Neglect...LPN was fired, RN was not

Nurses General Nursing

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I wanted to get everyone's opinion on a heated debate at my workplace. I work in a large hospital's Med/Surg unit. Usually 8-9 patients are lumped together as a "team" with an RN, LPN and CNA on each time. At night, it can be 12-14 patients, often with only an RN and LPN. Usually you 'split' the team with the LPN taking some patients, the RN taking some patients, and each person doing total care for their patients. One night about a month ago, an RN and LPN had 'split' their team. One of the LPN's patients was found dead on the floor at about 5am, they called a code but he had been dead awhile and rigor mortis had already set in. The patients was in his 60's and a GI bleeder, he was being prepped for a colonoscopy the following morning. I heard through the grapevine the hospital had done an autopsy and the patient had fell on the floor, hit his head, and died as a result. He had been dead about 3-4 hours before he was found. As a result of this, the LPN who was responsible for this patient was fired. The RN on the team recieved a verbal warning, but otherwise she was not disciplined. A lot of people at our work complained to our manager, and she said the LPN has a license too, and therefore she is legally responsible for her patients just like the RN is. I am an LPN but am also a full-time RN student and will graduate in 11 months with my RN. The LPN's at work have been bad-mouthing the RN and our manager, saying that the RN is over the LPN, and she should have been fired too. I personally agree with our manager...I feel that while I am not an RN, I am an Licensed nurse and with that comes personal responsibility for my nursing actions. A lot of my LPN peers disagree, so I have kept my opinion to myself for fear of my coworker's backlash. It is really a HOT topic at work now. What do you all think?? Am I right in my opinion?

How to you put a quote like that in your post...I cannot quite figure it out. I have heard responses from NA's like....Oh, I forgot to tell you the temp was 103, or when asked what was pt's accucheck, I went to lunch. I am trying to get the NA's to give a full report to the RN at end of shift....some info might get to nurse late, but better than not at all.

Don't take the qoute so literally. We all know when we say "everybody does it" we are not actually referring to EVERYbody. We are referring to those in that situation. Come on, you know that. You are just nitpicking and/or looking for an argument.

Specializes in med/surg, neuro, ortho, cardiol.

I can see how you must have taken my post....but I was really really asking for help...how does one put quotes like that in your own post.....I have not been able to do it yet......I went to reply and clicked on quotes, but could not figure it out from there !!!!!!!! If you re-read my post, you will see that earle and I agree. I will be careful from now on how I word things!!!!!!!

And I do not nit-pick.......but I have been know to argue now and then !!!! Take care

I can see how you must have taken my post....but I was really really asking for help...how does one put quotes like that in your own post.....I have not been able to do it yet......I went to reply and clicked on quotes, but could not figure it out from there !!!!!!!! If you re-read my post, you will see that earle and I agree. I will be careful from now on how I word things!!!!!!!

And I do not nit-pick.......but I have been know to argue now and then !!!! Take care

Oh I am soooo sorry! I didn't see it that way! And I just responded to another post by saying that people will pick out 1 word or totally not understand the post and tear ya to shreads over it! AND I DID IT!

I don't know why you don't get the post you are responding to as a quote. I click the reply button at the bottom of the individual post and it's there in the text area where I will type my post (just like above.) Sometimes it can be a pain becasue I will read a list of posts then decide to reply to a specific post and have to go looking for it so the quote will be there. Sometimes it just doesn't work when the reply I am replying to isn't a quote at the beginning and things REALLY get taken out of context!

This is a riot! I am guilty of what I complain about! LOL

I honestly thought you were praising your NAs for reporting to you. That didn't quite make sense but with the "how do you say that" at the beginning I figured your grammar just missed the mark a bit.

I'm not going to forget this one for a while. :imbar

Specializes in Med-Surg.
I have done so, and will do so again, if I'm conforted with the same issue! The RN should've been fired also!

so out of curiosity, what happens in such a situation when you say no? what's the response? do they bring in another RN? or relieve you for the night in favor of someone who will do what they want?

Specializes in ICU, ED, Transport, Home Care, Mgmnt.
so out of curiosity, what happens in such a situation when you say no? what's the response? do they bring in another RN? or relieve you for the night in favor of someone who will do what they want?

It depends on what staffing you have available. I supervise a 350 bed hospital, there are nights that I have to rob one unit in order to staff another. I may make one unit one nurse short in order to staff a unit that is 2 or 3 nurses short. I don't like to do it but that is my job. If a nurse refuses an assignment she is sometimes sent home, most of them lately (tonight) have walked off the unit without contacting the supervisor. :angryfire They have just screwed their fellow nurses on another unit. We don't pull people just to be mean but some nurses seem to think we do it just to spite them. I try very hard to be equitible and make sure everyone gets the help they need but the truth of the matter is if no one will come in to work and 14 nurses have called in "sick" on Saturday or Sunday night then we "do the best we can". :stone

I don't feel this has anything to do with wanting an RN, or anyone to take "a fall". It's about what some (including some RN's also) who felt that the LPN shouldn't have been the only one punished. I also don't think that the LPNs should take it into their own hands to report this RN to the BON. I don't believe that was the point at all. The point in MO...was that the RN has accountability for the delegation she makes, and to me, this was just casually tossed aside by their employers. But then again...*&^% always did run down hill.

