Do I report this?a long post!

**canoehead, BSN, RN** · Oct 10, 2002

You are a student? I would do nothing, you have more to lose than anything and probably won't make any impact other than to piss off the staff nurse. But know that when you went to that nurse with your assessment I for one would have thanked you for putting the O2 on and gone into the room to see myself what was up re suctioning. Maybe not that minute, but definitely before I left the floor, and within say 15 minutes.

sjoe · Oct 10, 2002

Don't you have a clinical instructor or other supervisor? That is the person to talk to about this, ASAP. (And make accurate notes on the incident for yourself, with names and times each event happened.)

kookyscientist · Oct 10, 2002

I think I probably miswrote what I meant in my thread. This incident happened on the job. I work as an Extern, but I am a student also as it is part of the job requiment. I put nursing student down because some people don't know what an extern is.

JAYNE DANCE · Oct 10, 2002

MMMMMMmmmmmmmmmmmmm TOUGH ONE.....ME I WOULD REPORT IT......I WOULD JUST NOT FEEL COMFORTABLE LETTING IT GO.........JUST IN CASE I MIGHT PI$$ OFF ANOTHER NURSE OR TWO!!!!!!!!!! I WOULD NOT CARE WHO I PI$$ED OFF, I GO TO WORK TO CARE FOR MY PT'S NOT TO GET BUDDY BUDDY WITH MY WORK MATES....IT IS SCARY TO THINK THAT THERE ARE SOME PEOPLE OUT THERE THAT HAVE A LICENSE TO BE A NURSE :eek:

purplemania, BSN, RN · Oct 10, 2002

If you were there as an employee the fact that you are a student is not relevant. You should have followed chain of command (charge nurse, nurse manager or whatever is P/P for your facility). Otherwise, I think you acted wisely and the primary nurse is a prime example of the nurse YOU don't want to become.

SmilingBluEyes · Oct 10, 2002

I would be speaking w/my nurse manager about this incident PDQ. I know you don't want to make trouble w/coworkers, but I bet this is not an isolated thing, rather a habit with this nurse. Pretty dangerous place to be doing your externship if this is what example you have to follow.....

Where was the house supervisor in all this? Charge nurse? anyhow, your conscience won't let you allow this to rest, Follow your chain of command like others before me suggested.

darius000 · Oct 10, 2002

Speaking as an After Hours Nurse Manager (from Australia), same as a House Supervisor over there, I think that you should report this incident. As sjoe says, write down everything you can remember about the incident, because you spent so much time consoling the wife, she will remember you. In Australia, we use such reports to work out where problems are, they are not, and cannot be used as ammunition to fire somebody. Can you expain what an extern is?

cactus wren · Oct 10, 2002

At my hospital externs are student nurses who are almost finished with schooling. They are able to take patients, although only 2-4 a shift, they do all the patient care,charting ,and are gradually allowed to give meds, with their preceptor watching over them.Usually only have 1 or 2 at a time, and usually only over the summer break. And most of them have stayed with us after they graduate, and pass boards .This way they are already "oriented" to the hospital, and have an easier transition to this wonderful, stressful world of nursing.

shygirl · Oct 10, 2002

I would have reported this to the nurse supervisor and my instructor! You are going to be a good nurse!

Shygirl

kookyscientist · Oct 10, 2002

Actually I did follow the chain of command because the nurse that I told was the charge nurse for the night. She was the one that defended the other nurse.Next step up is supervisor. But anyhow I appreciate all the input from you. It is bothering me because I haven't worked since the incident so I don't know if the man survived or what. Also, cactus gave a pretty good description of an extern, except we are not allowed to give meds at all. Our murse manager won't even let grad nurses pass them until they pass their boards. I'll keep you posted.

RNed · Oct 10, 2002

You did the right thing by informing the nurse of your findings, actions and concern. The O2 was started and his sats went up to 96%. The question of suctioning is subjective. Should he have been suctioned or not who knows?

I somewhat agree with canoehead, here.

Report ? What are you going to report except your findings and actions? You did that to the nurse. If you are drawing a conclusion that this patient would not have gone into V-tack if the patient had been suctioned - that is an assumption. The patient could have gone into V-tack at the time of suctioning, before suctioning or after suctioning.

If asked as to what actions you preformed related to this event then answer truthfully and fully, but don't assume there is a fault because the other nurses did not act in the matter you felt they should have. You may find out later after your reporting - the patient had a potassium of 2.2 or 6.8 or some other abnormal lab finding which could have attributed to his V-tack. Hypoxia is only one of many reasons a patient may go into V-tack.

It would be appropriate to inform the charge nurse that during this time a family member was present and needed help. Do we have a policy that identifies a spokes person for this family need during a code event? If not should we develop one? Would Social services be an appropriate referrel?

I hope you get the idea here, there are many factors why patients do what they do. Sometimes even with the best nursing and medical care the outcomes are not good. I am not saying that you do not report things, you do. However, you report the facts and leave the conclusions, assumptions and analysis up to those skilled in that side of nursing. Strong clinical, experienced, long time staff can get "away" with making some conclusions and guide the investigations of quality care provided by other staff and this is done usually around the corner and quietly with the charge or management staff. Seldom do students and the inexperience get "away" with this. If there is a need for more information, they will come to you and ask.