Pt got no care all night

LPNer · Mar 21, 2005

This is every nurse's nightmare! What I don't understand is, WHY did the charge nurse not tell you she assigned you another patient? And how is it that a patient in restraints (what are 3-points, anyway??) didn't have 1:1 nursing with at least a CNA?
That facility sounds like a huge lawsuit just begging to happen.......I'd get my rear-end outta there ASAP, if I were you. :stone

He had, from what I understand BLE and one wrist restraint. Could have been BUE and one LE, I really don't know for sure. Restrained pts do not get 1:1 nursing care, they do, however, get assessed every hour and permitted out of the restraints for at least 5 minutes every hour. At least that is the policy, which, when I am assigned to a pt, gets that care. You are generally in the room more than that anyway because you just can't trust a rowdy confused pt to be alone. Alas, I can only speak for myself.

Long Term Care Columnist / Guide · Mar 21, 2005

Geez......how can hospitals be generally good and have ONE floor that sucks?? Who's in charge of that floor, and who do they report to? There's got to be a reason why they can't keep regular staff.......I'll bet they've got a bad manager, it can't just be the charge nurse. Or can it?

I think just about every hospital has that one unit that no one likes to work in, either because its management stinks on ice or its organization (or lack thereof) leaves a lot to be desired. Our OB floor has a combination of both.......almost nobody likes working up there, it's very disorganized and many of the staff act like prima donnas. Not only that, the manager is a 30-something whose own nose is in the air most of the time, and she always blames the float nurses whenever something goes wrong because HER nurses "know better than that--they're specialists" :uhoh3: I get along with everybody, because that's what I do, but I can see why a lot of my co-workers don't like being pulled to that floor!

What's funny is, even some of the DOCTORS don't like putting patients on that floor........we had one who out-and-out refused to put a 15 YO diabetic up there last week, even though she was clearly not appropriate for an adult med/surg unit. She eventually ended up in the ICU.......she had a FSBS of 694, for pete's sake, and was going to need an insulin drip, so as the acting floor supervisor at the time, I refused to accept the patient. (Of course, that didn't make the doc very happy, but since we don't do insulin gtts on M/S anyway, I had no problem with that.)

I'm glad you wrote up an incident report, LPNer........and for your sake, I hope you never have to get pulled to that floor again. It's not worth it. :stone

LPNer · Mar 21, 2005

Geez......how can hospitals be generally good and have ONE floor that sucks?? Who's in charge of that floor, and who do they report to? There's got to be a reason why they can't keep regular staff.......I'll bet they've got a bad manager, it can't just be the charge nurse. Or can it?
I think just about every hospital has that one unit that no one likes to work in, either because its management stinks on ice or its organization (or lack thereof) leaves a lot to be desired. Our OB floor has a combination of both.......almost nobody likes working up there, it's very disorganized and many of the staff act like prima donnas. Not only that, the manager is a 30-something whose own nose is in the air most of the time, and she always blames the float nurses whenever something goes wrong because HER nurses "know better than that--they're specialists" I get along with everybody, because that's what I do, but I can see why a lot of my co-workers don't like being pulled to that floor!
What's funny is, even some of the DOCTORS don't like putting patients on that floor........we had one who out-and-out refused to put a 15 YO diabetic up there last week, even though she was clearly not appropriate for an adult med/surg unit. She eventually ended up in the ICU.......she had a FSBS of 694, for pete's sake, and was going to need an insulin drip, so as the acting floor supervisor at the time, I refused to accept the patient. (Of course, that didn't make the doc very happy, but since we don't do insulin gtts on M/S anyway, I had no problem with that.)
I'm glad you wrote up an incident report, LPNer........and for your sake, I hope you never have to get pulled to that floor again. It's not worth it. :stone

We all think it is the management. The nurse manager didn't want the job but somehow they talked her into it because nobody wanted to deal with building up a good staff base. She doesn't seem to have the fortitude to do it herself, preferring to rely on agency. I would be willing to help out up there to get it together, but as an LPN I am not in a very good postition to help. That is the one bad thing (well there are others) about never having had the money to go back to school. Bummer.

LPN1974, LPN · Mar 21, 2005

Sounds like the problem on that floor is because there is no regular staff, or very little of it. Agency nurses are great, but they can't be expected to know and do the routine stuff that regular staff know about like breaking down charts, etc.

If management could just get some regular nurses to take over the floor for awhile I betcha they could get things straightened out and running smoothly.

Sounds like this would be a great project for a group of nurses to pull together and show how things can be done.

You get a bunch of good nurses together and things can get very creative.

redwinggirlie · Mar 21, 2005

I haven't read the other posts, but, is there not a CNA who works with the nurses on your shift? Would they have known? You said the patient was tacked on to you. Do you not have other support staff on board? Does your floor have a chalkboard or something to that effect with who is covering whom so all can see? I see this as a breakdown in the system your place uses. How can people go by a room without seeing someone is there? Surely there had to be a MAR or a chart floating around. I wish you well And I do hpoe your patient is fine too. No malice intended, I just find this unreal.

LPNer · Mar 21, 2005

I haven't read the other posts, but, is there not a CNA who works with the nurses on your shift? Would they have known? You said the patient was tacked on to you. Do you not have other support staff on board? Does your floor have a chalkboard or something to that effect with who is covering whom so all can see? I see this as a breakdown in the system your place uses. How can people go by a room without seeing someone is there? Surely there had to be a MAR or a chart floating around. I wish you well And I do hpoe your patient is fine too. No malice intended, I just find this unreal.

Thank you, I am still feeling as though it was a bad dream!

Yes, we did have one CNA last night, 4 nurses and 22 pts. He came to me to ask for help with several pts through the night (if you had read some of the other posts, that would make better sense). I have worked with him several times when floated to that floor. I am sure the pt was turned and cleaned through the night.

He always asks me if this pt or that pt is mine just before he tells me what he needs, I usually am able to help and it's quicker for all of us if I do and move on. He did not ask for help with the man in 90. He is a tall man, I could see him as I walked past to get to 91, however, he is not a heavy man and is very capable of moving all over the place, that's why he is restrained! The CNA would not likely need my help with him.

It is definately a communication problem! There is a board on every floor with pt name, Doc and nurse. I've never seen night shift use it on that floor (we always use ours on ortho) I knew the man was there, I didn't know he had no nurse.

The whole thing is like a bad bad dream and I shudder to think the charge nurse felt like it wasn't a priority to make sure I knew she changed the assignment after the shift started!