Duty of care? Opinions please

  1. Hi,

    I work in a hospital and my best friend who works as a home visiting nurse was recently telling me about something he had heard about in his workplace.

    A nurse went to visit a patient at home and they did not answer their door, the door was unlocked so the nurse went in to check on them. The nurse found the patient lying there who was not able to respond in words.

    The nurse left the home because they did not feel comfortable in the situation and contacted their manager for advice. The manager told them to call the patient on their phone, but there was no answer.

    The manager told the nurse that they would organize for another nurse to go along with them at a later time.

    The 2 nurses went together to see the patient and called an ambulance.

    The patient died a few days later.

    What are your opinions on this situation?

    Thanks in advance.
    Last edit by sharpie12 on Nov 18
    •  
  2. 26 Comments

  3. by   Guy in Babyland
    Quote from sharpie12
    A nurse went to visit a patient at home and they did not answer their door, the door was unlocked so the nurse went in to check on them. The nurse found the patient lying there who was not able to respond in words.
    The patient's condition has changed for the worse and is in distress.
    Quote from sharpie12
    The nurse left the home because they did not feel comfortable in the situation
    Instead of calling 911, they call their supervisor
    Quote from sharpie12
    The manager told them to call the patient on their phone, but there was no answer.
    Instead of telling them to call 911, the supervisor tell them to call the patient which has already been established that they can't speak. If the patient was in cardiac arrest, would the advice be the same, to call the patient?
    Quote from sharpie12
    The manager told the nurse that they would organize for another nurse to go along with them at a later time.
    Like after the patient died?
    Quote from sharpie12
    The patient died a few days later.
    Big surprise
  4. by   sharpie12
    [The manager told the nurse that they would organize for another nurse to go along with them at a later time.
    Like after the patient died?]

    Sorry, what I meant by 'later time' was several hours later that day, as the first nurse did not feel comfortable. So the manager organised another nurse to go along with the first nurse.

    [The manager told them to call the patient on their phone, but there was no answer.
    Instead of telling them to call 911, the supervisor tell them to call the patient which has already been established that they can't speak. If the patient was in cardiac arrest, would the advice be the same, to call the patient?]

    I'm not sure why the manager made this decision because as you mention, this was already established when the first nurse visited. Patient found to have had multiple infarcts once admitted into hospital.
  5. by   Wuzzie
    I'm not entirely sure what you want to get out of this thread. Is it personal education or information gathering to mount a complaint? Either way, our speculating on a situation that may or may not have occurred and with the very minimal and rather unclear details provided cannot be construed as expert advice. It would be much more beneficial for us to ask you what would you have done had you been the one in that situation? Or as the supervisor?
  6. by   JKL33
    Agree with Wuzzie.

    What do you think should happen when someone finds a patient in a condition such as this?
  7. by   BBP42
    As a visiting nurse, my agency policy would be to call 911 immediately and stay with the patient until they arrived. I would call the supervisor as soon as I finished calling 911, to update them. The delay in response may or may not have contributed to the subsequent death, but I cannot imagine a nurse just leaving a patient in that condition.
  8. by   sharpie12
    Hi Wuzzie,

    Was just wanting everyone's opinions on what other people (opinions from a spectrum of different nurses with different levels of experience) would do in the situation and what our responsibilities would be relating to duty of care.
  9. by   sharpie12
    Quote from JKL33
    Agree with Wuzzie.

    What do you think should happen when someone finds a patient in a condition such as this?
    My response would be to call the ambulance STAT as time may be of the essence. And am just wanting to know what other people would do in this situation who come from a wide spectrum with different levels of experience.
  10. by   Apple-Core
    Based on the limited info provided, I would have stayed with the patient, called 911, and waited with them until help arrived while taking vital info to pass onto the paramedics.

    However, there is a lot of missing info here, so it's not really fair of us to judge that RN for making the call they did.
  11. by   amoLucia
    This sounds tooooo much like a hypothetical school assignment for an entry level Practice of Nursing class (where else would you hear 'duty of care' fro a new poster like OP?).

    And too much ambiguity makes this all too questionable. Altho I do like OP Wuzzie's take on the possibility of some legal fishing.
  12. by   jodispamodi
    My opinion is this, They had a duty to act. Once they went in the home and saw the patient down they should've called 911 and provided whatever aid they could until EMS showed up. Sorry to say, but this kind of comes under abandoning a patient.
    When I worked homecare we made an appt with the patient for a certain day and time frame, if they did not answer the door we would go and look in windows, and possibly try doors just to ensure the patient wasn't collapsed in their home. JMHO
  13. by   JerseyBSN
    The first nurse is guilty of patient abandonment unless the patient was a known DNR but I still would have called their contact number(s)

    If the patient was not a DNR I would first call their contact (daughter/son/POA, etc) if no answer I would go ahead and call the ambulance.

    The manager is incompetent. My manager would NEVER EVER tell me to leave and send two other nurses at a later time!
  14. by   LadysSolo
    Many of my patients I see in home (in fact all of them, actually) have told me not to knock (I do the first time) and just to come in. They know when (approximately) to expect me. If I would go in and find one of them down I would follow CPR protocol (establish pulselessness/breathlessness and call 911, etc. if appropriate.) I of course know their CPR status. If they are a DNR/CCA and have arrested, I would follow their wishes.

close