is stealing them. P's word is considered useless because her dementia, so no complaint of hers will do much, so they take her medications. How do I know? Exsil did a LOT of home health work and that is how she got a LOT of her medications. Just leave the patches on a few extra days each, blame complaints on the patient's problems, and you can score a LOT of free drugs. It is likely the supervisor doesn't want you to have the license numbers so you can't see how many nurses are on the program for nurses with addiction issues. Exsil LOVED home health care because it was just so easy to score her medications. Her second favorite job was in nursing homes because no one listened to the patients when they complained and it was super easy to fake the records and steal the medications. I am betting that this is going on with P's medications.

This administrator is in CYA mode. There is NO reason you have to go to ANY person at the home before filing your complaint - NONE AT ALL. SO go file it anyway. And do what you can to read the license #'s and check them out either online or through the state nursing board or whatever the licensing group is.

As for the new doctor, have you checked hin out yet? Call his office and ask some questions. google his name to see what you can find. If you don't like him or he doesn't respond in a timely manner, ask around and find someone else. Given ALL the lies and misdirection of the person who recommended him, I would be VERY leery of him.

File a complaint with the nursing board and this admin's supervisor about Nurse Ratchett. Yelling at a patient that way is called Elder Abuse - report it. As for CPS, report to them by all means, but report to the other agency also. Based on the admin's reactions, I would guess that CPS won't do much but the other agency might put some sanctions/requirements in palce that would cost $$.

I know this is really difficult and aggravating for you, but you are doing a really good job. P is lucky to have you.
 

TerryJ2

Well-Known Member
I went in today and followed up on several things. One is that P's percocet scrip is written "every 4 hrs, as needed, while awake." I don't THINK so! That's why she wakes up in pain and it takes 2-3 days to catch up. I requested that the new dr write, "Every 4 hrs on schedule." (One of the nurses helped me with-that. There are all sorts of weird ways to word things.)
I checked the Fentanyl patch and it is new, as of today, with-a # written on it.
I will ask the dir when she is going to re-train the staff, because I noticed that 3 says ago, the Fentanyl patch had NO writing on it. In addition, the faxes said, "Faxed to dr, 10/3/11." It should have had initials, and then a follow up note regarding whether it was filled. There was another note at the top of the page that said, "Re-faxed." No date or time, no initials. But it was clear that the dr had not responded.
The doctors are in the same office so I am calling right now to request that the new dr call me or meet with-me. I want to explain to him why I put in this change request and what I expect of him. (In a nice way, of course. :) ) I really believe that the new percocet scrip syntax will help immensely.

In regard to nurse Ratchett, I haven't seen her for a cpl days ...
 

TerryJ2

Well-Known Member
Oh, and I called Visiting Angels and told them what the asst living dir said in regard to being good friends with-the Visit Ang director. The response was, in a heightened tone of voice, "What difference would THAT make?"
Ka-ching.
 

TerryJ2

Well-Known Member
:)

So, I just got off the ph with-the Commonwealth of VA dept of health professions enforcement div. I was transferred twice and then disconnected. Sigh. Finally got a person who knew something. She said I don't need the nurses' lic #s (I asked twice whether I was "allowed" to have them and she danced around it), and she said that it did make sense to go through Soc Svcs first and then if Soc Svcs recommended it, to go to the Dept of Health Prof enf div.
Paperwork.
Gotta love it.
 
H

HaoZi

Guest
Is the writing on the patch the day it was applied? If not, perhaps you should also write on the patch with a Sharpie...
 
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