Job Suspension

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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.

The majority of patients in LTC are DNRs. Until DNR status is clarified a new admit is always a full cor, even if they come in from another facility with DNR papers. It sounds like that patient had some significant health problems, and if he was in a LTC facility and not going home he was probably already very medically fragile. With patients like that you have to also take into account that the trauma of CPR could kill them.

But sometimes families have difficulty coming to terms with that, and social services may have been working behind the scenes to address a more realistic cor status with the family. If all of this happened while the family was still struggling with this it may be a situation where they are taking their frustration out on the facility, and the facility sees a liability issue and wants to cover themselves with a thorugh investigation.

In any case, when a situation like that comes up it can cause a lot of confusion. LTC facilities do not put cor status identifiers anywhere but in the chart (at least the ones I've worked for) so just by working with a patient you would not automatically know it, and you can't just start CPR on a patient who more often than not is a DNR.

It is not uncommon in a situation like that to put the involved parties on administrative leave until the investigation is done. More likely than not the OP will be cleared completely -- unless there is some need to throw the staff under the bus.

But still, a lot of this is unclear.

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well thank you all for your input. i received a call saying i would return to work next week. im not sure what has happened to the other nurse involved. by the way, i am planning to get asap.

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If you can get onto this site, and obviously you can, you can get your insurance immediately.

So do it.

NOW.

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Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.
Yes, I already indicated that I'm not entirely familiar with how it works.

But it seems to me...from an outsider's viewpoint...that unless you know that they are DNR, you have an obligation to attempt resuscitation. I'm looking at it solely from a litigation standpoint - what is worse - to start CPR on a DNR, or to fail to do CPR on a full code and have them die?

Assault and battery vs. manslaughter.

Hmmm...

The dead don't sue......the living who are on a vent with a very angry family do.......:smokin:

I agree to code is better than to not code......I am a huge supporter of code first ask questions later.....but LTC's are a different breed all together. LTC's are a whole new ballgame of rules and regs....do's and don'ts. Being an OB nurse, no one expects you to be aware of the different nuances. Once CPR is started 911 is called...there is no resident or ED doc or hospitalist that responds nor is there any ICU nurse to save the day.......that involves a trip to the emergency room and CHA CHING the bill goes higher. It can be called INVOLUNTARY manslaughter but usually it's negligence in the civil court families are after....$$$.

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Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.
well thank you all for your input. i received a call saying i would return to work next week. im not sure what has happened to the other nurse involved. by the way, i am planning to get liability insurance asap.

Good for you...:redpinkhe

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Specializes in LTC.
The dead don't sue......the living who are on a vent with a very angry family do.......:smokin:

I agree to code is better than to not code......I am a huge supporter of code first ask questions later.....but LTC's are a different breed all together. LTC's are a whole new ballgame of rules and regs....do's and don'ts. Being an OB nurse, no one expects you to be aware of the different nuances. Once CPR is started 911 is called...there is no resident or ED doc or hospitalist that responds nor is there any ICU nurse to save the day.......that involves a trip to the emergency room and CHA CHING the bill goes higher. It can be called INVOLUNTARY manslaughter but usually it's negligence in the civil court families are after....$$$.

That is so true. One time a nurse found a resident with out a pulse and no B/P. Resident was a full code, no CPR was done. Family did not sue. I think they were a bit relieved IMHO.

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Specializes in CCU, SICU, CVSICU, Precepting & Teaching.

it sounds like -- and please correct me if i'm wrong -- the op is a nurse who found (or was led to) a patient in need of emergency care which she did not provide. instead, she went to get the patient's nurse instead of calling a code or an rrt or paging the nurse or just plain yelling for help. if that is indeed the case, i understand the suspension.

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it sounds like -- and please correct me if i'm wrong -- the op is a nurse who found (or was led to) a patient in need of emergency care which she did not provide. instead, she went to get the patient's nurse instead of calling a code or an rrt or paging the nurse or just plain yelling for help. if that is indeed the case, i understand the suspension.

i believe the aid transferred the patient to use the toilet, when the patient became non responsive. the aid seeks out help for someone more qualified to assist in the emergency. op checks patient for pulse and leaves to grab a machine to check his blood pressure and a glucose tester. also to seek out the nurse assigned to said patient.

then op finds pt nurse and assist in placing pt in bed and grabs a few things as requested and leaves to tend to her patients.

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Specializes in CCU, SICU, CVSICU, Precepting & Teaching.
i believe the aid transferred the patient to use the toilet, when the patient became non responsive. the aid seeks out help for someone more qualified to assist in the emergency. op checks patient for pulse and leaves to grab a machine to check his blood pressure and a glucose tester. also to seek out the nurse assigned to said patient.

then op finds pt nurse and assist in placing pt in bed and grabs a few things as requested and leaves to tend to her patients.

again, i don't understand why the op left the patient instead of sending the aide to find those things. and what is a pt nurse? is that a nurse who provides physical therapy??

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Could PT nurse mean "part-time" nurse?

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PT nurse = patient's nurse

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PT nurse = patient's nurse

I think you're right. Thanks.

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