treating a visitor of your pt? reprimanded for not doing it.... - page 6

am i right or wrong here? just fyi, i work in a subacute rehab attached to ltc. during report, had a nurse manager come in, tell me pt "had fainting spell" and to go see her. i get up, go in the... Read More

  1. by   Nurse-To-Be-Joy
    I'm not a nurse, but I have a little story to add to this. While working in the hospital as a transporter/housekeeper, a patient in one of my rooms died. He was in his 60s and his 90+ y/o mother was there. When he was pronounced, the mother fainted. Thankfully, she fell right back into one of those visitor chairs that you're able to push. So, I had to take her down to the ER right away. The nurses on that floor weren't allowed to do anything.
  2. by   P_RN
    challenged annie. I'd like to hear more about how things differ in the ER from the US to the UK.

    You stated
    I feel its sad people are so scared of being sued at every opportunity
    Yes we are. We are liable for what we do, and unfortunately we live in a litigious society. The majority of US nurses are privately employed even if the agency is county or state owned.
    How is your employment different? I hate to say socialized medicine because I don't really understand it completely.
  3. by   gauge14iv
    "She may make a p&p stating staff nurses may treat visitors with noninvasive measures as they see fit. now, i'm all for helping someone who is indeed in trouble (CP, MI, resp distress, fall or fx); but i refuse to do anything other than offer to call an ambulance for anyone else."

    Great - so a visitor falls, a nurse from your facility gives that visitor some advil - to which he has an allergice reaction and dies - now who is liable? I would hope she would reconsider that idea or at least talk to an attorney first!

    As for "responsible for treating the ill" Yes we are responsible for treating the ill WITHIN OUR CAPACITY, LEGAL ABILITY AND THE LIMITIATIONS IMPOSED BY THE NURSE PRACTICE ACT.

    A visitor for whom there is no known history, no established relationship and no physcian available should be sent to the ER or to their own physician for evaluation. Period. We would be doing them no favors by offering them treatment if we really do not have the whole picture!!! Some folks really are that allergic to the most mundane of medications! You have no way of knowing!
    Last edit by gauge14iv on Nov 22, '05
  4. by   gauge14iv
    I had a friend put it this way -

    The advice of two neighbors who consult each other regarding medication, treatment and the provision of first aid changes drastically when one of those neighbors is a medical professional...

    In other words - you can't tell your neighbor to do the same thing you would tell a patient to do, because your neighbor hasnt had the benefit of a full workup. Unless you have the licensing, equipment and resources to work them up and prescribe treatment, you can't do that.

    In a doctors 0ffice - what happens to the patient who walks in with chest pain? He gets an ambulance ride to the hospital - even the doctors office doesnt have the resources, staff and equipment to do a full workup and potential resucitaition for someone with chest pain.

    Patients need to be handled in the environment best suited to their needs.
  5. by   DeeSki
    Quote from Noryn
    As far as this on the write up, "LPN incorrectly assessed situation, and did not render care as appropriate" there are so many things wrong with it and I would honestly have a field day with the nurse manager. I would have her list out the appropriate care.
    As a first year (first semester) RN student, I may be putting my foot in my mouth but I do believe that I recently learned that only an RN can ASSESS a patient. LPNs are able to gather data but not assess. I'm not sure if this is a state by state rule. I am in NY. This would lead me to believe that the NM incorrectly identified the problem.
  6. by   redwinggirlie
    Nope. You are not wrong. Talk to risk management, check your policiies. I think you did the right thing.
  7. by   janetrnc
    You did the right thing. I tell my staff not to do it even for employees of other hospital departments who just "want you to check my BP, its been up". You assume the liability if you take that VS and don't act if its abnormal.
  8. by   Nickle
    OP, I think you did the right thing, for all the same reasons given by the other poster's who have validated your actions.

    This thread has given me a lot to think about in terms of liability; I will no longer be taking family member's BPs "out of curiosity." Instead, I'll politely redirect them to the outpatient pharmacy downstairs, which has one of those automatic BP self-check machines.

    I have one question for everyone: would it have been appropriate to call 911 anyways? I suspect the family would have been less likely to refuse transport if the EMTs/paramedics were right there. Then the issue of liability is out of the staff nurse's hands; if they refuse again, the ambulance team can document that.
  9. by   fp nurse
    I work in a doctors office, if we have someone walk in that is not are pt we will call 911 for them. If need be will perform basic life support untill they get there.Where would you document info about this pt? I think legaily you can not treat this pt without a consult pending?
  10. by   fp nurse
    you go girl. way to stick to your guns. Standing up to both of them takes guts. I honestly think i would have gave in. People like you make me proud to be a nurse.
  11. by   fp nurse
    [QUOTE=IMustBeCrazy]The word "assessed" has me concerned. I know in many states, LPN/LVN's are *not allowed* to assess patients, it's in their nurse practice act.

    So, what does yours say???

    ~IMBC[/QUO

    You seem very upset with a LPN doing a assessment. Please keep in mind alot of state laws are different. I can and do perform assessments. Which is completely within the nurse practicing act.
  12. by   rehab nurse
    wow....i never had so many replies to a thread i started!

    i got a lot of good information from all of you. i find it very interesting the differences in opinion everyone brings here. i especially find it interesting how other countries are not so worried about being sued as we are here in the US. everything i learned (and am learning now) in school, has always been to cover yourself and protect yourself from being sued and/or losing your license.

    at work, the NM who wrote me up is going around and trying to find others who agree with her way. she won't talk to me. i did fight the write up, and it has been thrown away for the time being, as we have no policy. i told the DON to contact an attorney as she comes up with a policy for this, and she agreed to do just that.

    work is becoming terrible. morale is down, and i am burning out quickly. i have fmla for my migraines and back pain, and i have been missing a lot of work lately. as soon as i walk in the door to that place, i can feel the tension. i always feel on edge, and as if i have to defend every decision i make. i will be glad to be done with school so that i have other employment options. i love being an lpn, but i hate how so many people assume you're an idiot because you're not a "real nurse". that's the attitude at my facility. i just wish i could control my stress better. i hate feeling like this all the time.

    i just wanted to pop in here and say thanks to those who took the time to respond to me, i really, truly appreciate your time to tell me how things are done at your place of employment.

    back to the books for me~exams coming!!!
  13. by   talaxandra
    Quote from P_RN
    I'd like to hear more about how things differ in the ER from the US to the UK. <snip> How is your employment different? I hate to say socialized medicine because I don't really understand it completely.
    I'm an Aussie - we also have universal health care, and a low rate of medical litigation (though it's growing..) And we don't treat visitors - at least not where I work (acute care), for all the reasons other members have listed.
    I've taken relatives down to cas for assessment, I've directed them to the chemist downstairs (to buy analgesics etc), and have suggested that they speak to a doctor about whatever it is that they asked me about.
    There's just too much that can go wrong. Well, that and I'm concerned about how much faith some people have in nurses' opinions, especially if the advice matches what they want to believe. Don't get me wrong, I think nurses as a group rock, and often dispense valuable and informed advice. But I had a 'check out chick' at a bakery once tell me that she'd found breast lump "but it'll be okay, right?"
    "The majority of breast lumps are benign, but even young women get breast cancer (this was pre-Kylie) - the only way to know for sure is to have it assessed. You need to see a doctor as soon as possible."

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