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?

I hate to be a nag, but this is another example of why it's so important to carry your own liability insurance. Does anyone reading this believe that the hospital is going to lift a finger to defend either of the nurses? The LPN who was fired could now be sued for malpractice by the family, and she isn't even employed by the hospital anymore, SO .... No help there! The hospital was attempting to minimize its own liability by firing her. The RN who hasn't been fired could also be sued, and, if she's (he's?) expecting any support or defense from the hospital, I've got some swamp land in AZ that I'd like to sell her ...

I notice that a lot of people who have debated against carrying your own insurance on this BB often seem to assume that people only sue out of some cagey, calculated determination of who has the money ... It's not that simple -- some families just sue because they loved their family member and perceive that the health professionals caring for them dropped the ball in a big way. It's not always about money; sometimes it's about justice ...

Yes, the hospital insurance company will "lift a finger" to minimize/defend its money against civil action. They will make the nurse look like Nightingale. Families might WANT to sue, but that isn't how the system works. It IS about money when it comes to actually filing a civil action. If the family had to pay "out of pocket", it could end up costing them thousands, with no absolute that they would receive any of that back. Only very rich persons could afford that kind of money.

Remember, it isn't the families fronting the money, it is the lawyers. So, they will not spend unless they know they will get their $$ worth.

Remember, it isn't the FACILITY fronting the money for defending an action, it is the insurance company. They want their staff to look like the greatest nursing staff ever.

Major misconceptions in the nursing issue- propaganda from the insurance companies.

Mschrisco

The reason why the LPN got fired is because she took report on the pts. and it was in her scope to do rounds and check on her pts. at the beginning of the shift. The RN did not take report on the LPN's pts. & was not responsible for providing any care for them unless it was out of the LPN's scope like giving an IV. I do not think that the RN should have even been written up. It is customary practice that RN's and LPN's often divide tasks, or pt loads and each take their own report. In court it could be proven beyond a reasonable doubt that the LPN got report and was responsible and accoutable for those pts. The RN could prove that she had no knowledge or report on the pt. It could also be proved that it was a custom or practice for licensed nurses to take report only on the pts. they were responsible for. :o

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?

the lpn was wrong for not checking on pt in timely manner...may not have saved pt but certainly would have made a better case than the one presented that the pt had laid there for a lengthly time

as for insurance it is worth the cost....just as having car insurance doesn't let you drive recklessly but when you need it and don't have it that will be a terrible feeling THAN GOD I HAVE NOT BEEN IN THAT POSITION but i know people who have mortgaged their homes to pay for lawyers.

the lpn was wrong for not checking on pt in timely manner...may not have saved pt but certainly would have made a better case than the one presented that the pt had laid there for a lengthly time

as for insurance it is worth the cost....just as having car insurance doesn't let you drive recklessly but when you need it and don't have it that will be a terrible feeling THAN GOD I HAVE NOT BEEN IN THAT POSITION but i know people who have mortgaged their homes to pay for lawyers.

What were these people defending themselves against?

Mschrisco

Lawsuits will go for the deep pocket. ;)

This from my attorney...who is also a nurse. She has mixed feeling about nurse and would agree about the propoganda out there. Also the trend of lawsuits against nurses...which is rising in my state of Texas.

Lots of nurses here carrying million dollar policies for the taking.

Food for thought.

Liability insurance for nurses where I am presently employed is paid by the hospital and will continue for 5 years after my employment. I used to carry a when I worked in another facility. I dropped it since I started working here. It is one of the benifits for working in this hospital.

I hate to be a nag, but this is another example of why it's so important to carry your own liability insurance. Does anyone reading this believe that the hospital is going to lift a finger to defend either of the nurses? The LPN who was fired could now be sued for malpractice by the family, and she isn't even employed by the hospital anymore, SO .... No help there! The hospital was attempting to minimize its own liability by firing her. The RN who hasn't been fired could also be sued, and, if she's (he's?) expecting any support or defense from the hospital, I've got some swamp land in AZ that I'd like to sell her ...

