What could be the ramifications?

Specialties Emergency

Published

Hi all...been a long time since I've been here. Between school and working in the ER, not much time. I had an experience a couple of weeks ago and just wondered what the ramifications could be with something like this. Right now I am an ER tech, so I know that legally it can't really affect me, but I'd like to know what can happen to the nurses involved. Thanks.

Patient presented in private vehicle stating "I know I am having a heart attack, it hurts so much!" Patient is 46 yo. Brought into ER by stretcher and taken into trauma bay. Nurse comes in and asks a few very vague questions as patient is writhing in pain on the stretcher. Nurse leaves patient without a line started nor hooking up to monitor. Doc comes in (after listening to nurse stating that patient was a "drug seeker") and asks a few questions of fiance who accompanied patient. Doc leaves. Patient is still not on monitor and is without a line.

A trama alert is called and tech is told to move patient to a regular room. Tech is told not to bother hooking patient up to monitor because "he doesn't need it". Patient still complaining of chest pain and extreme headache. Nurse AGAIN told of this and nothing is done. Trauma rolls into ER and patient that was moved codes. Patient is revived, put on monitor and nurse tells doc that she did this and that as soon as patient was brought into the ER (none of which is true and I knew it).

Who is responsible for this nurses actions legally and can I be dragged in on all of it? She was reported to the nurse manager and as far as I know nothing was done. This particular nurse has also overdosed a pediatric diabetic..order read 5mg and she gave 50mg, overdosed another adult patient in the same manner and is busy flirting with the male EMT's. and having an affair with another nurse in the department, and ignoring most of her duties unless she absolutely has no choice but to do them.

I'm very concerned that she is going to kill one of our patients someday. I understand that there is a nursing shortage, but why in heaven's name would they keep someone on staff like that? What are the ramifications for the rest of the staff that may be on staff when she does these "mistakes"?

Hey Hye now easy on the EMT's you are touching on a nerve over here, but I have to agree with waht everyone says especially CEN35, DOCUMENT, DOCUMENT, DOCUMENT and if you can't get anywhere with the ER nurse manager move up the chain of command, but always , always document, even if you don't think it is significant.

LPN & EMT-CT

Love the EMT's!!! Great bunch of people who really care about everyone (even the frequent flyers!). It's all about being part of the team, no matter which team you are on.

I work tonight and hope the little princess isn't on...sometimes it takes all of my energy just to not tell her off when she gets on the "I'm so cute" mode. but the patients are the most important thing, not her (wish she'd realize that).

Specializes in ER, PACU, OR.

well ess,

we have had a couple "i'm so cute" girls in our er. they are great friends outside of work. however, they always cop the, "what's wrong attitude, or why are you not paying attention to me attitude." in the meantime they stand around and flirt with some of the guy nurses and firemen/medics that come through the door.

unfortunately, i am not the type of person to say, why? because this is not the time to act like that (and/or be an airhead). just my two cents......and i know i am alone on this one....unfortunately some people thrive on it!

i mean hey? imho.... there are flirts (sorta the equivelent to the liberal), and hopeless romantics (equivelent to the conservative) at least in the gender area. they are 180 degrees apart! i'm the hopless one.......

like you said, the patients are the important things at work.

me :)

p.s. - trust me, i can still be a joker or goof at work. (i usually am) the difference, is i don't let it interfere with what needs to be done! :D

Originally posted by RNFROG3

...We talked and cried( I cry when others do) I explained that the pace and the stress here was too much. I also told her I thought that she would make a good community health nurse or office nurse, or rehab nurse...

Please don't dump your trash in my yard...

I'm a PHN who has referred in woman with absent FHT's, a kid with PERITONSILLAR ABSCESS, patients with Hypertension, chest pains etc, etc.

Office nurses are the front line for subtle presenting problems often. I know of a _receptionist_ whose index of suspicion was ticked by a mother who called in about her child's vague abdominal pain that progressed to a reduced level of consciousness. Child developed a virulent hepatitis that threw him into hepatic failure.

Nurses who don't have the capacity to think about out-lier presentations are a danger anywhere they go.

We have a policy at our ER that all chest pain pts must have an 12 lead EKG within 10 minutes arrival time to ER, even walk-ins are taken right back to a room and EKG performed prior even triage notes or vital signs!! We document time the EKG given to which MD also. We hook up the monitor, establish IV,send cardiac panel and give 4 baby ASA chewed per protocol. Some pts that were least suspected of MI has gone to cath lab!!!

We also get frequent flyers that have learned that chest pain gets you back immediately. I like to mention the little boy that cried wolf story after cardiac has been ruled out. But as a nurse, I'm glad our policy is better to be safe than sorry.

