A question about home health nursing

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Hi I'm a new LVN I started working with this home care company where I was working 40 hours a week with a patient with a G-TUBE, the other I was taking care of my patient, my shift ended at 4 and at that same time my patients next feeding was scheduled so I gave him his feeding and I left him under the care of his mother, so two hours laters my patients mom called me freaking out that her sons g-tube fell out and that she cant find it so then she takes him to the hospital and the dr told her the stoma has closed, so now the mom is upset at me because she says its my fault and I keep telling her I was not there when It fell, right before I left I made sure the G-tube was inside my patients stomach.I'M 100% sure the g-tube was in place because as soon as I was done giving him his last feeding I left his mother was there so Idk why she is blaming me, she signed me off and I left. I documented my care but I'm scared she might contact the board and I can lose my license... any advice or thoughts would be great but I cant sleep because of this :( :(

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Rule #1: don't ever give your patients your personal phone number.

You documented everything appropriately and the mom assumed care of the pt. A lot can happen in two hours. I'm not sure why the mom even feels you are remotely to blame, but I am sure you have nothing to worry about. The worst that could happen is she could ask you to be taken off the case-- happens all the time, and agencies understand and will place you somewhere else. Sounds like you might be better off.

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Specializes in Pediatric Private Duty; Camp Nursing.

I always end my notes w "Left ct in c/o mother in stable condition." And then when mom signs it, it's binding. Mom agrees ct is stable at the time, and "stable" includes all medical appliances to be in working order. W my trach cts, I add for clarification, "Left ct in c/o mom in stable condition w 3.0 Bivona trach intact, patent, midline, w ties @ 1 fingerbreadth." I have heard of incidents where trachs have come out after a nurse leaves and and this being blamed on the nurse. Again, when mom signs that form, she is acknowledging that she is receiving the child in the condition documented. Parents should give the child a once-over before resuming care.

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I am sorry that this has happened to you. It is likely that Mom blamed the last nurse on duty because she does not want to take responsibility for losing the G-Tube. Mom should NOT have stopped to call you when she could not find the G-Tube. She should have used her back up kit (they are trained prior to the child leaving the hospital), immediately. Had she done this, she may have been able to maintain the stoma.

You are not responsible for things that happen when you are not there. The burden of proof lies in the hands of the accuser. Does Mom have a video or witness of you removing the G-Tube? No! What did she sign at the end of your shift? You are not likely to lose your nursing license over this. The child's life was not in danger.

Next time do not give your personal contact info to Mom.

Hopefully you end your notes like the previous poster suggested or something like "patient in bed, HOB elevated, feeding running per orders, g-tube patent and patient tolerating feeding without emesis or gagging. Diaper dry. No S/S of distress or discomfort. Patient is stable. Report given to and care transferred to Mom."

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As far a trachs,thats why my agency requires we add "trach ties secured to one fingerbreadth tightness". Too many kids had trachs that came out because ties were too loose.

You know what irritates me? Nurses who write 3 sentences for an 8 hr shift for a kid with a vent,trach,and a gt. I know up its off topic. That is why i cant stand Maxim's assessment sheets.

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Specializes in Peds(PICU, NICU float), PDN, ICU.

I write a very similar note with every pt at the end of my shift. It covers me for anything I can think of. I would take this as a lesson and make sure you document well at the end of your shift. I doubt you would lose your license over this. Your agency needs to give you more training with documentation and they need to document that the mom is trained to know what to do if the gtube comes out.

At the end of my shifts, I write: NAD. VSS. Awake/resting with eyes closed. In bed/crib with rails up x2. HOB ^. Resp 24, even and unlabored. 4.0 Neo Shiley midline, patent, ties secure. O2 sat 100%. Humidifier on and connected to trach via trach mask/ HME connected to trach (depending on pt). GT patent, secure. Diaper dry. 0 pain at end of shift. End of shift tasks completed. Equip plugged in, charged, and working properly. Go bag is stocked and ready. Report given to mom, who assumed care.

The above is a sample and I mold it to the pt I have and the environment/equipment. I make sure that I'm covered as much as I can before I leave. It's the last chance to "show" that you left the pt in good condition and left the next caregiver in a good situation. Hope that helps!

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