Loyalty to the nursing home or the patients?

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Loyalty to the nursing home or the patients?

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I am a nursing assistant in a nursing home.

I recently manually transferred a patient from bed to wheelchair by hand (which I know is unsafe and illegal but that’s how we do it here) and I almost dropped her. The brakes on the wheelchair were broken. So when I attempted to place her in the chair, the chair kept moving.

If I would have been a little weaker or the patient a little heavier I might have dropped her, her hip might have broken etc.

I spoke to another woman about this. One brake on her husband’s wheelchair is broken. She said she made several complaints to the staff with no results.

I contacted the department of health and I asked that I remain anonymous.

My manager spoke to me today and said that he knows that I made this complaint. He explained to me that I must be loyal to the nursing home and never make a complaint to the health department but rather come to him and he will be happy to take care of it. He added that he had not heard any complaints from the woman I mentioned.

Does anyone have any opinion about this?

Care Decisions Elder Abuse Skilled Nursing Facility

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Maybe he didn't "know" it was you and just suspected it was.

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Don’t have an answer other than to follow your heart. God bless you for caring. How sad...

Residents at nursing homes should not be in danger. Employees should not be put in a compromising position either. What a shame...

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Agree with that!

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yes. you need to start a daily diary of your job and your supervisor is a moron and simple doesn't care.

document there names / time and whats unsafe and who u reported it to as well as time patient info and etc..
i used to work at a hospital and reason i tell you this is cause when thing will get real bad you need to know that you took this job to help people not be on the facility side and allow violations and patients that have trust in these places to get hurt and one day find yourself being blamed by the same creep who told you to go to him 1st.

Obviously this guy or lady doesn't care and believe me knows most chairs are broken and limited lifts on the floors that actually work. if that patient fell and hit his or her head, you would of took the blame and i seen aides get charged with felony in new york due to this and there supervisors (come to me 1st) left them to hang. The place can not retaliate or approach you saying i know its you that mDe the claim. if they do that again or fire you, you can sue them. You are protected by law but i would look for another place to work at while you are there now and just be careful as equipment they give you to use to help patients u i would personally exam 1st make sure there safe and working. That guy might set you up now, if he knows it was you i assume you told him it was he will single you out and document every day with names and hours. i went through some thing like this my 1st job and i sued and was protected by law. back then my old boss at a urology clinic made a settlement i accepted over 65k. he also had to pay for my lawyer and promoted me in the clinic that i left 5 months later and moved on to better place and people and docs that actually care for there patients.

dont let this guy give you bad habits and once u do its all over for that career u in and ur putting patients u chose to care for at risk. go speak with admin, find out who the owner is of this place, let them know what happened and what he said and how u feel like now ur job is at risk and u feel not safe nore do ur patients, and remind them patients that live there do not complain as of fear of retaliation and for there safety.

please always use a lift and never move anyone by yourself. thats why its always required to have two or more people move someone out of bed and into a wheelchair that you should always check its working properly before you place them in. good luck

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Use your home/ personal phone to contact the health department again. Start a log of discussion of Loyalty & especially being asked about or told "I know you made the complaint". Document & file with EEOC and perhaps ACLU. It is against the law for your employer to ask about who filed a complaint!!!

Next write an email or note...copy it..stating that per your conversation on (date) regarding loyalty to the NH, you will bring any future issues to her directly...and do so...but continue to document and see if you catch wind of others who are like minded but perhaps too afraid to file complaints...especially those told not to file but to go to staff. Try to get personal #, email, or other contact info...perhaps under another excuse. ( A picnic, event, you got extra tickets to something...). They can be called as witnesses if you get fired or any retaliation.
So at work act cooperative. But cover your butt with documents and report their illegal attempt to dissuade you. Keep doing the right thing.
In many states there is a 6 month protection period. If you don't go on record with EEOC about their illegal attempt to dissuade you from filing reports, then you won't be protected if they find an excuse to let you go.

I learned this the hard way. I didn't have a way to contact my co-workers for witnesses to my defense. They waited 6 months and then "wrote me up" for minor or made up infractions.
You might also reach out to you Congressional Reps office for guidance and support. First make sure they don't have personal relationship with the owners. They can be a great advocate, and provide protection from retaliation.

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Does Israel have the EEOC and ACLU too?

