Job Suspension

[charmayn05]

Ive been working prn at a ltc/snf for 6 months as a new nurse. This week I went in to assist an aide who said she needed help. (this was not my assigned hallway) The pt was unresponsive, but still breathing & had a pulse. I left the pt with the aide to get the VS machine & his nurse. Later, I leave the room several times to get things his nurse asks for. The last return, was during the transfer of the pt out of the bathroom & to his bed. He passed while doing so. His nurse tells the aides to prepare the body & I leave the room to begin my morning med pass. Later, the nurse says to me the pt was a full code.FULL CODE! I trusted her & her judgement & I was a fool. Now, I have been suspended, pending an investigation. I just got my license & I feel like its about to be snatched out of my hands. Please offer any advice.

[Whispera, MSN, RN]

I don't understand. The patient's nurse was with him? You were getting things she asked for? How would you know to stay, if you were busy getting things and she didn't say, "stay."

Did SHE not initiate CPR when it was needed?

[charmayn05]

no cpr.

[DarkBluePhoenix]

I am not a nurse, but she never once started CPR right?

And why are you blamed and not her?

She is his nurse, and shouldn't have the patients aide knew he was a full code eh?

After you left to get her stuff she should have started CPR, but since she didn't, its her fault not yours

[mazy]

Yes, agree with Whispera. How is any of this your fault? The patient wasn't yours, how would you know the cor status? From what you're saying it sounds like you did the right thing when you went in, you got the nurse and vital signs; why would you need to perform CPR on a patient who was breathing and had a pulse? Why were they transferring the patient from the bathroom? Did he ask to be transferred? If he was alert and mobile enough to go to the bathroom why would you start CPR?

Before calling a dr you need a full set of vitals and assessment info, at first glance it sounds like all of you were following protocol.

This doesn't make a lot of sense. Have you documented any of this? My suggestion is you sit down and write down what happened in this incident, every specific detail, all times and dates, names of involved parties, and hang onto it for the investigation so you can back up your version of events against those of another nurse who seems to want to blame you for this.

To be honest, from your explanation of events I'm not even sure there is any blame at all to be assigned to anyone involved, including the other nurse. Sometimes things like that just happen.

[mazy]

Oh, OK, just re-reading, it sounds like there was a question about performing CPR when he crashed after toileting. Probably wasn't a good idea to transfer a patient in distress but did he ask to go to the toilet? Still not understanding why this has anything at all to do with you.

[carl5480]

Have you told us the whole story? Because I agree with the others, this doesn't make sense. There's no way a "helping" nurse would be blamed for this situation when the primary nurse was right there...

And how does trusting the primary nurse regarding code status make you a fool? It is THEIR job to know, not yours. What are you supposed to do, leave the patient unconscious in the bathroom while you run to the chart to check their code status?

Although, it might not be a bad idea to treat all potentially coding patients as full codes until told otherwise, for just this type of situation.

[Marshall1]

Whomever the nurse was assigned to this resident is ultimately responsible. It's up to him/her to know the code status and to act accordingly - not you, not the CNA - the nurse assigned. Maybe I'm missing something here but like others who are responding, something doesn't make sense..if the resident was unresponsive how did he get into the bathroom? I dunno..but for now, based on what your wrote..I'm not seeing how you would be responsible not failing to initiate CPR - plus, if the resident has a pulse and is breathing CPR wouldn't be initiated anyway...

[klone, MSN, RN]

Why would you try to toilet an unresponsive patient? Or did he code while on the toilet? I'm confuzzled.

What kind of "things" were you getting/doing for the pt's primary nurse?

[charmayn05]

the pt was transferred to the bathroom by wheelchair to use the toilet by his aide. he was transferred back to bed using the wheelchair. i went to get a manual blood pressure cuff & glucometer. later i found out the pt had diabetes, chf,hypotension, & cancer (everywhere). he was not expected to pass, he was there for therapy.

[charmayn05]

Have you told us the whole story? Because I agree with the others, this doesn't make sense. There's no way a "helping" nurse would be blamed for this situation when the primary nurse was right there...

And how does trusting the primary nurse regarding code status make you a fool? It is THEIR job to know, not yours. What are you supposed to do, leave the patient unconscious in the bathroom while you run to the chart to check their code status?

Although, it might not be a bad idea to treat all potentially coding patients as full codes until told otherwise, for just this type of situation.

We have a new DON, i dont think she wants to make any exceptions. The only way I wouldve known the code status is by looking in the chart. There arent any symbols in the room nor anything on the armbands.I feel like a fool simply because I have no control over whats going on. I have no idea how this is going to affect my job or my license. And honestly, I worked to damn hard for this to just blow up in my face.

[caliotter3]

I suggest you obtain legal counsel. I fail to see how you are responsible when the assigned nurse was in attendance.