Feeling Unsettled...

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This is my first post, but I really need a sounding board. I am an LPN working in a LTC facility. I normally work 7-3 and carry a patient load of 26. Last week I was filling in on 11-7 so I had 52 patients and 2 CNAs. This was not my usual hall and I'm not familiar with all of the patients.The particular patient in question was afairly new admit,in his 90's with a very worn out heart. The only report I recieved on him was that he had been given an enema on 3-11 with a good result. Shortly after midnight I checked his vitals which were WNL and administered his scheduled breathing treatment. He was in no acute distress. A couple of hours later I did my usual walk up the hall to ensure everyone was alive and off of the floor. The CNA also made rounds every 2 hours. At 5 am, the aide called me to the patients room, he was dead. Yes I know it happens sometimes, these people are elderly and in poor health after all, but when I sat down to chart I discovered the 3-11 nurse had not charted at all on the patient, not even signed off that he'd had an enema. The family, when I called to inform them of his passing began to tell me that he had been vomiting the day before and that they had been present when he recieved the enema.Well, to make a long story slightly less long, I had to talk to the DON today about this and I find out that the resident had been complaining of abd/back pain and had NO bowel sounds before this enema was given and he was "assisted" with a bm by the 3-11 nurse. I feel at wits end because the nurse did not give me a full report on the patient therefore I didn't anticipate any problems with him. The family feels we were negligent, and actually so do I. I feel the 3-11 nurse is moistly at fault, but where does all this leave me?:o

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Specializes in Ortho, Neuro, Detox, Tele.

I don't believe I can legally advise you, but I personally feel that as long as your charting is present and you ensured he was alive every hour minimum...you should be ok. The previous nurse may have malpracticed...when do you give a enema with NO bowel sounds? Isn't that usally indicative of some kind of GI problems? Did he have any other complaints all night? just my .02

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Specializes in OB, HH, ADMIN, IC, ED, QI.
This is my first post, but I really need a sounding board. I am an LPN working in a LTC facility. I normally work 7-3 and carry a patient load of 26. Last week I was filling in on 11-7 so I had 52 patients and 2 CNAs. This was not my usual hall and I'm not familiar with all of the patients.The particular patient in question was afairly new admit,in his 90's with a very worn out heart. The only report I recieved on him was that he had been given an enema on 3-11 with a good result. Shortly after midnight I checked his vitals which were WNL and administered his scheduled breathing treatment. He was in no acute distress. A couple of hours later I did my usual walk up the hall to ensure everyone was alive and off of the floor. The CNA also made rounds every 2 hours. At 5 am, the aide called me to the patients room, he was dead. Yes I know it happens sometimes, these people are elderly and in poor health after all, but when I sat down to chart I discovered the 3-11 nurse had not charted at all on the patient, not even signed off that he'd had an enema. The family, when I called to inform them of his passing began to tell me that he had been vomiting the day before and that they had been present when he recieved the enema.Well, to make a long story slightly less long, I had to talk to the DON today about this and I find out that the resident had been complaining of abd/back pain and had NO bowel sounds before this enema was given and he was "assisted" with a bm by the 3-11 nurse. I feel at wits end because the nurse did not give me a full report on the patient therefore I didn't anticipate any problems with him. The family feels we were negligent, and actually so do I. I feel the 3-11 nurse is moistly at fault, but where does all this leave me?:o

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I'm a fledgling legal Nurse Consultant with a little experience, and have always been interested in legalities of Nursing Practise.

If that was me, in your position, I would call my own attorney (not the hospital's or the union's or the Nurses' Association one), but one who has a lot of experience with medical/nursing issues. The first visit should be like an interview, with no work done (like a letter written on your behalf), and be without charge. Then if your community is big enough, go to another reputable attorney and see what his/her opinion of your liability is, too. Stay away from his family - leave the case for lawyers.

If it looks like you're going to have to go to court for either side, have the attorney there who you liked best (who answered your questions well, so you understood, not legal mumbo-jumbo, and looked like someone who would earn respect for his speaking capabilities and knowledge). You really weren't the Nurse who did any procedure on the patient other than the respiratory one (and he was breathing), you charted it appropriately, I hope, so I doubt that you'd be pinpointed for not being there at his bedside at the moment of his death. Therefore, it's doubtful that your attorney would have to do much, other than see that no implication of fault was assigned to you at the trial. You want to keep your cost to a minimum, so it may not be necessary for your attorney to be there at depositions (which can go on and on). He/she can and should read the report of those, to know if anyone is assigning blame to you.

Please accept my sympathy for your unexpected loss of a patient whose condition had not been properly communicated long before you were assigned to him. From what you wrote, it seems that you did everything you could, given the lack of information you received. :madface:

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Take a deep breath and be prepared. Sit down with yourself and write down all you remember from report and everything you did with that pt. that night. Do it while you are calm and remember it all. Then just tell the truth. Did you chart all you did? You did your assessment of the pt and took what actions you felt were appropriate. You don't say much about his Dx or his current condition. But, like teacher, I agree. Don't talk with anyone about this, not even your co-workers. I know this will be hard for you, but hang in there.

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Thanks for the support. I did get called into the DON's office and was able to produce my report sheet (I save them) which clearly showed what report I was given and what the patients vital signs were. The 3-11 nurse was fired and the other nurse who gave the enema for her but failed to chart it was disciplined. My DON was pleased that I take my own vitals, most of the other nurses have the CNA's get theirs. She told me that as far as she could tell I did nothing wrong.

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And pick up malpractice.

http://www.nso.com

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Specializes in OB, HH, ADMIN, IC, ED, QI.
Thanks for the support. I did get called into the DON's office and was able to produce my report sheet (I save them) which clearly showed what report I was given and what the patients vital signs were. The 3-11 nurse was fired and the other nurse who gave the enema for her but failed to chart it was disciplined. My DON was pleased that I take my own vitals, most of the other nurses have the CNA's get theirs. She told me that as far as she could tell I did nothing wrong.

Thanks for the followup, and for keeping a record of everything, always. Right is might! Keep upthe good work!

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