Who is accountable?

  1. Do CNA's and PCT's work under our license? I am just wondering because a few days ago one of my patients recieved too much insulin due to a PCT's error. The PCT told the nurse the wrong blood sugar for a patient. The nurse covered the blood sugar (which was like 350) with humalog. Later it was realized that the patients blood sugar was really 200ish. The PCT got the rooms mixed up!! The nurse called the doc and everything. Well when I came on and recieved report I immediately rechecked the patient's SQBS. It was 40!!! I had to start an IV and push D50. If something would of happened to this patient, who would of been accountable? The PCT or the nurse?
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  2. 23 Comments

  3. by   stressgal
    The nurse is the one who administered the insulin, so it is the nurses responsibility and/or "fault". Looks like an opportunity to review the procedure and put a plan in place to make sure it doesn't happen again.
  4. by   TazziRN
    But the nurse administered it based on the PCT's report. What was she supposed to do, go back and repeat the BS to verify it?

    It would be like a nurse calling a doc with a lab report and the doc ordering a med/tx based on that. Who would be at fault, the doc or the nurse?

    Yes, there was an error but I think it's the PCT's fault. Yes, they work under our license but they have culpability too.
  5. by   fultzymom
    I would think the PCT because she is the one who mixed up the rooms et patient results. The nurse did not give the wrong dose for the acu check result given. She was given the wrong result. Completely not her fault. OH! Just a thought I had. Did she document it wrong also? Or did she just give verbal report wrong? One way to be sure is to check the documentation before giving. But if it was documented wrong, then that would not solve the problem. But if they said one thing, documented another and you double checked the chart real quick the problem would present before the insulin was given.
  6. by   TazziRN
    Good point, I didn't think about the documentation
  7. by   TigerGalLE
    I'm not sure how it was documented. I doubt it had been documented yet. We write all SQBS on a dry erase board in the nursing station. So it was written up on the board wrong. I guess that complicates the matter.... Thankfully the patient was okay after some D50. I just didn't know of PCT's worked under our license. I guess because we delegate the task then they do. But I don't see how a nurse could be blamed in a situation like this.
  8. by   mandykal
    I think it's crazy how PCT/CNA's are performing tasks that should require more education. Facilities such as assisted living are having them "assist" residents on medications....Hospitals have them insert foley caths...and now they're check glucose.

    Lessoned I taught myself was to check pt glucose in room sequence that way if I so happen to forget, I check the memory and the odds for my routine is slim to none for getting anyone mixed up. I have eight accu checks currently.
  9. by   TazziRN
    Normally they do work under the RN's license but they can be held accountable for their mistakes too.
  10. by   TazziRN
    Quote from mandykal
    I think it's crazy how PCT/CNA's are performing tasks that should require more education. Facilities such as assisted living are having them "assist" residents on medications....Hospitals have them insert foley caths...and now they're check glucose.

    Lessoned I taught myself was to check pt glucose in room sequence that way if I so happen to forget, I check the memory and the odds for my routine is slim to none for getting anyone mixed up. I have eight accu checks currently.
    Checking the glucose is not a big deal, what's done with the result is.
  11. by   TigerGalLE
    Speaking of PCTs doing tasks that require more education.... Monday transport came to get my patient for MRI... Well he had been gone for about 15 minutes and the PCT comes to me and says "Hey I forgot to tell you. I checked "so and so's" sugar before they went to MRI.. It was 34, I figured I'd recheck it when they got back." I said "EXCUSE ME? YOU THOUGHT WHAT? He'll be dead when he gets back! Did you give him anything to eat? drink? anything? Why didn't you tell me???" So I had to sprint down to MRI with an amp of D50!! I rechecked him and he was 40! Thankfully he had a PICC!!! Talk about panic attack! Geezzzz you shouldn't be able to take SQBS if you don't know the normal level!!!!!!!!!! When I returned she apologized and I know she was embarrassed. Well I hope I gave her a lesson she'll never forget!
  12. by   txspadequeenRN
    this scenario is exactly why i get my own blood sugars and do all of my own insulins....
  13. by   TazziRN
    Quote from TigerGalLE
    I had to sprint down to MRI with an amp of D50!!

    I'm sorry......this gave me a mental picture of Ellie Patterson, the cartoon mom, running at top speed after her kids with her knees way up in the air!!
  14. by   olol765
    I was under the impression that we are responsible for our own licenses. Just like we don't work under the doctors license....

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