Neglect...LPN was fired, RN was not - page 18

I wanted to get everyone's opinion on a heated debate at my workplace. I work in a large hospital's Med/Surg unit. Usually 8-9 patients are lumped together as a "team" with an RN, LPN and CNA on each... Read More

  1. by   mattsmom81
    Lawsuits will go for the deep pocket.

    This from my attorney...who is also a nurse. She has mixed feeling about nurse malpractice insurance and would agree about the propoganda out there. Also the trend of lawsuits against nurses...which is rising in my state of Texas.
    Lots of nurses here carrying million dollar policies for the taking.

    Food for thought.
  2. by   LadyBugRN
    Liability insurance for nurses where I am presently employed is paid by the hospital and will continue for 5 years after my employment. I used to carry a liability insurance when I worked in another facility. I dropped it since I started working here. It is one of the benifits for working in this hospital.

    Quote from elkpark
    I hate to be a nag, but this is another example of why it's so important to carry your own liability insurance. Does anyone reading this believe that the hospital is going to lift a finger to defend either of the nurses? The LPN who was fired could now be sued for malpractice by the family, and she isn't even employed by the hospital anymore, SO .... No help there! The hospital was attempting to minimize its own liability by firing her. The RN who hasn't been fired could also be sued, and, if she's (he's?) expecting any support or defense from the hospital, I've got some swamp land in AZ that I'd like to sell her ...

    I notice that a lot of people who have debated against carrying your own insurance on this BB often seem to assume that people only sue out of some cagey, calculated determination of who has the money ... It's not that simple -- some families just sue because they loved their family member and perceive that the health professionals caring for them dropped the ball in a big way. It's not always about money; sometimes it's about justice ...
  3. by   Scubadiver
    Quote from LadyBugRN
    Liability insurance for nurses where I am presently employed is paid by the hospital and will continue for 5 years after my employment. I used to carry a liability insurance when I worked in another facility. I dropped it since I started working here. It is one of the benifits for working in this hospital.
    If it was truly just about justice - then why go for the big pay-off? Is that going to fix whatever went wrong?
  4. by   ceceliajane2003
    Yes, in that facility the LPN was working within her scope. Now, aren't supervisors responsible if their nurses do something wrong?And, its poor hospital policy NOT to use the RN_LPN team work.













    Quote from Destinystar
    The reason why the LPN got fired is because she took report on the pts. and it was in her scope to do rounds and check on her pts. at the beginning of the shift. The RN did not take report on the LPN's pts. & was not responsible for providing any care for them unless it was out of the LPN's scope like giving an IV. I do not think that the RN should have even been written up. It is customary practice that RN's and LPN's often divide tasks, or pt loads and each take their own report. In court it could be proven beyond a reasonable doubt that the LPN got report and was responsible and accoutable for those pts. The RN could prove that she had no knowledge or report on the pt. It could also be proved that it was a custom or practice for licensed nurses to take report only on the pts. they were responsible for.
  5. by   Dixiedi
    Quote from ceceliajane2003
    Yes, in that facility the LPN was working within her scope. Now, aren't supervisors responsible if their nurses do something wrong?And, its poor hospital policy NOT to use the RN_LPN team work.
    I think a lot of people get confused with the RN being responsible for the LPN thing.
    Just becasue an LPN works under the direction of the Doc or RN does not mean they are responsible for the LPNs actions or inactions. The LPN is responsible for everything that is within her scope of practice. S/he is also responsible to make sure the RN partner is aware of anything (like TNP that needs hung) that is outside her scope.
    This is where I have issues with the LPN scope of practice. Why can an LPN not spike a bag? We have to know what to expect (good and bad) from what is hung, we have to know what to do if something is not right, we have to know if/when/why/how to hold it in relation to labs, tolerance, etc. We need to be able to understand drip rate, recognize to fast/slow, etc. What's the big deal with spiking the bag? LOL
    It is my understanding just from reading these threads that too many LPNs have the attitude "it's not within my scope of practice so I don't need to know it." How can a nurse provide excellent pt care with that kind of attitude? How can LPNs advance in nursing with that kind of attitude?
    Oh, I've gotten up on my soap box, better shut up for now.
    The point I was trying to make is, the RN is NOT responsible for the LPN, the LPN is responsible for her/himself. Respondent superior (that would be the Doc/hospital I think and not the staff nurse becasue the duty was within the LPNs scope of practice) does come in to play if the family should sue for wrongful death, but that's the only way.
  6. by   loerith
    "Once upon a time...."

    {just kiddin }

    I was a Director of ICU. I had a nurse on night shift who refused to take an IABP patient even though she had had 2 inservices on baloon pumps.

    The next day when I was informed of this I was told, "the nurse said she was not comfortable with the assignment." I haughtily laughed this off and remarked, "If she wants something COMFORTABLE, go be a librarian."

    I then related the incident to my Boss, the Director of Critical Care Services. He had a lil different slant on it. He said, "Just for kicks call the State BoN and see what they say." Which I promptly did.

    Here is what the BoN told me.

    "If a nurse states that he/she is uncomfortable with an assignment and you give them the assignment anyway. Then YOU become the party responsible should any problems develop with this patient."

    End of story.

    the moral?.........

    You CAN refuse an assignment !



    Love and Peace,
    loerith
  7. by   CHATSDALE
    LOERITH: What the board told you is probably true but a nurse like this should be moved to another floor...if you have need of a nurse who can and will be called on to do something then they need to become proficient in the procedure...this only fair to the patients and to their fellow staff members..you will not have happy campers if they come in to work and find that their assignments are going to be determined by someone else and telling them that they are verstile and valuable don't cut it
  8. by   loerith
    agreed Chatsdale!



