Could I be held liable for not telling a doctor?

RNOTODAY, BSN, RN · May 22, 2006

I am leaning towards....its her health information, and just because she decides to tell you and joke about it, thats her business, and you telling anyone else would be out of line. You have no liability. Your not even remotely in a caregiver type situation with her, so it means nothing. The real matter here, imho, is the fact she is using the machine willy nilly for her own use... now, if you want to let someone be aware of that, then thats up to you. Say nothing regarding the sugars, except on a personal--casual level, like the next time she brings it up, try to educate her more.

I work with this one girl who faints a couple times a month, is nauseous daily, and has had chest "tightness" recently. I asked her if she told her MD about any of these sx. She said NO. I told her (she is a cna) that her doc needed to know about these sx.... and that was that.

NurseLatteDNP, MSN, DNP, RN · May 22, 2006

Unless you are in a nurse-patient relationship with this woman, then no you cannot be held liable for not telling someone about her blood sugar levels. In fact, I would go so far as to say that you do not have the right to go to someone with details of her health condition. Unless she is showing evidence of impairment due to her condition (not likely) then you can only continue to do what you are doing by educating her.

In my hospital we are not allowed to take BP, glucose checks or any vital signs of patients family members, even if they ask us to, because we can be held responsible for not treating the person, if the results are critical. I would think that we could be held responsible if the CNA dies at work because of her glucose levels, and we knew that it was that high, and did not do anything to report it. This opinion is based on our policy regarding the patients family members.

SharonH, RN · May 22, 2006

In my hospital we are not allowed to take BP, glucose checks or any vital signs of patients family members, even if they ask us to, because we can be held responsible for not treating the person, if the results are critical. I would think that we could be held responsible if the CNA dies at work because of her glucose levels, and we knew that it was that high, and did not do anything to report it. This opinion is based on our policy regarding the patients family members.

No you are wrong. By taking a BP, glucose, vital signs etc. you are entering into a nurse-patient relationship which is why you are not allowed to do it. If the CNA dies at work, there is NO way you can be held liable unless you have assumed a role as her caregiver which obviously you are not since you are working side by side. Just because her BG levels are high and you know about it, does not make you responsible for her. She is still responsible for her own health.

BabyRN2Be · May 23, 2006

Have you ever been present when she tested? She could be just telling you that it's high when it's not. Some people like the attention.

This is exactly what I was thinking. I don't know if a person can have obvious symptoms when their sugar is that high, but the fact that she laughs when her sugar is so high, well, I'm thinking that she's using it as an attention device.

JessicRN · May 23, 2006

of course you are not liable because she has high blood sugars if she were impaired in some aspect then I would notify the manager of her impairment. It is not your responsibility to be "managing" this employees health.

I agree but she should be told not to use the hospital monitors though. That is the same thing as a staff member with hi BP who takes his/her own BP at work, who does not take medication smokes and is overweight and eats every kind of junk imaginable.

psalm, RN · May 23, 2006

...if this happens again, document it in an incident report! It is an incident that is not the usual occurance at work. Just document that CNA jones came to you and stated her BS was 349 and she was laughing. In our hosp. we don't have to sign our names to an incident report, however, I always sign mine so if there are any additional questions from my NM, she knows who to ask.

...you are not her nurse but you are the charge nurse and you are responsible for safe pt. care. Having said that, let the NM decide what course to take with the aide...again with pt. safety in mind. If a person comes to work drunk or high they are impaired...and are not knowingly allowed to work.

CA_Nurse · May 23, 2006

I think your biggest liability issue is allowing the employee to use the facility's testing machine for personal use. That being said, I would not allow her to test unless she uses her own supplies. As for your role in the situation regarding her disclosure of high glucose levels, I think it would be a violation of her privacy to share her personal medical information/condition with another staff person. If she is asymptomatic, there is not much you can do. However, if she exhibits symptoms of hyperglycemia, you can definitely report your observations to your manager (especially if you feel she or her patients are at risk). If I were in your shoes, I would contact the facility's employee assistance program for advice. They would know the laws regarding your rights/responsibilities in this particular situation. I hope this helps.

NRSNFL · May 23, 2006

Hello All,
Just a quick question..... I work with this NA who tells me she was diagnosed with "pre-diabetes" several years ago and that she was prescribed Glucophage BID. She says she takes the med for a little while and then eventually just stops taking it. Every now and again she will check her blood sugar while we are at work (she doesn't have one at home) and EVERY TIME it is above 200. Several days last week it was 350 and even 429 one day!! She came and told me "hey Tam, guess what..my sugar is 429! and then she proceeded to start laughing. ***!!?? People that are that ignorant and noncompliant about their diabetes makes my blood boil!!:angryfire Anyways, I angrily tell her that she desperatley needs to call her MD and make him aware of these high sugars and to just be honest with him about her noncompliance. I go on to tell her that she needs insulin(she is not even on a sliding scale). The entire time i tell her this stuff and try to educate her she just laughs. So now to my question... Me being the charge RN... could I be held liable b/c I didn't notify the manager, occupational health nurse ect? Oh I forgot to add that she appears to be asymptomatic when her sugars are that high, b'c if she was having sypmtoms I definately would have done something. Plus I worry that she could be putting patients at risk by taking care of them with her sugar that high. Please send some advice my way. Thanks!!!

Honestly, it seems as though you are more likely to want to "report her" because of her blood sugar because you are concerned for her own health and would like her to deal with her issue rather than because of patient concerns. If she hasn't had problems with her job, then frankly, it's not your business. Additionally, if she is retarded enough to go around announcing a blood sugar of 429 with failing kidneys then that is her fault. Anyone who has worked one on one with diabetics knows there are like 4 personality types, two most prevalent are those in denial and those who are super controlling over their diabetes. She is in denial, and until she gets a wound that won't recover or a foot amputated, it sounds like she won't take care of it...but certainly she's crossed over to the type II land and out of pre-diabetes. But to be honest with you, I'd express your personal concern and say "I'm worried about you and honestly, if this affects your job, I may be obligated to report it. I really hope you will reconsider taking your medication". At that point, if she doesn't and it is still going nuts, then do what you are comfortable doing, but you can't control everyone by reporting them. I too am pre-diabetic (but not that bad) and diet managed, but I will tell you, I'm emotionally and mentally worse off when I'm low instead of high. When my blood sugar is low, then I'm a space cadet with bad shakes, like I'm going through DT's...when it's high, I wouldn't know the difference.

Good luck to you with this.

Antikigirl, ASN, RN · May 23, 2006

Been in this situation as well...and frankly, there was no imparement with my staff member either therefore I had no recourse to notify anyone.

It is hard not to place yourself in the nurses role with everyone...however, you are not her nurse nor her MD. There may be other health conditions, social conditions, underlying issues you are not aware of that her own MD's and RN's do...therefore your suggestions are good (except for the insulin comment, you can not make that judgement...what if she is fine if she takes her glucophage and maintains diet...she won't need insulin...so that is an MD call), and I would continue as a compassionate co-worker to suggest proactive things she can do for herself...including perhaps how concerned you are of issues down the road (like neuropathy, hypo/hyper acute situations...)and that you want her to be around for a long time .