Patient Abandonment?!?! - page 2
by TaylorMaidRn 4,186 Views | 12 Comments
I have been working for a home health agency that has used some questionable ethical practices, but this may be a new low! I was given a schedule one day that was just not humanly possible..a ten hour day by their points system... Read More
- 0Jan 10, '12 by Marie.rnI am just curious, but you say that it was the 1st TPN to ever be administered? If a patient needs TPN, how were they getting their nutrition before the order for the TPN?
If you take an assignment (patients for that day) and you leave and abandon that assignment and do not provide care to those patients than you can get abandonment but otherwise no you cannot be charged with abandonment.
Did you inquire with the agency and tell them you did not have experience with TPN? There are rules with blood sugar and so forth, but in home healthcare the rules change related to in home care vs hospital care. Like in the Nursing Home a sterile dressing change is clean because it is considered to take place within the patients home.
I always ask for help, find an experienced nurse to ask for help and guidance. Sometimes I ask a nurse with experience (actually 99.9% of the time) and I research the topic thoroughly so I know what they told and demonstrated for me was correct. I have video's of all of the proper ways to do skills, you can get updated ones and books from ATI and other places. I read up on it from text books from my online college library, my textbooks from school, and on line references from distributors that tell me how to use their equipment.
HOpe this helps you in the future.
- 1Jan 10, '12 by TaylorMaidRnMarie.rn- yes, this was her first TPN treatment, she was originally supposed to receive it in the hospital, however, she requested to the dr that she be able to do it at home and go back to work so that she could keep her medical insurance which covered her son who was on a transplant waiting list (all this according to info sent from hospital). I had not accepted my schedule for the day, this was the disagreement and the reason I left and they fully knew this was the reason I was quitting when I walked out. I try to learn as much as I can and update my education when I come across any new skills that I will need to be able to perform, however, up til this day, the agency had a policy not to accept TPN patients, so I did not seek any instruction on it before hand. The agency had just decided to accept this patient because they were desperate for money/having problems meeting payroll. They did not warn us ahead of time so that we could prepare by educating ourselves on this skill. As far as getting another nurse to help me, only one other in the field staff had any experience in this and she probably would have helped me, except that her schedule wouldn't allow..she was scheduled to see patients an hour away from our location. The nursing supervisors had experience with tpn but refused to help.
The agency KNEW I didn't have any experience with TPN because they keep a skills checklist in our file, AND I told everyone who could hear me that date that I was inexperienced with this. Since this has occured and I am not currently employed, I have logged many hours reviewing material on TPN therapy.