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
It is unrealistic to think that the radiology nurse would be responsible for every patient that goes through radiology. Interventional radiology is different. There should always be a nurse to nurse hand off if a patient is under going an invasive procedure.
Who is responsible for the patient if they go to the cafeteria? Radiology staff are educated in BLS, but seldom have to use it. I am a certified radiology nurse. We have had the same problem, patients coming from the floor, ER, or "step down" ICU. Even if your patient requires telemetry, they should be placed on a transport monitor and brought down by a qualified individual that can monitor the pt and act on the monitor were the patient to become unstable.
As the radiology nurse, I preformed mock code blues and mock rapid response team drills monthly. The staff in radiology are very intelligent. They are not trained like nurses. They need practice to know how to handle those situations. Also, they need support from hospital administration that they will not get in trouble for making the wrong call. It is a culture in hospitals to dump on radiology. My staff have gotten in trouble for calling a code when the patient was unresponsive, but had a pulse. The next time a situation occurred, they did not want to call a code in fear of being wrong and getting in trouble. I have given my staff cart blanch to call a code or rapid response regardless if they are "sure" or not. I will take the heat and deal with the angry doctors and ER/ICU nurses that responded unnecessarily. I'd rather call them and not need them, than need them and not call them.
Should you be responsible for your patient coding in radiology? Not if you documented the stability of the patient upon transport. You should however respond to the code. Nobody knows anything about your patient except the diagnosis given for the exam ordered, if they have an IV, if they are NPO and allergy status. You will be able to do the most good for your patient giving the code team their history.
You should not suspect the CT tech is covering anything up. You have no foundation for such an accusation.
The pt was not monitored, so no body knows what happened. The CT tech could have called a code faster. I'm telling you that rad techs are darned if they call a code and are wrong or second guess themselves because of the last tongue lashing they got for being wrong. They are often trained to call the nurse to find out baseline status. Something could have happened during transport and the CT tech did not see the pt until they were unresponsive.
Please do not think radiology is evil. They are misunderstood from years and years of nurse vs the world culture.
It is unrealistic to think that the radiology nurse would be responsible for every patient that goes through radiology. Interventional radiology is different. There should always be a nurse to nurse hand off if a patient is under going an invasive procedure.
Who is responsible for the patient if they go to the cafeteria? Radiology staff are educated in BLS, but seldom have to use it. I am a certified radiology nurse. We have had the same problem, patients coming from the floor, ER, or "step down" ICU. Even if your patient requires telemetry, they should be placed on a transport monitor and brought down by a qualified individual that can monitor the pt and act on the monitor were the patient to become unstable.
As the radiology nurse, I preformed mock code blues and mock rapid response team drills monthly. The staff in radiology are very intelligent. They are not trained like nurses. They need practice to know how to handle those situations. Also, they need support from hospital administration that they will not get in trouble for making the wrong call. It is a culture in hospitals to dump on radiology. My staff have gotten in trouble for calling a code when the patient was unresponsive, but had a pulse. The next time a situation occurred, they did not want to call a code in fear of being wrong and getting in trouble. I have given my staff cart blanch to call a code or rapid response regardless if they are "sure" or not. I will take the heat and deal with the angry doctors and ER/ICU nurses that responded unnecessarily. I'd rather call them and not need them, than need them and not call them.
Should you be responsible for your patient coding in radiology? Not if you documented the stability of the patient upon transport. You should however respond to the code. Nobody knows anything about your patient except the diagnosis given for the exam ordered, if they have an IV, if they are NPO and allergy status. You will be able to do the most good for your patient giving the code team their history.
The patient was coming from a regular medical bed for a routine CT. I really appreciate your input. It always helps to see it from another side.
Dobieb2009
39 Posts
Many reasonable answers to a difficult situation.