lost my license, my self-esteem, confidence and respect all in one shift - page 2
by Alibaba 3,146 Views | 17 Comments
this man comes in from the hosp. to our ltc. he is end stage everything you can think of and in pretty bad shape. when the hosp. called in report, they told me he was a brittle diabetic...boy were they ever telling the truth! she... Read More
- 0May 27, '06 by Alibabathanks everyone for your input. I have had some sleep and reflection and it still irks me to death. my decision to give my notice still stands because I don't think I can survive another situation like that. Have you ever been in a situation that you just knew any action would come back to bite you in the caboose? Well, that's how I felt last nite. The facility accepted that man during the day, but he did not get there till after 8pm, I was informed in my report from the admissions director at my facility that he was coming in as HOSPICE,, but that was a lie because hospice had not been consulted yet and not seen him or accepted him yet (I called to ask them to come and consult). We are not skilled so even starting IV stuff was a hassle. The on-call was as unsure as I was coz he okey a verbal from the family, then called back stating we needed an actual signed copy by the family for it to be legal, the super was helpful, but still distracted with her numerous duties, and the DON,well she's on 'vacation'!. dont forget that even with glucagon, his bg's were still dropping into the teens and to add to the madness, I still have to do a 40 resident medpass, skin assessments, charting and all the other things that need to be done. I hope I don't lose my license because I love nursing, but I can't help feeling as is s..t will hit the fan and I will be conveniently standing at bullseye. All I know right now is that I can not be in that situation again. It's a gut feeling, but even if a doc signs an order not to send the resident back to the hospital and for dnr, isn't my main responsibility to the patient? this was not a code situation, but I know with most certainity that the hospital could have been able to up his blood sugar IV. I just feel like I should have sent him back and now am feeling like I did not give optimum care
- 0May 27, '06 by banditrnI'm new to LTC - but I can tell you that if I were left in that situation, and neither the ADN or administrator was responsive, I would be giving my notice the next day.
It sounds to me like you did the best you could - I can't imagine you losing your license. At the hospital, we very often took 'verbal consent' with two licensed staff listened to the consent, then signing.
- 0May 27, '06 by EricJRNI have to admit - reading your title, I thought you had the beginnings of the perfect country and western song. After reading the post though, it sounds like you were doing your best under some very adverse circumstances.
I don't know how you guys in LTC do it sometimes. I'm a spoiled NICU nurse. If I have four patients, I'm getting slammed.
- 0May 27, '06 by Ms.RNi dont know about you all but when patients are admitted from the hospital, advanced directive papers are not signed immediately after patient is trasferred to the facility. that means patient is still a full code and we have to everything, including sending patient to the hospital. if i was in that situation and feel that patient is critically ill, i would send patient to the hospital and doctor can yell at me later, but i'm protecting my ass.....!!!!
- 0May 27, '06 by CseMgr1Just another example of our sick healthcare system being on life support itself, discharging unstable and dying patients like this fellow to an inappropriate level of care and leaving us to pick up the pieces...all in the name of the Almighty Dollar and at the cost of our licenses, day after day after day.
- 0May 27, '06 by leslie :-DQuote from wantobernwith so few resources and so many implications, i totally agree: i would have sent him right back out to the hospital, writing a very detailed nurse's note.i dont know about you all but when patients are admitted from the hospital, advanced directive papers are not signed immediately after patient is trasferred to the facility. that means patient is still a full code and we have to everything, including sending patient to the hospital. if i was in that situation and feel that patient is critically ill, i would send patient to the hospital and doctor can yell at me later, but i'm protecting my ass.....!!!!
- 0May 27, '06 by LoriChrI'm sorry you had such a terrible night. I worked the first 7 years of my nursing career in LTC on the night shift. The sheer amount of patients we are expected to care for, not to mention how sick many are, is unacceptable.
You did absolutely nothing wrong. You cared for your patient and attempted to get a much needed DNR order. I honestly don't know what more anyone could expect.