    Love and Peace,
    loerith
  9. by   happylush
    I would think the RN would be at fault also..... technically she is still in charge of overseeing the lpn and that the patients needs/etc are being met.... I agree though being that I am currently working as an LPN on a medical floor, that sometimes it is very hard to get to all of your patients every hour .... some of the patients we get are insanely hard " dressing changes in isolation with trach's, total cares, etc" and they take time.... on the other hand, I don't know if being the rn, delegating a patient with a GI bleed would have been the best either to give the lpn. depending on the severity of the case... although I have to admit I get them all the time! I would think though that the RN should be at fault also...........
  10. by   ceceliajane2003
    B
    I am an LPN, 15 yrs. worked in most(or many areas)Experience brings alot. Any, GOOD>if ANYONE, does not feel comfortable doing something, then to protect the PATIENT there is no alternative. Thats what supervisors are for.BUT-the nurse needs asep by step introduction,(physically be watched a few times) she/he cant abuse the-the "oh I'm not comfortable"--GET EXPERIENCE OR GET OUT.Really. But its the way the facility sets up things I disagree with.
    Tale care----
    cj











    comic sans5red
















    Quote from loerith
    "Once upon a time...."

    {just kiddin }

    I was a Director of ICU. I had a nurse on night shift who refused to take an IABP patient even though she had had 2 inservices on baloon pumps.

    The next day when I was informed of this I was told, "the nurse said she was not comfortable with the assignment." I haughtily laughed this off and remarked, "If she wants something COMFORTABLE, go be a librarian."

    I then related the incident to my Boss, the Director of Critical Care Services. He had a lil different slant on it. He said, "Just for kicks call the State BoN and see what they say." Which I promptly did.

    Here is what the BoN told me.

    "If a nurse states that he/she is uncomfortable with an assignment and you give them the assignment anyway. Then YOU become the party responsible should any problems develop with this patient."

    End of story.

    the moral?.........

    You CAN refuse an assignment !



    Love and Peace,
    loerith
  11. by   pickledpepperRN
    I am getting too tired so will just say, "I would rather lose my job than my patient or license!
    The Kentucky "assignment under Protest" (in a previous post0 is a great way to document that the management was informed of an unsafe assignment. With unity like the rehab unit had refusing an unsafe assignment while waiting (and the previous shift continues care) has worked great. At least i have been told that.

    Thank you Brownie for the information. Here's more:
    http://www.calnurse.org/cna/np/

    and for those in California there are classes. These CE classes are fun, inexpensive, and you get breakfast and a nice lunch.
    "Staffing Standards by Scope, Ratios and Acuity: How to Promote Safe Patient Care Assignments".
    Below are the dates and locations of the classes, Download the full brochure for class times, details and registration form.

    http://www.calnurse.org/cna/ce/


    I can't find where a registered or practical nurse must accept any assignment in New York.
    I do know in California a nurse must accept the assignment, establish a nurse- patient relationship, and sever the relationship without giving adequate notice for ABANDONMENT to occur. Taking report does not establish the relationship. Introducing yourself to the patient or beginning care does. Then what is reasonable notice?


    http://www.emsc.nysed.gov/rscs/chaps...e_Act-full.htm
  12. by   LisaG21
    To reply to your post.

    At my hospital we team up with 9 patients with either 2 lpns and a tech or 2 rns and a tech or one of each and a tech. The lpn is totally responsible for her/his patients. They do not work under an Rn except the Charge but so do the other rns. I feel that the lpn should have been fired. Why was he dead for 3 hours! Don't you do 2 hour checks???? :angryfire I get soo heated when I see that people aren't doing their job! The Rn is luckey she just got a warning but if she had any fault in this then her day will come soon too.
  13. by   mattsmom81
    Quote from loerith
    "Once upon a time...."

    {just kiddin }

    I was a Director of ICU. I had a nurse on night shift who refused to take an IABP patient even though she had had 2 inservices on baloon pumps.

    The next day when I was informed of this I was told, "the nurse said she was not comfortable with the assignment." I haughtily laughed this off and remarked, "If she wants something COMFORTABLE, go be a librarian."

    I then related the incident to my Boss, the Director of Critical Care Services. He had a lil different slant on it. He said, "Just for kicks call the State BoN and see what they say." Which I promptly did.

    Here is what the BoN told me.

    "If a nurse states that he/she is uncomfortable with an assignment and you give them the assignment anyway. Then YOU become the party responsible should any problems develop with this patient."

    End of story.

    the moral?.........

    You CAN refuse an assignment !



    Love and Peace,
    loerith
    Of course we can. We DON'T have to just blindly accept whatever the facility dishes out to us.

    Supervisors and charge nurses try to bully nurses into taking assignments in the way described...but we don't have to take it. Refusing an unsafe assignment and/or refusing to take shift report/responsibility ( even leaving the premesis if they try to force us) may lose us a job and a good reference, but we DO keep our license and we make a point very strongly. Our choice to do so and I have done this. Every situation is different and we must make our own best call. Understand your state's abandonment laws well before you try this though...to avoid legal problems yourself.

    If nurses do not feel competent to accept the asignment it can be seen as our professional DUTY to refuse. If a nurse chooses to ACCEPT the unsafe assignment they had better have filed a Safe Harbor (or your state's version) for protection. Because if something goes wrong, the facility will quite likely try to turf the liability to the nurse. I've seen it happen too many times, and the nurse is railroaded, framed, fired...so the facility showed how they dealt with the 'problem'.

    Don't count on your facility having your back, nurses.

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