NOT saying this LPN shouldn't have been held accountable. YES it was HER responsibility ALSO to ensure this pt. was taken care of, and not left totally off her radar! But when you hear soooo many say..."YOU are working under MY license", and "I and responsible for what you do or don't do." Then when the stuff hits the fan...."Hey you have a license, and you accepted the assignment, so you are the only one responsible". Makes ya wonder... :stone

Thankfully... I work with RNs, who believe that just because an RN "splits" a team, doesn't mean she/he doesn't STILL have the 'ULTIMATE" responsibility for those pts. she delegated! When they ask me...even though they KNOW I am a "STRONG" LPN...(their words not mine), they STILL ensure everything has been completed, and check in with me to see how everyone is doing. Makes sense to me...but then I am probably the only one...who sees it that way.

When something is delegated, the person delegating someone to it evaluates the appointees abilities. That done, her responsibilty is done. In an acute care setting, the RN may have other responsibilites depending on the hospital, but the actual care of that pt has been delegated to the LPN. The LPN proved her ability many nights over and over again. That pt was her responsibility.

If the LPN were new or had never worked that area before it would have been the RNs fault, she would have been overwhelming her, a bad chioce when she delegated the responsibility.

No matter how you look at it, it was the LPNs responsibility. An LPN does not work under an RNs license, she has her own license. If there were too many pts for her, it was her responsibility to say so.

However, as neglectful as I find the LPN to have not even "sneaked a peak" one can not forget the institutions neglect by not having enough staff.

Thankfully... I work with RNs, who believe that just because an RN "splits" a team, doesn't mean she/he doesn't STILL have the 'ULTIMATE" responsibility for those pts. she delegated! When they ask me...even though they KNOW I am a "STRONG" LPN...(their words not mine), they STILL ensure everything has been completed, and check in with me to see how everyone is doing. Makes sense to me...but then I am probably the only one...who sees it that way.

i'm an RN and i agree with you. if i am the team leader, i ultimately feel it is my responsibility to oversee others, usually by my communicating/touching base/being kept updated. i don't care if it was a team of RN's; hypothetically if i was assigned team leader, there are certain responsibilities that i would feel were mine. but as we do not know the intricate details of this case, there are always circumstances that will sway one's perspective.

i'm an RN and i agree with you. if i am the team leader, i ultimately feel it is my responsibility to oversee others, usually by my communicating/touching base/being kept updated. i don't care if it was a team of RN's; hypothetically if i was assigned team leader, there are certain responsibilities that i would feel were mine. but as we do not know the intricate details of this case, there are always circumstances that will sway one's perspective.

As a team leader it's your responsibility to be the resource, the "helper" if needed, and many other things. It's not your responsibility to follow your team members around to make sure they are doing their job.

As a team leader it's your responsibility to be the resource, the "helper" if needed, and many other things. It's not your responsibility to follow your team members around to make sure they are doing their job.

no, i would not follow them around but as i stated, i would communicate with them throughout the shift. that's my personal style and not a generalized endorsement.

no, i would not follow them around but as i stated, i would communicate with them throughout the shift. that's my personal style and not a generalized endorsement.

Keeping in touch with another nurse who's response is "I'm making it" or "Not completely drowned yet" or some other indication that she/he is aware of the status of all his/her pts is what you are talking about. Understood. However, if he/she does not know anything to tell you because he/she has not done his/her job how oculd you possibly know and feel anyresponsibility?

Keeping in touch with another nurse who's response is "I'm making it" or "Not completely drowned yet" or some other indication that she/he is aware of the status of all his/her pts is what you are talking about. Understood. However, if he/she does not know anything to tell you because he/she has not done his/her job how oculd you possibly know and feel anyresponsibility?

dixie,

let me give you a gen'l rundown on how i start my shift. even when another nurse has her/his own pts., if i'm doing charge i make it my responsibility to know what's going on with all of them. then i give my 2 cents on what my expectations are: for example, if there's a patient that presents with clear indications of potential problems, i would make sure i communicated my concerns to the staff involved. call me neurotic or whatEVER but if i'm doing charge, i am (or feel) ultimately responsible.

dixie,

let me give you a gen'l rundown on how i start my shift. even when another nurse has her/his own pts., if i'm doing charge i make it my responsibility to know what's going on with all of them. then i give my 2 cents on what my expectations are: for example, if there's a patient that presents with clear indications of potential problems, i would make sure i communicated my concerns to the staff involved. call me neurotic or whatEVER but if i'm doing charge, i am (or feel) ultimately responsible.

That's pretty much what I said. And that does not put your eyeballs on that pt. My point was that the responsibility was delegated to her, that took the responsibility away from the teamleader/charge nurse for watching after him. It was her responsibility and her responsiblity alone.

If an LPN on your team made a medication error would you consider that your responsibility too? What if another RN on your team did the same?

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