Major nursing liability

[Cjhays]

Ok. So scenario you are the charge nurse. You notice the keys are missing to the med room and e-kit. Call nurse in call no answer. Call nurses that left shift one answer checks, no keys. Call the other numerous times leave message, text ...no answer. In the shift you have a diabetic crash and need glucagon . You can not give it it's locked up. Who would be responsible for the coma or possible death of this patient ?

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[dudette10, MSN, RN]

It would be both the current and last charge nurse. Handing over the keys should be part of charge-to-charge report, and both screwed up.

If, at the beginning of shift, the current charge nurse asked the last charge nurse for the keys, and they could not be located, the last charge nurse would be responsible for looking for the keys or obtaining a second set before she went off shift. If an event that could be prevented occurred while the last charge was looking for the keys, the current charge would probably not be held responsible for the event.

That's my opinion anyway...

[RescueNinjaKy]

I believe that any nurses that knew about the key missing would be responsible as there is due diligence. If they knew that the key was missing then it is imperative that they address it by obtaining a second set first or ensuring that there is an alternative method to obtaining emergency medications.

The priority would be to have those available asap, as any reasonable nurse would know that access to emergency medications is vital, and without it, there is a huge opening for liability and death/harm to patients.

[ktwlpn, LPN]

No spare keys? Every facility has spare keys stashed somewhere. No tool kit to take the flipping door off the hinges? No packets of sugar to pour in the patient's mouth? Does not sound like a safe work environment.

I think if something like that happened in my facility both the off -going and oncoming nurse would be in a world of hurt.

[Karou]

I agree that it would be the current and previous shift charge nurse for not ensuring that the keys were exchanged at shift change.

I am curious what happened in this situation.

Was there no spare key? There should be. If the med room door was locked than in addition to the glucagon, no patients/residents were able to receive any of their medications. I would be calling the administrator/DON/everyone and demanding we get a key or locksmith to get that door open. A spare key should be available in the future.

[liberated847]

I would find the nearest fire axe and destroy the lock, I would not let someone die because of keys

[canoehead, BSN, RN]

Call security to open the door and provide spare keys while you track down the original set. The previous charge nurse may have her phone off to sleep, you may need to send the police to her door to wake her.

[wheeliesurfer]

Just a thought, but this sounds like a homework question to me. Who do YOU think is responsible in a scenario like this?

[Esme12, ASN, BSN, RN]

Who is responsible? You all are including the facility.

The nurse because she didn't answer the phone and is supposed to. The nurses who didn't hand off the keys and is supposed to. You because there should be no coma...call 911.

On site supervisor/security should have keys. The administrator on call should have alternative plan. If all else fails break the door/window and unlock the door or simply call 911.

[RNx8yrs]

All of our narcotics etc are in the pyxis. We have a small drawer for each patient, usually puffers and insulin. Wait for it! They gave us each OUR OWN KEY! So much less stress. One key fits all. Another idea prior to the golden rule of keys was to put the keys in the pyxis and nurse removes a key and is responsible for returning it.

[anon456, BSN, RN]

Many of the meds needed for variations of this scenario would be in the crash cart, which does not require a key to open.

[nurseprnRN, BSN, RN]

I agree: homework. OP, thank these nice people for writing your paper for you.