Have you every heard the phrase – honesty is the best policy? It is an ironic truism. True, because honesty is always preferable to the opposite, dishonesty, and yet ironic because why do we as humans need a policy (a written rule) encouraging honesty? Shouldn’t honesty be innate? Shouldn’t we know to tell the truth, without some kind of law or rule that requires it?
The phrase reflects something true about us as humans, that while we know it is best to tell the truth, we sometimes need external accountability such as laws, or rules or policies to encourage us to do what we know is right. In fact most laws and rules are written to encourage some kind of life preserving, enhancing, or protecting doctrine. Don’t steal. Don’t speed. Don’t drink and drive. Don’t take advantage of a senior adult. Don’t abuse an animal. You get my point.
And in many companies, nursing homes included, internal rules and policies exist that provide guidance to the staff (and families) as to how and when to act. These rules are helpful.
- Not sure whether to notify the doctor of a patient’s fever? Check the policy or physician orders.
- Not sure whether to call the family when a loved one falls? What is the facility policy?
- Not sure whether to change the medication of a patient who has fallen three times? What does the policy say.
Hopefully, the decision makers have enough training and experience to know what is right and how to care for patients appropriately without having to refer to a cheat sheet, or set of rules or policies – but the policies help. They can act as maps for behavior when two paths exist, or better yet, policies should be created after thoughtful discussions such that they incorporate the thinking of many, not just one healthcare provider.
So when families call our office about an incident that occurred in a Virginia nursing home, one that appears to the family as neglect, or worse, abuse, we often encourage the families to request a copy of the facility policies related to the incident. For example, the fall policies. The assessment policies. Nutrition policies. Change in condition policies. That way, we can investigate the case, and frankly the allegations of negligence with the written policies as a back drop.
Truthfully, they can be a tremendously helpful map for patients families during care, and during litigation.
There is one catch. Under Virginia law, the only people who have an automatic right to receive or review the policies are CURRENT RESIDENTS. Not past ones. So if you are at the hospital undergoing a hip replacement after a preventable fall, you can try to get the policies, but the facility can refuse.
All of this narrative ends with one simple bit of advice: Loved ones of nursing home patients in Virginia, should request copies of all policies and procedures while their loved one is a resident. They may help direct and impose future care, and assist in any litigation.
And yes, honesty is still the best policy. Don’t we all need reminding now and again?