Need Advice

[TITL]

Im a nurse of several years, working in a northwestern state. Anyway, I was charge nurse on the floor. A floor I dont normally work. We had a pt in early 80s who was there for afib and avf bleeding (hx CRF, DM, CAD). Pt had been in dialysis where vascular surgeon saw pt and applied syvek like material over access sites and pressure dressing. Pt INR was >15, Hgb 8.2, all of which MD noted. Orders given for Vit K 5mg Sq , hold anticoags, and AM CBC, INR. FFP not given b/c of high risk of hypervolemia. Introduced my self to pt and family after shift change. One particular family member was rude, demanding, and vociferous. Spoke with this family member several times and was obviously frustrated, but didnt say anything to this person or family. I was alerted that this person had a complaint that I was rude and condescending. Being frustrated by this after all my dealings and patience with them i made an ignorant comment that i didnt care about this persons complaints. Mind you this wasnt even my personal pt and b/c of being charge nurse and thier concerns i assessed this pt several times. First, they stated they had difficulty moving digits of hand. I beleived this to be result of compression wrap. Assessed circulatory status (WDL), AVF (WDL), sensation WDL, access sites still persitently oozing no significant loss of blood and expected in setting of INR>15. Dressing rewrapped. Later pt nurse told me pt BP was low 90s systolic. On review of chart noted pt had been hypotensive on day of admission. Several antihypertensives had been d/c'd. On review BP had been running in low 100s to 90s. This all occured in the setting of just returning from HD, on Cardizem drip for afib (HR 90s) with order to switch to PO (unfortunately nurse did adminster this in setting of low BP), and Hgb of 8.2. So, no real suprise and no signs of hypoperfusion, so i figured we would continue to monitor unless pt decompensated. Later however nurse told pt began to become confused and BP now low 80s over 40s. MD paged and I immedialtey assessed pt. Shockingly, neuro status was then unremarkable and pt was lucid. BP 94/52. ABD appeared benign and pt denied back of flank pain.AVF site had some gauze on it under wrap which had maybe 20cc blood sites still oozing, but no spurting or anything out of the ordinary. Told nurse to stay and watch pt as i waited for MD call. Though moments later nurse said pt had went unreponsive. I entered room to find pt not breathing with no pulse. Code then intiated. Pt was in PEA, but later responded to epi. Neo drip started and BP normalized. Pt was also intubated and then sent to CCU.

Next day, I was told I was on suspension for the next days work. I guess because my of comments that, I didnt care about complaints of family member. Then had meeting on later in week, and was mortified to find that I was fired. I beleive that my comments were certainly to blame. But during meeting they stated there was a delay of care (there will no report on my license). I dont know if the nurse caring for the pt had prior concerns,but if so she didnt let me know, which she should have as I was charge. Unfortunately, pt died during thier ICU stay. I dont know the cause of death but I presume hemmorhage, either GI of intracranial. I feel like i was scapegoated because of my comments and the family members complaints. Now Im inconsolable and questioning whether I had done anything wrong (other than my asinine statement, which was reported). Plus, Im scared that I will have a hard time finding a job because on question I know my facility will have me listed as not rehirable. Please give advice.

[SEDATOR51]

Im sorry to hear of your problem, sorry to have no solution at this time. Except to say family is taking you out due to lost of love one. And your hospital i think , did the wrong thing to terminate you, they may have been covering for something and yes you were the scapegoat. Talk to a lawyer. I have seen things like this reversed and nurse's name cleared and hate to say it nothing changed. But you still have poss getting a job maybe not in hospital, but home care or nursing home or rehab center. Good luck