Help! Am I Responsible

[tigress_8207]

Hi all just in need a bit if advice.I am a new nurse working on a medical floor.While working night duty with another RN with a patient ratio of basically 1 nurse to 12 pts. I admitted an 86yr old male from the accident and emergency department to the unit at 03:00hrs. He came with syncope,decompensated ccf secondary to ACS,Ischemic heart disease.A-Fib,Mitral regurgitation, Diabetic and Hypertensive.He was Oxygen at 3L/MIN Nasal Cannula Alert and responsive to verbal commands.My assessment also revealed hearing aids to both ears.he was wearing glasses,had in a urethral catheter and milde pedal edema bilaterally.Temp 35 pulse 93,R 24.BP 165/80,Random blood glucose 8.6.unit has no saturation probe as case with majority of units so no saturation percentage could be ascertained at the time.Braden score 19 and a falls risk score of 10.Falls wrist band was placed,sign places and cot sides up.About and hour later while checking on pt he was out of bed and a bi confused.I assisted him back in to bed.He later pulled out his cathether still inflated and small amout of bleeding from member.Dr was called requested a condom sheath be placed until able to see patient I cleaned it of with some saline and placed condom sheath.Later pt was restless and kept trying to get out of bed and had to be restrained for his safety.I handed him over to next shift and left.Was told wife is missing back piece from one of the hearing aids and wants hospital to compensate.Heads have asked me to write a report.It is my understanding now that hearing aid should have been confiscated by the Accident and Emergency department as is done with all personal belongings.I documented all my findings and care given to this patient during my shift but i feel like i did something wrong.Should i have taken off the hearing aids and stored them?Any Advice is much appreciated.Thanks Guys.

[KRVRN, BSN, RN]

Perhaps they should be confiscated in an unconscious pt. He was initially alert and would most certainly not benefit from them being removed. The hospital may have a stipulation in the paperwork that they aren't responsible for personal belongings. It's not a win-able situation. If they were removed, then it could be argued that was the cause of the confusion. That wouldn't be acceptable since the confusion ultimately led to restraints. It would have been prudent of you to leave them in. The hospital may choose to just eat the cost and reimburse them. You say Accident and Emergency and use some other terminology that make me think you aren't in the US, so your laws could be different.

[brownbook]

Our hospital policies, and the admission form, state the patient is responsible for any personal belongings. However this does not absolve the hospital and care givers from being prudent. Family can be, has a right to be, really annoyed if hearing aides, glasses, etc. go missing. How the hospital handles such missing items can vary.

I would tell the administrators that you had to prioritize your patients care. Keeping him alive, in bed, catheter on, etc., were your priorities during your shift. Caring for his hearing aide was priority 24 page 3!

[RNlove17]

why would they confiscate hearing aids? To confuse an already confused patient even more? They should be removed at bedtime but I just don't understand why you would purposely make it harder for a patient to hear. I get reasons why such as surgery, unconscious, etc, but sounds like he was alert. Am I missing something?

You are the scrapegoat, I mean nurse

I love how the man is hypoxic and the higher ups just care about hearing aids. How about an o2 sat!!

[tigress_8207, ASN, BSN]

Will find out our hospital policy with regards to that.I'm just trying to be able to cover myself since on this floor doctors orders mysteriously disappear when something goes wrong.Or they cross the order off and write a new one and then it looks as though you have administered things on your own without first checking.We have a few docs that will give verbal orders and if an adverse reaction occurs he will blatantly deny the order the other RN is not going to stand by you and say yes it was given.I have seen it happen with my collegues.

[tigress_8207, ASN, BSN]

@RNlove you are so correct.They are only interested in preventing the hospital from law suits.I live in the Caribbean.They dont care about the pts at all.Imagine they said to me that i have the pts spoiled.But the reason why too is because this guy was an american visitor and sorry to say but they kiss ass to light skinned people here.If he was from anywhere else they couldnt care less.As far as i'm concerned a patient is a patient and i treat every one of them the same regarless of the homeless man on the street to the president.I'm not saying the claim should have been dismissed at all but i just dont think they are handling it correctly.And i do feel like the scapegoat apparently the charge nurse and her senior dont get along and im being put in the middle of their squabble.From what i was told yesterday the senior is insisting on the report since she had asked to charge nurse to investigate and report back to her and she didnt.Well i made sure i submitted mine.Charge nurse still hasnt written one told me she doesnt have time for that.IMAGINE.

[tigress_8207, ASN, BSN]

A bit off topic here but this unit is absolutely horrible.Most of the nurses are horrible.This pt came in with CCF had in a urethral catheter and was alert and oriented.was on heparin and some other meds. About day 5 i noticed he was having a bit of haematuria so i held the heparin.The shift before didnt hand this over and had given him.anyway doc was informed saw him and doesnt even acknowlege it. Each day it gets worst visible blood clots.I keep with holding the heparin but it seems like im the only one who is concerned about it.By day 5 doc discharges pts who is still having haematuria. my shift had ended when doc did this and i immediately challenged him as to how he can send pt home with haematuria.He completely ignores me and charge nurse tell me to leave doc alone and let the pt go home so another one can get the bed.He is the doc and if he says pt can go then pt is to go.Well not only did the pt go home he went with the iv access which none of the nurses took out and his catheter that non of the relatives had any idea how to empty.

2.Shift handed over a pt that was complaining of chest pain throughout shift.No one bothered to called doc.when i assessed this pt he was screamimg in pain.I told them to please go call doc ASAP.Assumed they did within mins this pt crashed and previous shift are gone.I call doc telling him to hurry and when he comes he tells me no one called.Pt later died.

3.that same day pt in opposite bed has extremely swollen bottom lip when i enquire they said to me "oh he probably has an allergic reaction" I said probably? Asked if doc knows and response as you can guess is a big no.To them it was no big deal.Doc happens to pass thru at the same time and ask what is wrong with pts lip and why no one called him i told him i was just enquiring and what response was.Pt had to have a massive about of antihistamine stat.

[SlightlyHumerus]

@RNlove you are so correct.They are only interested in preventing the hospital from law suits.I live in the Caribbean.They dont care about the pts at all.Imagine they said to me that i have the pts spoiled.But the reason why too is because this guy was an american visitor and sorry to say but they kiss ass to light skinned people here.If he was from anywhere else they couldn't care less….IMAGINE.

Note to self: avoid Caribbean hospital at all costs

[MrChicagoRN, RN]

This unit is absolutely horrifying.

I have resorted to documenting every detail of my shifts however insignificant i think it is and taking pics of doctors orders etc.

My husband has even suggested i purchase a small tape recorder to record all conversations and i think i will do just that.Its every man for himself on this unit.

Sorry if things are horrible, but....

Doctors orders are part of the patient record. What is the policy and the law about photographing and keeping these documents?

Recording a conversation without the knowledge of both parties may be illegal. It certainly is in Illinois.

[tigress_8207, ASN, BSN]

We are not allowed to record anything but in cases where a doctor's orders are put into question and you think it will magically disappear then you can take a pic to save your skin as its the nurses who are blamed for everything.

[tigress_8207, ASN, BSN]

lol its not the hospital its the nurses wel at least the ones i now work with.So miss my other co-workers they are the best