I notice that a lot of people who have debated against carrying your own insurance on this BB often seem to assume that people only sue out of some cagey, calculated determination of who has the money ... It's not that simple -- some families just sue because they loved their family member and perceive that the health professionals caring for them dropped the ball in a big way. It's not always about money; sometimes it's about justice ...

Specializes in Critical Care, ED, End of Life, Pain.
Liability insurance for nurses where I am presently employed is paid by the hospital and will continue for 5 years after my employment. I used to carry a liability insurance when I worked in another facility. I dropped it since I started working here. It is one of the benifits for working in this hospital.

If it was truly just about justice - then why go for the big pay-off? Is that going to fix whatever went wrong? :o

Yes, in that facility the LPN was working within her scope. Now, aren't supervisors responsible if their nurses do something wrong?And, its poor hospital policy NOT to use the RN_LPN team work. :uhoh3:

The reason why the LPN got fired is because she took report on the pts. and it was in her scope to do rounds and check on her pts. at the beginning of the shift. The RN did not take report on the LPN's pts. & was not responsible for providing any care for them unless it was out of the LPN's scope like giving an IV. I do not think that the RN should have even been written up. It is customary practice that RN's and LPN's often divide tasks, or pt loads and each take their own report. In court it could be proven beyond a reasonable doubt that the LPN got report and was responsible and accoutable for those pts. The RN could prove that she had no knowledge or report on the pt. It could also be proved that it was a custom or practice for licensed nurses to take report only on the pts. they were responsible for. :o
Yes, in that facility the LPN was working within her scope. Now, aren't supervisors responsible if their nurses do something wrong?And, its poor hospital policy NOT to use the RN_LPN team work. :uhoh3:

I think a lot of people get confused with the RN being responsible for the LPN thing.

Just becasue an LPN works under the direction of the Doc or RN does not mean they are responsible for the LPNs actions or inactions. The LPN is responsible for everything that is within her scope of practice. S/he is also responsible to make sure the RN partner is aware of anything (like TNP that needs hung) that is outside her scope.

This is where I have issues with the LPN scope of practice. Why can an LPN not spike a bag? We have to know what to expect (good and bad) from what is hung, we have to know what to do if something is not right, we have to know if/when/why/how to hold it in relation to labs, tolerance, etc. We need to be able to understand drip rate, recognize to fast/slow, etc. What's the big deal with spiking the bag? LOL

It is my understanding just from reading these threads that too many LPNs have the attitude "it's not within my scope of practice so I don't need to know it." How can a nurse provide excellent pt care with that kind of attitude? How can LPNs advance in nursing with that kind of attitude?

Oh, I've gotten up on my soap box, better shut up for now.

The point I was trying to make is, the RN is NOT responsible for the LPN, the LPN is responsible for her/himself. Respondent superior (that would be the Doc/hospital I think and not the staff nurse becasue the duty was within the LPNs scope of practice) does come in to play if the family should sue for wrongful death, but that's the only way.

"Once upon a time...."

{just kiddin :p }

I was a Director of ICU. I had a nurse on night shift who refused to take an IABP patient even though she had had 2 inservices on baloon pumps.

The next day when I was informed of this I was told, "the nurse said she was not comfortable with the assignment." I haughtily laughed this off and remarked, "If she wants something COMFORTABLE, go be a librarian."

I then related the incident to my Boss, the Director of Critical Care Services. He had a lil different slant on it. He said, "Just for kicks call the State BoN and see what they say." Which I promptly did.

Here is what the BoN told me.

"If a nurse states that he/she is uncomfortable with an assignment and you give them the assignment anyway. Then YOU become the party responsible should any problems develop with this patient."

End of story.

the moral?.........

You CAN refuse an assignment !

Love and Peace,

loerith

LOERITH: What the board told you is probably true but a nurse like this should be moved to another floor...if you have need of a nurse who can and will be called on to do something then they need to become proficient in the procedure...this only fair to the patients and to their fellow staff members..you will not have happy campers if they come in to work and find that their assignments are going to be determined by someone else and telling them that they are verstile and valuable don't cut it

agreed Chatsdale!

Love and Peace,

loerith

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