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(solution) Hi. I need to write reaction or reflection paper. I don't need to

Hi. I need to write reaction or reflection paper. I don't need to write a summary about it.

You can briefly describe the topic in general but you are expected to critically assess a problem or solution within the reading and describe as reactions to or reflections of the reading. (good, bad, eye opening, questions you may have, etc.).

The majority of these reaction or reflection papers should focus on this.

This paper should be Two pages. Double spaced. 12-point Times New Roman font, 1 inch margins. It must be complete page in length.

INPERSPECTIVE DON?S CORNER by Betty MacLaughlin Frandsen, RN, NHA, MHA, CDONA/LTC, C-NE Hidden cameras N ewspaper headlines shocked readers


recently by declaring that 14 nursLong-term care facilities


ing home workers from one New


that keep the lines of


York facility near Albany were arrested and


communication open


charged with neglect. Eight others were arbetween residents and


rested in a Western New York nursing home.


families and that respect


These actions resulted from the use of hidden


their rights will go far in


cameras installed with consent of residents?


preventing abuse and


family members. Attorney General Andrew


other inappropriate actions


Cuomo reported conducting a six-week


concerning residents.


investigation using all necessary tools to watch


over the vulnerable who cannot advocate for




In the Albany area facility, hidden cameras revealed


the following: At a glance... ? Staff often left residents in the same position


for an entire shift, failing to turn and position an


immobile resident.


? Nurses failed to administer medication and


treat bed sores.


? Staff failed to check for incontinence or change


undergarments for long periods of time.


? Staff falsified medical records to conceal this




? A physician?s assistant created a false record of


an annual physical that was never performed. In all, six licensed practical nurses (LPNs) and


seven certi?ed nurse aides (CNAs) were charged


with felony ?rst-degree multiple counts of falsifying


business records and misdemeanor willful violation


of public health law. The physician?s assistant was


charged with one count.1


The Western New York investigation revealed


similar ?ndings:


? Staff routinely failed to properly transfer a


resident in and out of bed. Instead of using a


mechanical lift with assist of two caregivers, 48 ? JUNE 2010 they put the resident at risk of injury through


other methods.


? One aide failed to provide range of motion




? Two LPNs failed to administer insulin, failed to


provide skin and wound treatment, and failed to


check vital signs.


? The employees falsified medical records to


conceal the neglect and mistreatment.1 Falsifying business records is a Class E felony


punishable by up to four years in prison. The other


charges are misdemeanors with varying maximum


prison terms of up to one year.1




INPERSPECTIVE While this ?sting? operation may catch


many by surprise, use of hidden cameras


and similar ?ndings are not new. Consider


these other cases:


? In Texas, first-degree felony abuse


charges were filed against a nurses?


aide captured by a hidden camera


striking a woman to get her out of her


wheelchair and then throwing her into


bed. The resident, paralyzed from a


stroke, also suffered from dementia. When the facility failed to act on


complaints from her husband, stating


the woman ?could not identify her


abuser,? he took action and installed


the camera.2


? In Ventura County, California, a family


noticed unexplained bruises on their


70-year-old loved one admitted to


the facility following a stroke. Family


notified administrators, but there was


no investigation. The family set up a


hidden camera and captured what


they could not believe. A CNA was


seen slapping the resident, violently


bending her fingers, wrists, and neck,


and pulling her by her hair. An investigation showed the nursing home


knew this was a problem employee.


Other families had complained of


suspected abuse, and one named the


CNA in writing, but she was allowed


to continue to work with residents.


The family was awarded $7.75 million


by a jury after facility owners refused


to settle out of court for $500,000.3


? In an Illinois nursing home, seven


patients were admitted who had


criminal backgrounds after the facility


failed to conduct background checks.


Two deaths resulted from neglect,


and cameras showed mentally ill patients were out of control and elderly


residents lived in fear. Two workers


and three patients were arrested,


and the administrator?s license was


suspended.4 to meet the needs of residents.


? Staff falsely documented that the


care was provided.


? Staff members intentionally abused


or neglected residents.


? Staff failed to report what they saw


others do or fail to do. ? Administration did not adequately


investigate family concerns. In each case, the installation of hidden


cameras was the vehicle by which neglect


and abuse was substantiated. In most of


the examples, family members ?rst tried In our examples several key things happened:


? Staff failed to provide care designed




to work with administration to gain resolution, but when they


perceived they were not heard, they resorted to other means.


