Is this gross negligence?

[Chad_KY_SRNA]

Yesterday at 1500 a CNA noted coldness and dark discoloration to the RLE of a resident on the unit, the DON was the only nurse he could find at that time, she assessed the foot at that time. That residents doctor was in house at 1600 for rounds on his patients but nothing was documented and the doctor was not informed of the coldness and discoloration. At 2200 while performing a routine bedcheck the resident complained of pain to the CNA from earlier in the day. At this time I had not personally been in the room but had overheard the other CNAs talking about the foot earlier and went in to see what the problem was. The residents foot was cold, a dark purplish black color, pulses went from strong to absent. Obviously cap refill was horrible. I told them that I would be right back that I was going to go light a fire under someones butt that it looked like a blood clot to me. The unit nurse came in assessed the foot and sent the resident out to the ER. As far as I can tell from the other CNAs the residents foot had been this way the whole time and the DON did nothing. We looked in the chart and shift report book but there was nothing. I don't even know how to begin to deal with this. The DON saw the foot and the unit nurse knew that it was discolored, cold, and painful to the resident from what the CNAs were telling her, I feel that someone needs to be held responsible for allowing this to fall through the cracks for seven hours until I, as a CNA, saw the foot and went and drug a nurse into the resident room.

[CrunchRN, ADN, RN]

Wow - you are a great patient advocate!

[mattsmom81]

In order for there to be negligence (legally)there must be : a duty established, failure to do what a reasonable and prudent nurse in the same situation would do, damage or injury to the patient, and a direct relationship between the nurses failure and the damage...her action or inaction must cause damage/injury.

Sooooo...If I were on peer review I would want to know if the admitting nurse notified the attending doc immediately and asked for new orders surrounding the extremity, and ensure appropriate followup. Failure to do this, resulting in the patient ending in amputation would likely constitute professional negligence IMHO (but I'm not an attorney or legal nurse)

I agree with the other posters' advice as far as keeping a record for yourself of everything that happened. Just in case something comes of it. This is essential particularly if a nurse was in your position...to CYA.

Good job...you did very well. :)

[Tweety, BSN, RN]

(Be careful the information you post Chad, it might come back to haunt you.)

Good job on your part. This could have been a very serious situation and that assessment finding warrented immediate emergent action on the DON's part. She/he did not do what any RN would have done and this could be negligent if there's a bad outcome. I hope no harm comes to the patient because heads could roll.

I think you did all you could have done. Being the patient advocate and reporting findings, even if you have to report them over and over is what good CNAs do. You're with the patient, you're our eyes and ears and I personally value that in a CNA.

[TracyB,RN, RN]

I agree that the DON probably did not do what any "reasonable and prudent nurse" would have done. Especially since nothing was documented?

You know the rule... "If it isn't charted, it wasn't done."

[dekatn]

Good job Chad and as Tweey stated, do be careful, I would do as the others said and write down exactly what took place and keep it for your own records.