We also have variance reports that anyone can fill out for any reason to give our nurse manager heads-up. Many changes has resulted from these reports.

Have I missed something??? No one has suggested that the state board of nurses be notified?? Sounds like NOW would be a good time. Just venting.

I could only read a post here and there b/c of the feelings that were trying to break thru. No wonder I was approached by a total stranger to join a class action over the massive mi death of my young husband. I am a licensed nurse w/yrs of exp (but not ER) and this is the first time I have learned that people presenting w/sx of MI are drug seekers. The autopsy which I paid double for confirmed the negligence/malpractice even though I did learn that sometimes it is hard to catch a MI in progress. And it has taken me more than 10 yrs to finally convince a MD that I have HTN and I am monitoring my cardiac "events". (And getting my affairs in order). I became a nurse b/c of my husband's death and now I am in the process of preparing to leave nursing for good. Sorry but I've probably already said enough that the wrong people can identify me. Nursing might have been a calling for me all my life. But it brought me to hell on earth. Sorry to vent like this. I seek no sympathy or empathy, but I am human and have not been able to properly cry for almost 20 yrs now. I can't take it anymore.

She is very dangerous.

A word about documenting. Most ERs DON'T have computer charting, it only makes sense that they dont with the flow. So this (cough) RN can document whatever she wants for times as to when she put this guy on a monitor etc.

I sounds like she is getting away with whatever she can, so what is a lie on paper to save her butt.

You said in your first post that she TOLD THE MD that this pt was a drug seeker and he took her word for it. I really dont think he is not going to back her up....since he SHOULD HAVE ASSESSED HER AS WELL....AND NOT JUST TAKE THIS NURSES WORD FOR IT THAT HE WAS DRUG SEEKING.

Specializes in Critical Care.

It is so difficult to seperate your personal feelings sometimes but this is a prime example of why we must not judge. Treat all c/o CP seriously. If you are concerned I suggest you talk to the charge nurse, unit manager, etc... Document your observations on a incident report. I am sure management is aware of this nurse but unless people are willing to document problems then they are stuck with them. You would be doing the entire department a favor if this nurse no longer worked there, such a shame that he/she will bring her poor nursing to another facility.

the original post is pretty old, b ut it would be interesting to see another update.......wondering about an ethics comittee and a report to risk mangmnt??????

Callioter3,

I can almost feel your pain. I lost my father from a massive MI related to not only a physician's negligence but also a nurse's negligence. It happened in March of 1980 and I feel it as if it just happened. I hope you were able to get resolution through your class action suit although I know that it couldn't possibly make up for the loss of your beloved husband.

I will pray that God will give you the peace you so deserve in your life. I am so sorry your pain is still so raw.

This only proves why the attitudes by ER personnel about drug seekers shouldn't be projected onto patients just because they are being treated for chronic pain. Think before you act or judge. This could easily be any nurse misjudging someone as a drug seeker when in fact something else is very wrong. This frightens me a LOT. I have cardiac problems. I know I will probably die because I am also a chronic pain patient. Can I trust that I will receive the appropriate care if I am ever desperate enough to go back to an ER? It's very likely I won't be offered any pain medication if I have chest pain either because it's been said to me "how can you be in any pain on all the medication you are on"?

I guess I'll start praying now and call my doctor and ask for a bottle of nitroglycerin. I will probably have better odds staying home with a bottle of nitroglycerin and baby asa than to go to an ER. You can't possibly imagine how frightening this is to read about these events. I think I'm more terrified of the prospect of having to potentially go back to an ER than of having an attack of chest pain.

Do you even have to ask if this nurse should be reported? What if this was one of your relatives? What if this happened to your Mom and it was your night off? If you have a problem with a situation then you need to become part of the solution otherwise you harbor a near equal amount of guilt. It's not always about saving your own a$$. There is personal integrity to think about also.

I realize that most of these posts are from a while back but the same situations are repeated I'm sure. What an unbelievable mess. The plain and simple answer is just recgnizing the differences between right and wrong.

Warm personal regards,

Pappy

I thought I would update everyone. This nurse is still working in the ER. She is still dangerous. About two months ago she was outside having a cigarette and an ambulance pulled in with a patient on O2. She walked over to the patient with cigarette in hand got up close and stated "what's your problem?". She's still the little princess and does exactly what she wants.

I have since left the emergency room (even though it is my first love) and moved to the med surg floor. The pace is much slower, the nurses work as a team, and trust my judgement (which is greatly appreciated).

This nurse has been "turned in" I don't know how many times and nothing has been done except for a conference with her boss. I just pray that no one gets killed by her attitude, judgement (or nonjudgement), and princess attitude!

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