Being new assisted living facility, I have many questions regarding liability and also difficult POA situations. I am the only RN on staff in the PM at my facility and am the "go-to-girl" for residents living in independent and assisted living quarters. I have had two situations now where the POA did not agree with my emergency treatment decisions. One situation was regarding a res with C/P, pain to the Left arm, abnorm vitals, and EKG changes. I of course wanted to send her to ER and called 911...POA refused. Second case regarding dementia res. with severe flank pain, POA refusing eval. Other than contacting MD or DON what else can be done? Would it be better to call for emergency help first and then get POA permission after? That has been the case(in regards to C/p sit) but I am wondering if I am somehow liable if I hear back from POA (as I am not always able to reach them stat) that they don't want treatment. Isn't it always better to err on the side of providing care than denying it? I trust my nursing judgement but some of these decisions POA's are making seem unethical, esp. since in these examples res want treatment. I feel so helpless in providing my residents care in these situations!!! I feel especially helpless in providing care for my resident that I care for with dementia. How is it ethical for POA to refuse any sort of work up for res. with extreme pain. Very frustrating. I also feel that being in Assisted Living your hands are tied sometimes. I feel like I am always balancing on doing too much or not enough. The residents in AL/IL are all somewhat independent and have the right to make informed health care decisions but I cannot help to feel sometimes though that to not take an action is somehow neglectful. Anyone working in this field have any ideas or help? Thanks!!
Thank you, Momma. I have cared for so many patients who, in a nursing concept of health, would have been healthier had they stayed in long term care. Before your post, I failed to look at it from the LTC nurse's point of view.
On another note, don't you wish the TOS included legal advise along with health care advise? ;-)
Last edit by Woodenpug on Sep 14, '11
: Reason: Forgetting to proof read before posting. Darn pc still doesn't do my thinking for me.