My patient did not get seen.

caliotter3 · Nov 6, 2011

You have to live too. You can't blame yourself for the failings of others or for stuff that just gets messed up.

SuesquatchRN, BSN, RN · Nov 6, 2011

And your visit would not have prolonged her life, Vtachy. If she was comfortable you did your job.

Long Term Care Columnist / Guide · Nov 7, 2011

I'm curious as to how you came to be involved in this.

For one thing, if the patient is in assisted living, they're no longer your patient, but a resident of the ALF. How was your supervisor able to "schedule" an appointment for them with the ALF nurse?

Secondly, how do you know that the resident wasn't seen by the facility nurse? I've got some folks in my building who'd swear they've never even met me, yet I've been in and out of their apartments many times. It may simply be that the resident WAS assessed and the nurse didn't bother to call you and the family to inform you of her findings.

Thirdly, that ALF nurse may be responsible for several buildings, or she may work only a few hours a week in that particular facility. ALFs are notorious for not wanting to spend money on nurses! Also, the nurse may have been sick that day, or, Heaven forbid, she may have simply forgotten.

Finally: Just because someone sees the ALF nurse behind a desk, it does not mean she isn't doing anything. Most ALF nurses are managers, not direct-care providers, and we do not have the time to do "rounds" on 80 or 90 residents each day. I will say that when an acute issue is reported to us, we usually make a personal visit to assess the resident; otherwise, we do a LOT of paperwork, schedule and train staff, hire and fire, delegate tasks of nursing care, act as facility administrator whenever he or she is out, and even give tours of the facility.

Of course, there is always the possibility that the nurse was indeed negligent in failing to see this resident. But one should never assume that based on a grieving family member's say-so.

Just saying.....

Vtachy1 · Nov 7, 2011

I'm curious as to how you came to be involved in this.
For one thing, if the patient is in assisted living, they're no longer your patient, but a resident of the ALF. How was your supervisor able to "schedule" an appointment for them with the ALF nurse?
Secondly, how do you know that the resident wasn't seen by the facility nurse? I've got some folks in my building who'd swear they've never even met me, yet I've been in and out of their apartments many times. It may simply be that the resident WAS assessed and the nurse didn't bother to call you and the family to inform you of her findings.
Thirdly, that ALF nurse may be responsible for several buildings, or she may work only a few hours a week in that particular facility. ALFs are notorious for not wanting to spend money on nurses! Also, the nurse may have been sick that day, or, Heaven forbid, she may have simply forgotten.
Finally: Just because someone sees the ALF nurse behind a desk, it does not mean she isn't doing anything. Most ALF nurses are managers, not direct-care providers, and we do not have the time to do "rounds" on 80 or 90 residents each day. I will say that when an acute issue is reported to us, we usually make a personal visit to assess the resident; otherwise, we do a LOT of paperwork, schedule and train staff, hire and fire, delegate tasks of nursing care, act as facility administrator whenever he or she is out, and even give tours of the facility.
Of course, there is always the possibility that the nurse was indeed negligent in failing to see this resident. But one should never assume that based on a grieving family member's say-so.
Just saying.....

No I think you have misunderstood. The ALF nurse was awesome and actually did our job! She is my friend and she spent 4 hours with this patient and their family on Friday night. She went way above and beyond she was awesome and thank God for her!!!

I'm saying that Hospice was supposed to see this patient daily. We prefill morphine syringes so that the wife could administer them, and patient began needing them every 2 hours. Thank God for the ALF nurse she saved our rear and filled them Friday night since no one from Hospice came to visit that day.

I looked at the schedule and the nurse from Hospice that was supposed to see this patient did not call in sick that day and was not overscheduled. I'll find out today what happened.

I was just curious to see if this has happened to other people because I'm new to Hospice and don't understand why this happened. Did they just blow me off when I scheduled this patient to be seen on Friday? I'm sure that there is some explanation.

Vtachy1 · Nov 7, 2011

So would you call your co-worker and find out why she didn't go see this patient? Or should I call and ask my sup, if I did something wrong when I called on Wednesday to make this patient a daily visit?

Hospice Nurse LPN, BSN, RN · Nov 7, 2011

So would you call your co-worker and find out why she didn't go see this patient? Or should I call and ask my sup, if I did something wrong when I called on Wednesday to make this patient a daily visit?

Talk to your super and let them handle the situation. I'm sorry your pt died, but you have a life and we all need days off from time to time. I think many hospice nurses (myself included) feel as though we have to be involved in EVERY aspect of our pts lives and feel responsible for anything that doesn't go according to plan. That thought process can easily lead to burnout. Be gentle w/ yourself.

Long Term Care Columnist / Guide · Nov 9, 2011

No I think you have misunderstood. The ALF nurse was awesome and actually did our job! She is my friend and she spent 4 hours with this patient and their family on Friday night. She went way above and beyond she was awesome and thank God for her!!!
I'm saying that Hospice was supposed to see this patient daily. We prefill morphine syringes so that the wife could administer them, and patient began needing them every 2 hours. Thank God for the ALF nurse she saved our rear and filled them Friday night since no one from Hospice came to visit that day.
I looked at the schedule and the nurse from Hospice that was supposed to see this patient did not call in sick that day and was not overscheduled. I'll find out today what happened.
I was just curious to see if this has happened to other people because I'm new to Hospice and don't understand why this happened. Did they just blow me off when I scheduled this patient to be seen on Friday? I'm sure that there is some explanation.

Thank you for clarifying this. :)

I'm sorry about your patient. FWIW, ALF and hospice usually work very well together for the comfort of residents who are on service, and I've seen some incredible collaborations between my facility and the two hospices that serve our folks. Every now and again, we get a "clunker" of a hospice nurse who's almost always a fill-in and doesn't want to come out when it's the weekend and the resident looks like they are CTD, but it's pretty rare......I bless hospice nurses for the work they do to help our folks and families get through what can often be a horribly painful, frightening, and lonely experience. :redbeathe