Is a patient out of my care if he is in another department off the floor?

[BiohazardBetty]

I had a patient code (and ultimately die) while in radiology. The patient had been off the floor, and out of my care for all practical purposes, for about 55 minutes prior to coding and was stable when he left my floor. Legally, would the patient still be considered to be under my care if I did not verbally transfer care to another RN? There was an RN in radiology, but is care of a patient assumed by that nurse simply because the patient is in that department? So far I haven't been able to find my hospital's policy answering these questions.

Just to answer a few questions I know will come up:

-the patient was stable when he left the floor, alert & oriented

-as soon as I heard the code blue announced overhead I called radiology to ask if it was my patient, notified the charge nurse, & immediately went downstairs to respond to the code

-the reason this is coming up is because staff in radiology apparently did not follow protocol & call the ALERT team when they became concerned about the patient & instead say they tried to call me, but I never got that phone call or a message saying they called

[JustBeachyNurse, LPN]

Sounds like radiology staff failed to follow protocol. (The systems error was failure to call rapid response and wasted time calling the floor) Your documentation should reflect your observations & assessments as well as the protocol you followed (i.e. Responding to the code when informed it was your patient)

[applesxoranges, BSN, RN]

It depends. Was he supposed to be on a monitor? If he was on monitor, was there someone watching the monitor? As in does the transport monitor show up on the screen?

[BiohazardBetty]

It depends. Was he supposed to be on a monitor? If he was on monitor, was there someone watching the monitor? As in does the transport monitor show up on the screen?

No, he had no monitors ordered.

[ProgressiveActivist, BSN, RN]

I once had a non monitored patient who slumped over in interventional radiology in mid sentence while talking to the IR nurse. She had a head bleed. Sometimes no one can foresee or predict a catastrophic event.

It is on the Radiology staff to prove that they attempted to reach you. It does sound like they are trying to deflect responsibility on to you for their failure to call for a rapid response.

[Lev, MSN, RN, NP]

Wow, this is a tricky situation. The best thing to do is document, document, document. If you have malpractice insurance, this would probably be a situation you would want to notify them about. This patient wasn't ordered cardiac monitoring or RN transport. How were the patient's vital signs before they went down to IR? Did they have any known diagnosis that could have caused them to code? How were the labs that morning? Technically, they are still your patient, but the radiology RN or whoever is down there is responsible for the patient at the time because they are the one with the patient. They should have called a code right away or a rapid response before the patient coded if anything was wrong.

[jadelpn, LPN, EMT-B]

Contact your malpractice insurance.

The "we tried to call primary RN" just wouldn't cut it. And what exactly were you to do? Tell them to call a code?

They have protocols as well. And apparently did not follow them. As well as most radiology departments have MD's on site as well, no?

Just for your own future practice, I would in fact give an SBAR report to the RN who is in the department. They should know where the IV is for instance, any applicable meds you have given, that kind of thing. CYA.

[Pangea Reunited, ASN, RN]

It makes sense that they would call you to assist in the code since you probably know more about the patient than they do. I don't see how you would possibly be responsible for calling the code, though.

[Been there,done that, ASN, RN]

Sounds like the radiology nurse made the wrong call , now attempting to throw you under the bus.

Report or not, licensed and unlicensed personnel are responsible to call a code/rapid response.

[Dobieb2009]

Our policy is to give report to the radiology nurse, and document that I did that. From there, it's her pt. Rapid response should have been called; you did the right thing by going to the ode, to assist and provide any additional assistance. The only problem I see is not giving report to the nurse receiving the pt. Sometimes they are too busy, or just don't care! You should e fine

[brai9284]

When we send people off the floor for tests...generally in the different departments there are not RNs..usually techs that run the tests. We would never get anything done if we had to call a report to the department they are going to. It was on radiology to call the rapid response or code.

[VANurse2010]

When we send people off the floor for tests...generally in the different departments there are not RNs..usually techs that run the tests. We would never get anything done if we had to call a report to the department they are going to. It was on radiology to call the rapid response or code.

Yep. Most radiology areas dealing with routine tests don't have RNs staffing them. It would be ridiculous and a waste of time to call report on every patient going to Xray, CT, MRI etc. Additionally, it would also be inappropriate for a staff RN to leave her other patients to go code someone (even her own patient) in a different part of the hospital. What a cluster this was.