Did I do the right thing?

[nursebecca35]

I know I did the right thing, but why do I feel so bad. I work Baylor 7p-7a in SN. One of my patients gets continuous tube feeding. I always change it out between 2-330am. Well at 330am sunday morning I changed it new lines date intial everything. Well I left that morning at 720. It was running fine. When I came back in at 7pm i started my med pass, had an orientee with me we were in this paticular room when i glanced up and the bottle was over half full. Now i calculated and it should have been under half full. Me and the other nurse kind of freaked out. We detached it made sure it was running ok and it was, no kinks or anything. I continued letting the bottle run. When I went to change the stuff at 330 Monday morning the screen said amoutn fed 487 and flush was 301. I had already told the charge nurse and she came over we wrote a letter to the DON. You know common sense tells me I had to do it, this patient cant ask for food she can't walk to the fridge and get something out. In 24 hours she only was fed 487. I cant believe someone could cut it off. I tried to think of everything possible maybe i forgot to cut it on, but then way is 180 ml gone. the rate is 45ml/hr in 4 hours that is 180ml. That is what should have been gone when i left. I feel bad for reporting it why do i feel so bad. I have only been a nurse for 1.5 years and this is the first time something has happend like this. should i have kept my mouth shut? or did i do the right thing?

[TheCommuter, BSN, RN]

:welcome: Welcome to our online community!

At my workplace, the CNAs will turn the tube feeding pump off and lower the patient's HOB during incontinent care, repositioning, bed baths, and so forth. They'll usually press the "start" button to resume the feeding, but sometimes they'll forget. I usually will not find out that the pump hasn't been infusing until I walk into the patient's room 2 hours later.

The CNAs are supposed to ask the staff nurse to turn the feeding pump on and off, but this is not always the case.

[Irish Nurse 89]

Are you sure that another nurse didn't add another can to the bag, to keep it from running out? This could be a reason whey it had more in it than there should be. One of the nurses could or CNA's could have cleared the pump also, which would make the amount that you are seeing at the time inaccurate.

[psalm, RN]

...did you check the nursing notes and the Tube Feeding record for add-ons? If pt. was having nausea, it may have been turned off for a while, nothing was said in report? How about the machine's "volume infused", was thaat diffferent from what was expected?

This has prob. happened to all of us at one time, for any of the above reasonings. Continue to monitor, and document, that way you will catch what happens (unless another nurse doesn't document, etc).

[nursebecca35]

yes the bottle was still signed from when I hanged it. The only thing that could have changed was the tubing and that does not wipe out amount feed. Nothing charted from that shift, only charted from when I hanged the bag last weekend. But it was the same bottle with my initals and date and time. Pt is non verbal, no n/v noted anywhere.

[Super Nurf]

Anytime you see anything you think is odd, you have to bring it up. You brought it to the charge's attention, where she/he goes with it from there is up to them. Obviously there was a problem which needed to be addressed. What is needed is to find out how it could have happened --not to place blame on anyone, but to make sure that it doesn't happen again in the future.

[Strawberrykool]

I am a CNA myself actually a GPN. And I ALWAYS turn off the tube feeding. I try to remember to restart it when I get done washing the patient. Nurses where I'm from don't move fast enough for me to wait for them to turn off the tube feeding. So i do it myself. YOu weren't wrong you did the right thing. The person who stopped it it should have remembered to start it back

[militarymom06]

It is possible that this patient had some residual, and that could be the reason why the pump was turned off. I had a patient that we were always having to turn his pump off because of residual, n/v or simply being just too full. I have a big issue with feeding pumps running 24/7 anyway. People just don't eat 24/7. I've been a nurse for 20 years and still don't know why tube feeders have to be fed 24/7. Don't get me wrong. If the order says continuous, then it does run continous, but people do get full. Maybe that's what happened and the previous nurse just failed to say anything in report. However, if nothing was even documented then you have a problem. I would have asked the previous nurse what happened when she/he came in the next day. I have had to report my fellow co-workers, in the past, and it's not a good feeling. You do have to cover yourself, because nobody else will.