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Did you try calling/talking to maintenance? Should be their job to fix it. Brakes get problems bc they are used a lot, and man handled a bit. Usually an easy fix/part.
At least where I worked you could just call them. No chain of command to do that, and get it taken care of.
Are these the site's wheel chairs or the residents privately owned wheel chair? That might make a difference as to who fixes them. Altho if their bed broke, I doubt the home would tell the resident's family to pay for that. If that is the case family should at least get the part or fix it. Good luck. Stay safe!
The manager sounds like a jerk. You know he doesn't have your back which would worry me.

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Oh gees. Maybe this is why people who care and work in NH go to work for private agencies. What a horrible situation. My thought initially is that your boss is grateful to have such a dedicated person, it's hard to find good people and so you were not let go, but the threat is there. Your manager is not the owner he reports to. The owner holds the moneybags and to replace broken items etc, means less $$. If you reveal an issue, and nothing happens, and then you report it anonymously, they will have reason to suspect you. This is an issue of ethics. Your concern is for the best interest of all. What if that person had fallen and broken something...you are responsible or will be the scapegoat, not the NH. What if that led to the person's demise? Of course the patient is not going to complain, from a place of fear while helpless in that place. Is that wheelchair still in rotation? Still broken? It really concerns me that someone found out. Who else knew beside you? Someone is ratting you out. Either at the nursing home or at the health dept. It's a dirty business. Whistle blower laws may come into play. If I had the funds I'd touch base with an elder law attorney and/or the long term care ombudsman when I was off duty and not in the facility and keep my mouth shut. Many jobs are out there for you, but of course it is a hassle. I'd hang tight and observe wrong-doing and keep a log and report it all, expecting my employment to terminate, but at the same time doing good for all to come after you. For me, the loyalty is first to the patients we care about. We have to stop letting the bastards win especially by intimidation.

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OP, have you ever worked in the US? I noted you are in Israel. Can you explain how the healthcare system works in Israel?
Who is the state regulatory agency for healthcare facilities in Israel?
You stated there is no policy & procedure manual there for your to reference when you are on the job. Were P/P reviewed with you in orientation?
I hope you stay there and fight for your patient’s rights as you are a wonderful asset to that NH.

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OH, wish he would have said that to being with as now my answer may make little sense....

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I would go to the manager first. If he does nothing about it, I would report it to the dept. of health that handles nursing homes. People are put in the care of skilled nursing facilities for safekeeping and care, not to put their health and lives in danger. The staff should also be protected from injury. In both cases that you mentioned, if the families have grown children, they should go to the manager with the problems. Sometimes they pull more weight than, say, a patient, or elderly caretaker. As wrong as this is, I have seen that the children or another caretaker who is firm in dealing with the manager are the only ones that get any attention. Also, try speaking to the quality control nurse, if you think he/she is approachable. That manager should be fired, and I pray that he is!

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IMHO, I think the loyalty should be directed to the patients because, after all, the Nursing Home is a business model.

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As well as the employer who's paying him...though I'm not disagreeing patient and personal safety should come first, just saying it isn't quite as simple for him to say my means of earning an income comes second as it is for us to say our loved ones should come first.

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Safety first. A local nursing home changed ownership and because all of the existing staff would endure a pay cut, many left. The facility was understaffed and as a result, an employee tried to move a patient from bed to chair using a Hoya lift without help when it is supposed to be a two-person job. The patient was dropped and was not checked for injury. A day later, the patient was clearly in distress and taken to the hospital where they determined that both legs had broken in the accident. Within one week, that patient died. Do what your heart and mind says is right.

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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....

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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.

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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.....

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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?

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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.

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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!

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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.

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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.

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Yes! Report things that need attention ONLY in writing so there is a record. Don't make it threatening or anything...just report it. If there happens to be an inspection of the facility where you are asked for reports of safety, or other, issues, you can share the info.

Do not record your info in anyway that would violate HIPPA rules. If you make notes that you intend to keep for yourself (in case you can't access email), then use code name for patient and do not mention specific health issues. Something like Granny Jane, requires wheelchair for all movement, brakes broken, reported xx day, xx time, email to John Doe.

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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.

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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.

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

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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.

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It's possible manager recognized the complaint based on initial report by employee....and just took a good guess at who the reporter was to Health Dept. I'm sure the initial job orientation mentioned reporting issues to appropropriate staff - use that training info in reply if someone asks you if you reported something beyond normal chain of command. -- Back it up with the obvious - It was not handled in a timely manner, I would be held responsible if things had gone wrong, I have my license to protect, etc. Use management's own words to back up having to go outside the facility to remedy a situation

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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!

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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.

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

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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.

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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.

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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.

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I suspect the manager was NOT given the staffer's name, but is saying this to all staff to see their reaction - and that'll tell him who made the complaint.

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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

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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.

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