LTCNS, LPN 623 Posts Specializes in Clinical Documentation Specialist, LTC. Feb 11, 2016 Good on you for advocating for your resident! A temp. of 101 would've had me sending her to the ER as well. I would rather deal with the PTB than find myself sitting in court answering as to why the resident was left untreated when she clearly showed s/s of a UTI, then rapidly declined and died from septic shock. Not on my watch.I'm curious...What was her blood pressure before you sent her out?
Been there,done that, ASN, RN 6,955 Posts Has 33 years experience. Feb 11, 2016 You are making this situation all about you, not your resident.
bathrobemom, LPN 90 Posts Has 3 years experience. Feb 11, 2016 If you were working in LTC, the symptoms you saw and actions you took are exactly what we would've done where I work. Those symptoms and straight cath make total sense. If you're not allowed to straight cath because you can't in AL, maybe that's why the morning nurse freaked out. She should've told you what they normally do for a suspected UTI. I don't understand why they didn't do anything for the resident while you were gone. I didn't think you were making it all about you. It sounds like your coworkers aren't working with you as a team and it's got to be hard to be a nurse without teamwork. I think you have every right to complain. We all complain about our jobs! I would be especially upset with that kind of environment. For me coworkers can make or break a job. Good luck if you are searching for jobs, there has to be something better out there.
%D#2 298 Posts Feb 11, 2016 Good on you for advocating for your resident! A temp. of 101 would've had me sending her to the ER as well. I would rather deal with the PTB than find myself sitting in court answering as to why the resident was left untreated when she clearly showed s/s of a UTI, then rapidly declined and died from septic shock. Not on my watch.I'm curious...What was her blood pressure before you sent her out?It was normal but I still didn't wanna take any chances.. She shouldn't have had to suffer like this but at least I know she'll get the care she needs now even if I do get reprimanded
LTCNS, LPN 623 Posts Specializes in Clinical Documentation Specialist, LTC. Feb 11, 2016 It was normal but I still didn't wanna take any chances.. She shouldn't have had to suffer like this but at least I know she'll get the care she needs now even if I do get reprimandedExactly. Good job :)
ScrappytheCoco 288 Posts Specializes in Emergency/Trauma/LDRP/Ortho ASC. Has 3 years experience. Feb 11, 2016 Come to the Emergency Department. We cath and place ivs all the time and the MD says... "Oh thanks for doing that...I'll order it."
PocketSize, BSN, RN 94 Posts Specializes in Emergency, LTC. Feb 11, 2016 I feel you on the job thing. Good luck with your search! I'd like to vent too but I'll zip it this timeðŸ¤
%D#2 298 Posts Feb 11, 2016 You are making this situation all about you, not your resident.I certainly don't think this is all about me.
Tenebrae, BSN, RN 1 Article; 1,848 Posts Specializes in Mental Health, Gerontology, Palliative. Has 11 years experience. Feb 11, 2016 So a straight cath is the same as an in out catheter?Personally if thats the case, I think its a brilliant idea. We have one very demented patient with a long term IDC who in the first 8 weeks they were in the facility pulled the @@@@@ thing out at least five times.
Been there,done that, ASN, RN 6,955 Posts Has 33 years experience. Feb 11, 2016 I certainly don't think this is all about me."Idk this isn't the place for me and im looking for other jobs and going back to school." And all the while, the resident has not received treatment.
nutella, MSN, RN 1 Article; 1,509 Posts Feb 11, 2016 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.In my area they send residents from AL out to the ER all the time to get evaluated for "altered mental status" or "fever" when the patient does not have a PCP who is doing home visits or has a NP who does home visits. It really depends a lot on the residents insurance and provider. Some health care providers who are part of medicare advantage plans are sending out their NP to see the patient in their home - home can be an AL facility.But if this is not the case, and the patient needs to be evaluated, they are being send to the ER - which is a long wait, not cost effective in most cases, and a lot of aggravation for most.
Libby1987 3,726 Posts Feb 11, 2016 As far as referring to home health for a straight cath, unless the patient was already on home health services, a referral for new change in mental status would be inappropriate..1) A straight cath is not a billable skilled service. Teaching a patient to self cath would be but not just a single time to collect a lab sample. and more importantly 2) Referring to home health for a recent and significant change in mental status is completely inappropriate, I wouldn't accept the patient and would advise you to seek medical attention (MD or ER) and then the MD/ER will make a referral to HH if appropriate and medically necessary to follow up, but not to perform initial diagnosis and treatment. If the patient was already receiving home health services, I assume that would have been the first call made 5 days ago.
