Quote from DusktilDawn
This is where I have a question. Was the Med Nurse fully appaised of the situation concerning the declining BP? It sounds like you assumed that when he was done what he was doing he would give the Hypertonic. Sorry, but if you didn't explain to the Med Nurse exactly what was going on with this patient and if the Med Nurse didn't tell you he would give the Hypertonic, this would be where you're at fault here.
This is where I have the same question. When did the Med Nurse say he was coming to give the hypertonic or did you assume he was coming. I have a rule to never assume anything. If the Med Nurse did say he was coming to give the patient a Hypertonic, then your documentation here would be correct, if not then I would say your documentation was based on an assumption and therefore incorrect.
Now I have some real problems with the PCT and Med Nurse here. I don't think this is a race issue but a CYA issue. Unless the PCT and Med Nurse can prove tampering with the monitor I don't understand how they can argue false documentation, unless your monitors don't have the time or an incorrect time on their display. The PCT was out of line telling you that you did not have an obligation to document what you do and the time you do it, PCT is for Patient Care Tech, unlicensed also, probably not educated the way an LPN or RN would be in the area of documentation. As nurses we do not omit or falsify pertinent documentation to cover another person, that is called fraud/malpractice and is subject to disciplinary action both legally and professionally. Why was PCT assigned as your preceptor to start with?
Sounds like the Med Nurse made this personal first, I would have left off the part about where he could put it.
Now as for the Charge in this situation, how may people were at lunch at this time? Was it appropriate to have this many people at lunch at this time, etc?
It sounds like there were only just you and the Med Nurse for ??? how many patients, I know you had 8, how many did he have? How far along are you in orientation and was it appropriate to leave you and one other nurse alone?
No slamming intended here, Nurseinthemaking, but I do have some questions concerning the situation as you can see.
I appreciate your response. Yes, he was fully informedm given BP's, status, Complaints and continued dropping. He told me it was not his patient, (let's think about this, when you walk on the floor, as a nurse, you assume responsibility for every patient on that floor. We have 2 Med Nurse, obviously they cannot take lunch at the same time, so when one goes, one stays, he assumed care of ALL patients Meds while she was out. He still told me that was not his patient, he would take care of him once he passed his meds to his patient, knowing the status of the patient. There was no assumption, he said, this is not my patient, but I do have 3 meds I have here, one being another hypertonic and one being Immodium, another was k+ I think, but at this point I can't remember it wasn't something of Dire Importance. Rapidly decreasing BP's have precedence over patients who need Immodium and K+, not that I am saying those patients are important, but there seems to be an issue with the fac that the RN who knowwhich comes first RIGHT. Especially one with 10 years under his belt and is a CNN too.
Yes our machines have times of BP's they will even tell you if they were Manual pushed or Machine done. They were all there in black and white, but he was so mad, he couldn't see past the end of his nose at that point. Apparantly he has a history of this sort of behavior I found this out after all the smoke had settled.
At the time this occured, there were 30 patients on the floor, the Med Nurse, Myself and 3 other Techs. THEY were all in the back corner congregating, just as they do each day. This is a very frustrating situation because the Dialysis Center I did Clinicals at in School, the Nurse actually sat between her patients and talked to them or if they didn't feel like talking she just monitored them. It is very hard to see patients sitting in their chairs spread out in a room with no one watching over them. I catch patients even before they say they are cramping, just by watching their facial expressions. I graduated August 19th and started there August 21st. They put me with a PCT to learn the machines, but in all honesty, she has only been with me 3 times. I requested last week to not be with her anymore, a) because there is a language barrier, B) because she has some handwashing issues c) she falls asleep while sitting in a chair d) she speeks in another language while I am working with a patient for all I know she may saying what a big butt I have
, I have no clue, but imagine how it makes the patients feel.
I was told by a Staffing Agency that after I had 6 months under my belt at a Dialysis Center they would consider that to be a years worth of ICU. So I don't want to leave Dialysis by any meens but am wondering if this is the place for me. I really do feel like Dialysis is my calling for any reasons, just not sure what to think about this situation.