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Most Liked Comments

  • 32

    The supe is trying to throw you under the bus for her failure to respond appropriately to the pt's change in condition. Write out your perception of events, complete with names. Stand up and speak.

  • 31

    Honestly... I would think about looking for a new job. I can't imagine working in an environment where my patient would have freaking DIED and nobody came to get me. At the first sign of bradying down at all, one of my coworkers would have stuck a head in where I was and said, "Hey, calivianya, your patient next door isn't doing too hot..."

    It's just unimaginable to me that the patient would have DIED, already been extubated and cleaned up, and the death certificate was signed, BEFORE ANYONE TOLD THE PRIMARY NURSE. Holy crap. That's just a terrible work environment. What a catty group of people. ICU is a team sport and ICU nurses should be looking out for each other, not just taking over a patient and getting everything done without even telling the patient's nurse.

    She screwed up because she extubated/cleaned up a medical examiner case, which wouldn't have happened in the first place if she'd just talked to you, so of course she's trying to blame you for her awful decision making abilities now. It is nursing 101 that you don't extubate or clean up a dead patient until you know for sure there isn't going to be an autopsy. That supervisor is an idiot.

    Seriously, don't worry about your "bad" decision, just get a new job.

  • 12

    Quote from GE90
    because of two reasons.
    1. inferiority is a real thing
    2. to most of these people, becoming a doctor is their lifelong dream, since they can't put the two letters MD behind their names, they have to do something to show the world "hey, we are smart and knowledgeable as doctors, so you better treat me as a doctor, would be even nicer if u actually call me a doctor"
    They say "u"?
    No wonder they get no respect.

  • 10

    Seems to me that patient B was circling the drain long beforehand. And that is what happens in ICU a lot of the time, no? Especially with a patient who is intubated only, with no other active treatments? So what exactly were you to "critically think" about?

    Putting that in perspective, I would state that the most immediate need at present was to get Patient A cleaned up. That you followed protocol and sought the assistance of your supervisor as you were to be in your other critical patient's room. I assume there were no pending orders for Patient B. Which means the patient was circling longgggg before he hit your unit.

    Imagine if you had said "Patient A needs to be cleaned up. But I am monitoring Patient B, will you go in and take care of Patient A?" THAT would have gone over well......Not.

    CYA and document everything. You dealt with the family, she just happened to be looking at the monitor when the patient expired. That your supervisor then went into overdrive and started the process of pronouncement and such is part of the job anyways, no?

  • 10

    Quote from qaqueen
    Then:
    Several months ago, I had two patients in the ICU. Pt A was recently intubated, on a paralytic, pressors, sedatives, and pain meds, Pt B a new admit, found down, unresponsive, intubated, no sedation, no pressors, no pain meds, DNR (brain activity testing planned for a.m.). I assessed Pt B, went in to check on Pt A and found that a clean up and linen change was needed. I told my supervisor what I was doing, which room I would be in, and asked that the supervisor listen for Pt B (monitor right next to supervisor desk). Supervisor said yes. Perhaps the bath took longer than it should have (about 30 minutes including linen change, with no assistance).

    While I was with Pt A, PT B expired. I was not informed that my pt was bradycardic or even that the pt had died. When I came out of Pt A's room, the supervisor told me "yeah just bradyed down and stopped". The death pronouncement had already been signed by the supervisor and another nurse, the patient was extubated and cleaned up. The supervisor had contacted the house sup to call the M.E., house sup was busy and had not called. I told supervisor I would call, I was told "no, house sup will do it". Okay. I contacted the family, greeted them when they came in. After the family left, I went to assess Pt A again. The supervisor heard from the house sup that it was an M.E. case, so went in and prepped Pt B for transport to the morgue.

    Although I felt that I should have been allowed to take care of my patient, I was very new to the department and did not feel it was appropriate to question the supervisor.

    Now:
    Several months later, the supervisor makes a statement to my manager in a meeting (with other people) about my inefficiency and lack of critical thinking. Telling my manager (not all the info above) that I chose to bathe a patient while my other was circling the drain.

    While it would have been great to delegate Pt A's clean up to someone else, there was no one to delegate to. Did I believe that Pt B would expire while I was in the next room? No, of course not, but it happened. I feel that the supervisor is being malicious. When my manager asked me about the incident, at first I did not recall it. When I did remember, I contacted the manager and said yes, it did happen, but that my perception was quite different than the supervisor's.

    I do not want to malign the supervisor. I do not want my manager to think I am an inept and/or incapable nurse.

    Should I just shut up? Or stand up and speak?
    Okay, you've since had several months to demonstrate your capabilities as a nurse. Any good manager would not let one incident described by another invalidate several months of subsequent observations.

    I also agree that the supervisor has sure conveniently forgotten her own ineptitude. Who the heck extubates/cleans up a patient without checking to see if it's an ME case?! It seems she wanted to keep you in the dark, and purposely hurried the post mortem care to make you look bad, only to find out it was an ME case and the post mortem care performed was inappropriate.

    Watch your back with that one.

  • 9

    When taking a telephone order, I've made it a practice to read it back to the doc, who can then confirm that I've got it right, or correct me if I have it wrong. In this case, I'd suggest that either you or the nurse relieving you should call the provider and get clarification.

    It's very hard to deal with cranky providers, but I'm even more uncomfortable guessing at orders I don't understand. It kinda verges on practicing medicine, I think.


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