Resident dies and nurse is to blame

  1. 0 We had a resident die recently and he was a very brittle diabetic, on a continuous tube feeding and a full code. (thankfully he was not on my hall). This res. blood sugar would sky rocket so high the CBG machine could not even read it. When he would get his insulin he would drop down into the 30's. The Dr. had been called numerous times regarding his insulin dosage, so that was changing daily, I don't know how high a dose or what long acting he was getting, I just know he was very brittle.

    For about 4 days this man would refuse his insulin, he was alert and oriented and therefore was able to refuse, he did not want his insulin for fear of bottoming out. the nurse on dayshift would chart that he refused his insulin at 8am and noon. But she never charted that she called the doc, the evening nurse only gave him insulin at 5pm, and res refused insulin at 9pm, the nurse never charted this nor called the doc. The night shift nurse comes in and the res requested his blood sugar be take, the ,machine would not read it, the nurse called the dr and told him about the blood sugar being to high to read, and that the res had also been refusing his insulin for the last few days. the doctor said that was his right if he didn't want the insulin then we can't give it to him. so he didn't give her any new orders or even tell her to give insulin.

    Later that night during the CNA rounds they found him unresponsive without resp or pulse. so the nurse started CPR and called EMS. and did all the necessary steps that she was suppose to do. The nurse was off for the next 2 days after that, when she came back to work, she worked her shift and when her shift was over, she was called to the office and put on suspension pending the investigation into this guys death. The DON asked her why she didn't give the insulin, the nurse told her she didnt have an order for it, and the DON told her she should have given it anyway.

    So now she is on suspension and will probably not be coming back. I think it's wrong for them to suspend her when she did everything she was suppose to do, she charted that she called the doc, told him that res had refused insulin on previous shift, and that his CBG was extremely high, doc gave no order to give insulin because res would refuse it. So the nurse gets in trouble for not giving insulin to the res. How is she to blame ??
    Last edit by Esme12 on Jul 2, '13 : Reason: Formatting
  2. Enjoy this?

    Join thousands and get our weekly Nursing Insights newsletter with the hottest discussions, articles, and toons.


  3. Visit  fairyluv profile page

    About fairyluv

    fairyluv has '1' year(s) of experience. From 'somewhere,usa'; Joined Mar '13; Posts: 99; Likes: 43.

    25 Comments so far...

  4. Visit  TheCommuter profile page
    3
    Quote from fairyluv
    How is she to blame ??
    Workplace politics seem to be playing out like a game of musical chairs where this particular nurse had the seat taken from under her because she was one of the last licensed staff members to have contact with the resident.

    In the nasty game of workplace politics, management will cover their bases by looking for the convenient scapegoat (read: the floor nurse with relatively little power).
    BrandonLPN, Meriwhen, and bluegeegoo2 like this.
  5. Visit  fairyluv profile page
    1
    that is just scary.
    elprup likes this.
  6. Visit  sallyrnrrt profile page
    3
    mgt. is wrong, the night shift nurse is correct
  7. Visit  michelle126 profile page
    2
    But...did she chart all of that? After a few refusals a refusal of care form could be done. If he was A & O, he signs it.
    KelRN215 and bluegeegoo2 like this.
  8. Visit  fairyluv profile page
    1
    Quote from michelle126
    But...did she chart all of that? After a few refusals a refusal of care form could be done. If he was A & O, he signs it.
    Dayshift nurse charted the refusal, evening shift nurse did not, night shift nurse charted that he refused insulin on previous 2 shifts and had been for several days and also called the doc, which neither dayshift nurse nor evening nurse did. night shift nurse does not give insulin. residents are asleep and night shift nurse does not have to do AC cbg's. I have never heard of a refusal of care form, I don't even know if we have one at our facility.
    BrandonLPN likes this.
  9. Visit  Meriwhen profile page
    4
    I sincerely hope that the nurse has malpractice insurance and/or has contacted an attorney. Not saying that she's in the wrong, but she needs someone to look out for her and her interests in all of this. It damn well won't be this facility.
    elprup, tokmom, VivaLasViejas, and 1 other like this.
  10. Visit  CapeCodMermaid profile page
    5
    I've never heard of a 'refusal of care' form either. We simply document in the chart/EMAR that the resident refused meds. We always explain and document the risks to the patient of refusing the meds and/or care. People are not prisoners and are allowed to refuse and make bad decisions. IF there was no order for insulin, the nurse could have had her license revoked for giving medications without an order. I'll bet there is more to this story than we know.
  11. Visit  kcdunlap profile page
    0
    The fact that the Doctors orders for insulin regiments made the patient bottom out when he took insulin no wonder the patient refused. The constant rollercoaster of blood sugars very horrible feeling. I hope the nurse has a good lawyer because if she documented properly she should not be held responsible. It is improper knowledge of treating this patients diabetes that caused this problem for the patient and made the patient terrified of taking their insulin which in turn made the patient go into DKA and die.
  12. Visit  DalekRN profile page
    5
    Quote from fairyluv
    DON asked her why she didn't give the insulin, the nurse told her she didnt have an order for it, and the DON told her she should have given it anyway.
    Wouldn't that be battery??
  13. Visit  2011RN profile page
    1
    Shouldn't the nurse have requested that the doctor give her orders for insulin and then approached the patient about taking the insulin to see if they would take it or refuse it? After all a refusal on one shift or even days of refusal does not mean that the patient would have refused that one time if offered the insulin. I think the nurse certainly should have pushed the doctor for some kind of insulin order and if the doctor refused to order the insulin then she should have documented that.
    KrysyRN likes this.
  14. Visit  sallyrnrrt profile page
    1
    Quote from CapeCodMermaid
    I've never heard of a 'refusal of care' form either. We simply document in the chart/EMAR that the resident refused meds. We always explain and document the risks to the patient of refusing the meds and/or care. People are not prisoners and are allowed to refuse and make bad decisions. IF there was no order for insulin, the nurse could have had her license revoked for giving medications without an order. I'll bet there is more to this story than we know.


    and careplan " the all get out " on it
    VivaLasViejas likes this.
  15. Visit  fairyluv profile page
    0
    I am not sure why she didn't push the dr for an order, other than maybe the doctor had been called several times in the last few days about the residents blood sugar and the resident refusing his insulin that the doctor figured he would just refuse anyway. like I said, he was never my pt. But nothing was done about the 3-11 nurse not charting his refusal nor calling the Dr. and the nurse quit today. I don't know why, I heard from the staffing coordinator that she came in got her paycheck and told him she quit and never gave a reason. This facility has fired soo many nurses in the last 6 months that I'm afraid to go to work for fear of getting fired for something that was hearsay or for doing the right thing, we had been told by our DON not to send anyone out to the hosp unless we absolutely have to, because they don't want the census to drop. another 11-7 nurse got wrote up for sending a res out who has Hx COPD and was in resp distress, she wrote her up for not assessing her lung sounds, nurse said res couldn't breath, she got her O2 and she felt that she needed to send her out right away. res ended up in ICU with pneumonia and died a few weeks later at the hosp.DON told that nurse that corporated was coming down on her cause they were sending to many res to the hosp.
    so what do you do ?? If you send them out to the hosp you get wrote up, and if you don't they die. , you still get wrote up or suspended. I wish there were more opprotunites for LPN's here. But there isn't much. You can't trust anyone. Everyone is so quick to throw ya under the bus.


Nursing Jobs in every specialty and state. Visit today and find your dream job.

Top