Another vent. I promise I'll stop when I get a new job. Swear I'm not one of those people who hates and runs from every job lol but this current one is taking every once of energy I have.
i get a call on my day off about an order the doc sent. "UA and CS, straight cath if necessary"
the day nurse was livid because it was for an AL patient. Still, our director said we can cath in AL as needed. I do this in our subacute unit all the time.
The reason for the order- this patient has been confused and combative most likely due to suspected UTI (she has dementia but is usually very sweet, foul smelling concentrated urine.. All the s/s) I couldn't get the urine cause It took me and 3 CNAs to toilet her for nothing, just to get her back into the chair and then into the bed as she went in her diaper.
she has hep c and is digging nails into people and trying to hit us. Just not a good situation.
so I called md and she said what about a straight cath? I said yes and some Ativan. She said fax me a reminder and I will fax the orders in the morning.
next morning day nurse flipped saying that I have no right to dx someone with a UTI and get order for a cath for an AL patient as its a liability to cath her and as an invasive procedure we could make a mistake and it's a liability.
im thinking, dude it's a urinary catch not a chest tube?
But it anyway I said go ahead get the order d/c for the catch and we'll try to get the urine. Been 3 days and still have not gotten it but I'm gonna let them call the shots cause I'm done with the arguing. Being made to feel dumb, and im done with the gossip too. As she ran and told the other nurses about everything.. I'm thinking, grow up?
Idk this isn't the place for me and im looking for other jobs and going back to school.
Home care and urgent care nurses won't come out to do caths according to previous experiences so it was the regional nursing director who told us we could do it.. If I go in today and she still has not been treated im going to send her out or request that MD put her on antibiotics
And since we are both sub acute and AL all this stuff gets confusing. I can do one thing on one side of the building but can't do it on the other side. Yet regional director is saying to do one thing and co workers are saying no. I'm looking for jobs in SNF right now.
Wow. That day shift nurse Is. Making. A. Molehill. Out. Of. Nothing. Besides the fact that as others have pointed out, you were just trying to do your job!
Home care and urgent care nurses won't come out to do caths according to previous experiences so it was the regional nursing director who told us we could do it.. If I go in today and she still has not been treated im going to send her out or request that MD put her on antibiotics
Wow. That day shift nurse Is. Making. A. Molehill. Out. Of. Nothing. Besides the fact that as others have pointed out, you were just trying to do your job!
Maybe not. If you do something that is out of scope for your facility, it can lose its license, and the nurse can lose theirs. That said, they could refuse to cath if that is the issue, but to ignore and not seek treatment is reprehensible. That is an issue!
Maybe not. If you do something that is out of scope for your facility, it can lose its license, and the nurse can lose theirs. That said, they could refuse to cath if that is the issue, but to ignore and not seek treatment is reprehensible. That is an issue!
Idk my director is still saying I should have cathed her but I sent her out. This is the biggest issue. I was off for three days cause I work 4 ten hour shifts.. I come back and she has a 101 fever. Sent her out im not playing these games anymore with who's right who's wrong and who should I listen to lol
Home care and urgent care nurses won't come out to do caths according to previous experiences so it was the regional nursing director who told us we could do it.. If I go in today and she still has not been treated im going to send her out or request that MD put her on antibiotics
Hopefully, this resident got to a higher level of care. And the family is not fumed over the fact that it has been a considerable number of days.
And if you send a referral and VNA declines, it is on them--and your record of prudent nursing judgment and no delay in care. Families love this stuff! Not. And you would then have the only other viable immediate option. The local Urgent Care.
And the regional nurse director can come in and do/ sign off on a straight cath if she is saying it is within your scope in AL. The regulations are crystal clear, and leave nothing to interpretation in my case.
Because when it comes to liability, I guarantee you the farm and all the animals that this regional director would deny that any such thing was said.
And there should be no confusion. What is done in sub acute for sub acute patients is far, far different than what is done for residents in AL.
Hopefully, this resident got to a higher level of care. And the family is not fumed over the fact that it has been a considerable number of days.
And if you send a referral and VNA declines, it is on them--and your record of prudent nursing judgment and no delay in care. Families love this stuff! Not. And you would then have the only other viable immediate option. The local Urgent Care.
And the regional nurse director can come in and do/ sign off on a straight cath if she is saying it is within your scope in AL. The regulations are crystal clear, and leave nothing to interpretation in my case.
Because when it comes to liability, I guarantee you the farm and all the animals that this regional director would deny that any such thing was said.
And there should be no confusion. What is done in sub acute for sub acute patients is far, far different than what is done for residents in AL.
Yeah I sent her to ER cause no one else was doing anything.. It is confusing and especially being a new nurse.. When everyone I work with and for, is saying all different things.
Yeah I sent her to ER cause no one else was doing anything.. It is confusing and especially being a new nurse.. When everyone I work with and for, is saying all different things.
Learn your regs and learn them quickly. An administrative person will hang you out to dry in a heartbeat.
Hoosier_RN, MSN
3,968 Posts
I've never heard of a hep drip in LTC, much less AL. What state is this? Those usually require pretty close monitoring