Morally What would you do?

[GeriatricSunshine]

Hello all! I have a moral dilemma and I know y'all are the smartest ladies (and men) that could help me.

I am an office manager at a retirement home, I work at the front desk. We have a lifeline like system and when the bell rings I get it because I am there. One of out residents is ill and in bed, she called the desk today in distress.

I called the nurses phone and it rang 5 rings, I looked around and she was no where to be seen. I decided not to waste another minute,I am a licenced personal support worker so I ran to her room.

She was trying to get out of her bed to go to the washroom. I urged her to wait until the nurse came. I went to get the nurse and then went back to keep her company.About 3 minutes later she said she had to go and was no longer waiting. She got out of bed so I ended up helping her to the toilet. The nurse came about 5 minutes later. She would have had a BM in the bed.

Now she is angry because this is not my "role" in this facility. I am however a human and the nurse took the time to grab meds, and water and all this stuff on the way there, taking her time.

I could not look at her and not help.

[1Tulip]

I never said I was going to even think of giving it, at least until I graduate from school and with an order. I was wondering what circumstances would warrent it with a portable O2 tank. Can someone give it at their discretion, like what Oxygen Sat rate would warrent it in someone who was just having a little trouble brething??

Yeah... I'd be a bit circumspect about giving O2. If I were a nurse at that facility, I'd have given you my thanks for helping the pt. to the BR... and also apologized for being tardy. But I would probably sit you down and have a talk about scope of practice if you started putting O2 on pts.

What about %sat? We don't want our pts below 90%. But whenEVER anyone's condition is changing (they are dyspneic now, for instance, even though 4 hours ago they were comfortable...) it's critical to figure out what's going on. That's why the nurse should be at the pt's side doing some critical assessment. You could theoretically get your patient more comfortable with O2 while the underlying problem gets worse.

Hey, what about a bedside commode your your little lady patient? (Prevent falls, but also figure out why she's having urgent need for the bathroom.)

So, there you are for what it's worth.

[DutchgirlRN, ASN, RN]

I agree that helping someone to the bathroom is not necessarily a nursing function. What if she had pooped in the floor and slipped in it? A broken hip would have made the nurse look worse than not being there in time to take her to the potty.

[GeriatricSunshine]

yes thanks. This Nurse is "one of those" she is really disorganzied but has to have a finger in every pot. I cannot figure out why she does not respond quicker. She seems to forget I was and am still a Nurse's aide. The course I took was a year and 2 months and the RPN course is only 2 years here! As well I read tons and my mom was a nurse.She always makes me feel dumb and I really worry about the residents sometimes!

Yeah a commode would be a great idea! Lots of things would if anyone listened.

[Daytonite, BSN, RN]

If I were you I would write this incident up on a memo and send it to your immediate supervisor. Keep a copy for yourself. Let your supervisor handle it through channels. Was the patient using the life line appropriately? IF not, that needs to be mentioned in your write up. If I were you I wouldn't interfere with nursing's protocols as it is outside your job description and chain of command and will only result in trouble for you. You need to speak with your boss and get clear instructions on how you are to handle a situation like this.

The next time something like this happens, if I were you, I would scream out "Somebody help me!" at the top of my lungs the minute I realized the patient was going to be in physical jeopardy. Do that loud enough and with enough emotion and someone will come running. The minute someone from the nursing staff shows up, you briefly tell them the facts and then leave. That way the nurse won't be angry at you for doing something that wasn't in your job description. Let her explain to other people why you were screaming for help in a patient's room if they ask. And, if you are chastised for not doing something you merely reply that it is not in your job description to perform patient care. The fact is that if the patient fell and sustained an injury while you were assisting her to the bathroom you would have been at fault for not getting a nurse and the state probably would have come down hard on the facility.

[canoehead, BSN, RN]

Did the OP mention oxygen? I looked back and can't see it.

I think that if you are a PCW as you say that you can help people to the bathroom without a nurse.

[MultipurposeRN]

If visitors can help patients to the toilet, why not this person? If I were that nurse I'd be so thankful someone helped the patient and saved her the humiliation of a bed change that I'd probably be saying 'thank you' all night.

[kitten77]

Above all, we are human. We can talk all day about legalities but won't. I think it is a shame the nurse could not have an open mind during this rare circumstance.