Is this my fault

[DialysisTech]

I am a PCT in an outpatiet dialysis clinic. I have worked in my facility for 2 years and I know my job and the companies policies so when my DON told me to do something I felt was against policy I questioned her. She belittled me and demanded I do as she instructed. I feel as if she was wrong but I am not a nurse so I am not sure if I have a valid complaint. Can anybody tell me if this is wrong:

Machine set up for patient. Machine failed repeatedly. Trouble-shooted machine with DON to no avail. "Back-up" machine brought into treatment area for use instead. Back-up machine failed repleatly. Trouble-shooted machine with DON to no avail. DON pressed the reset button and the "ALARM TEST FAILED" icon disappeared. DON told me to go get my patient and put her on. I told her that the machine had not passed and she replied: I know what I am doing, obviously you don't, so go get your patient and put her on....she has been waiting long enough.

I put the patient on the machine and guess what......machine presented with constant "pressure hold failed" alarms. DON had machine technichian come out to treatent room and calibrate the machine while the patient was still on the machine.

After that, the machine eventually ended up working without any further complications. As soon as my morning-shift patients were all on, I told the RN what happened [she was on the other side of the room working with a PCT who had an infiltrated fistula, trying to remedy that crisis, and was not aware of what my DON instructed me to do until after the fact] and the RN seemed very concerned with the way things were handled.

I am not sure what was said between the RN and the DON but there was a heated discussion in the conference room later that day between the two of them. Did I do something wrong? Can this end up being my fault?

[NephroBSN, BSN, RN]

I am a PCT in an outpatiet dialysis clinic. I have worked in my facility for 2 years and I know my job and the companies policies so when my DON told me to do something I felt was against policy I questioned her. She belittled me and demanded I do as she instructed. I feel as if she was wrong but I am not a nurse so I am not sure if I have a valid complaint. Can anybody tell me if this is wrong:

Machine set up for patient. Machine failed repeatedly. Trouble-shooted machine with DON to no avail. "Back-up" machine brought into treatment area for use instead. Back-up machine failed repleatly. Trouble-shooted machine with DON to no avail. DON pressed the reset button and the "ALARM TEST FAILED" icon disappeared. DON told me to go get my patient and put her on. I told her that the machine had not passed and she replied: I know what I am doing, obviously you don't, so go get your patient and put her on....she has been waiting long enough.

I put the patient on the machine and guess what......machine presented with constant "pressure hold failed" alarms. DON had machine technichian come out to treatent room and calibrate the machine while the patient was still on the machine.

After that, the machine eventually ended up working without any further complications. As soon as my morning-shift patients were all on, I told the RN what happened [she was on the other side of the room working with a PCT who had an infiltrated fistula, trying to remedy that crisis, and was not aware of what my DON instructed me to do until after the fact] and the RN seemed very concerned with the way things were handled.

I am not sure what was said between the RN and the DON but there was a heated discussion in the conference room later that day between the two of them. Did I do something wrong? Can this end up being my fault?

Let's start at the beginning here. IN NO WAY DID YOU DO ANYTHING WRONG.

My first response to that DON would have been, "You do know more than I do, so I'm gonna let you put this patient on this malfunctioning machine". I might have said it a little too loud. Other patients might have heard me. I would never have co-signed the dialysis treatment/flow sheet that the machine had passed test. I would have "let" the DON sign it. I would not have signed the first line that I initiated treatment on that patient either.

Your first responsibility is to safe patient care.

Now I would go up the chain of command and report this DON to the Administrator or whomever is her boss. I would just state the facts. Put it in writing, keep a copy. Tell them you were very concerned for the patient's safety and the dialysis unit's liability. If they see a potential $$$ reprecussion of an incident they will probably listen more. Copy your dialysis policy. I'm sure it states that if a machine fails it must be removed from the treatment floor and replaced. They policy does NOT say that if the second machine fails it can be used.

I'm so sorry you've be put in this situation. It never should have happened. But it sounds like this DON is not interested in safe patient care. That fact may come back to bite her in the ar*e. And it could come back on you too. And the facility. Tell the administrator that you don't want anyone to be in "hot water". Not the DON, not you, not the patient, and certainly not the unit.

Good luck with all of this.

[AmyLiz]

Wow...that's just stupid on the DON's part. Not your fault whatsoever. That's just bizzarre behavior on her part.

[Midwest4me]

YOU DID NOT DO ANYTHING WRONG!!!! I am curious however as to WHY a second back-up machine wasn't brought out? I understand the first one didn't pass and the back-up machine didn't either but why not try a third machine???? Where was the machine technician? The back-up machines should ALWAYS be functioning and if not, then should be clearly labeled as such. I agree with another poster----take this up the chain of command----just be sure the DON and administrator aren't buddies when you do it!(Been there.)

[chart209]

You did nothing wrong the reason we put machines into test is for safety of patients. DON has got some issues.