None of us want to believe that our sta? could be involved


in neglect or abuse, but we must remain vigilant in overseeing


resident care. Attorneys and investigators are waiting to step


in to right these wrongs, and the lesson for us is clear: As nurse


leaders we must take all possible steps to prevent similar occurrences from happening in our settings, and we must make time


to listen to our residents and their family members. Once they


have shared their concerns, it is imperative that we follow up


until they agree that they are satis?ed with our response.


The Centers for Medicare & Medicaid Services (CMS) provides us with guidelines to help us organize our protocols and


direct our sta?. F-223 Abuse states, ?The resident has the right


to be free from verbal, sexual, physical, and mental abuse, corporal


punishment, and involuntary seclusion.? This means residents are


not subjected to abuse by anyone, whether they are sta?, other


residents, consultants, volunteers, agency personnel, family


members, legal guardians, friends, or any other individuals.


F-224 Treatment of Residents & their Property addresses mistreatment and neglect. The following de?nitions apply:


? Abuse?The willful infliction of injury, unreasonable


confinement, intimidation, or punishment with resulting


physical harm, pain, or mental anguish or the deprivation


by an individual of goods or services necessary to attain or


maintain physical, mental, and psychosocial well-being.


? Neglect?failure to provide goods and services necessary


to avoid physical harm, mental anguish, or mental illness.5 F-226 Policy & Procedure on Abuse instructs us to develop


and implement written policies and procedures containing the


following seven components:


1. 2. 3. 4. Screening?Potential employees must be screened for


a history of abuse, neglect, or mistreatment through attempts to obtain information from previous/current employers, appropriate licensing boards and registries, and law


enforcement agencies who conduct criminal background




Training?Employees must receive orientation and ongoing education on dealing with aggressive and/or catastrophic reactions of residents; reporting knowledge of


allegations; and recognizing signs of burnout, frustration,


and stress that could lead to abuse and explanation of


what is considered abuse and neglect.


Prevention?Procedures should provide information to


residents, families, and staff on how to report concerns,


incidents, and grievances without fear of retribution; how to


identify, correct, and intervene in situations where abuse or


neglect are most likely to occur; and state the importance


of giving feedback.


Identification?Procedures must instruct staff in identify- 50 ? JUNE 2010 DON?S CORNER 5. 6. ing events needing investigation, such as suspicious bruising,


patterns, or trends.


Protection?Procedures must explain how to immediately


protect residents from harm while an investigation is conducted.


Reporting/response?Procedures should guide reporting of


alleged or substantiated incidents to appropriate agencies,


require corrective actions based on investigation results,


and include reporting action by a court of law that indicates


an employee is unfit for service to the appropriate agency,


registry, or licensing authority. Also consider what changes to


make to prevent future occurrences.5 Whether the individuals in our examples receive prison sentences or not, they will no longer work in nursing homes. Careers


of many years were ended by bad choices and bad actions. In the


long run, future residents will be protected from the substandard


care delivered by these individuals.


Any facility without a policy on use of cameras in resident areas


should develop one, with input from legal counsel. By following


CMS guidelines for abuse and neglect prevention, nursing homes


will establish a foundation for protecting residents from negative


events. Reporting of inappropriate behavior must be the facility


standard. Families should be listened to, even if they previously


reported what administration deemed to be unsubstantiated




Administration in our examples, for whatever reason, failed to


protect their residents. Nursing homes that establish open lines


of communication and feedback with residents and families, and


that respect their rights will go far in preventing inappropriate


activity from happening. They may, in fact, avoid the arrival of


hidden cameras in their own neighborhood. ?


Betty MacLaughlin Frandsen RN, NHA, MHA, CDONA/LTC, C-NE, has more than


30 years of experience in long-term care as a Director of Nursing, Administrator, and Regional Consultant. She is currently Vice President of Education and


Regulatory Affairs for AANAC. To send your comments to the editor, please e-mail References


1. Twenty-Two Arrested in Hidden Camera Nursing Home Probe, April 1, 2010. Available at:


2. Rosenfeld, J. Hidden Camera Catches Nursing Home Worker Abusing Paralyzed Stroke Patient.


Available at




3. Jeffcoat, M. Hidden Camera Evidence Helps Jury Measure Damages at $7.75 Million Dollars,


February 18, 2010. Available at:




4. Two Surefire Ways to Catch Nursing Home Abuse with Hidden Cameras. Available at: www.


5. The Long Term Care Survey (September 2009 Edition). Published by American Health Care


Association, Washington D.C. WWW.LTLMAGAZINE.COM Copyright of Long-Term Living: For the Continuing Care Professional is the property of Vendome Group LLC


and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright


holder's express written permission. However, users may print, download, or email articles for individual use.


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Sep 13, 2020





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