Basically I'm a little worried, I started this job back in November, I've worked at several different hospitals in all different areas (cardiac, psych, OB), but this is OB and Newborn at one of the largest hospitals in my area. I have NEVER had so many people complain on me before!! I am not used to this at all, even in psych my patients loved me. I'm a very relaxed person and can get along with anyone (I thought!) This is very long winded but I feel like there are some details that need to be known to understand whats going on.
I had a patient who was leaving AMA with their baby. We have to do certain tests before the babies can leave but it's typically done after the baby is 24 hours old. This baby was NOT 24 hours old yet but I was told we still needed to do it anyway. So I told the parents what it was for and why we do it and explained to them that even though I was doing it now, it would still have to be repeated correctly after 24 hours of life with their pediatrician, gave them the slip of paper with the information on it to give to their pediatrician. These patients were a home delivery and didn't want to be in the hospital in the first place, no separation from baby, no vaccines, no bath, etc. So while I'm doing the heelstick, Dad is hovering over me and baby, who is screaming and NOT bleeding enough for what we needed. I stuck the baby twice and explained that I didn't believe that would be enough for the lab and that they would have to get it redone. The parents both said it was okay and that they were ready to leave. So I charted that they refused it to be done because they didn't want me to continue. They were given their papers and about an hour later, walked out to go home. I realized after they were gone that I didn't get the paper back from them that they were supposed to give to their doctor.
I received a call from my charge nurse on Friday, approximately 3 weeks later, saying that the mom called up there and wanted to know why the results weren't in. She told my charge nurse that I stuck the baby 4 times and that it took me 30 minutes and I completed the test (which is not true.) When my charge nurse told her what I charted, the woman was upset. They definitely weren't the most sound of mind people, but I don't know who they really are and I'm worried that they're going to try to take this up the chain of command.
Looking back I realized that I charted incorrectly because I simply put "mother refused" instead of something along the lines of, "test attempted, mother refused after second heel stick." So now I'm worried that I'm going to get in trouble with work about it.
Has anyone experienced anything like this? Where they didn't chart something exactly correct and got in trouble for it at work? Or had a patient try to get you in trouble for something along those lines? I know that I'm being silly and my anxiety is getting the best of me but I can't get it off my mind!! If you've had something like this happen, what did your job do about it?
Specializes in Nurse Leader specializing in Labor & Delivery.
2). Again for the future reference: "required" tests (as far as I can understand, phenylketonuria and congenital hypothyroidism screens) are useless if done before 24 hours after birth due to high incidence of false positives.
Actually the tests, if done too early, will have a high incidence of false negatives. It takes a certain amount of food in the system for a minimum amount of time before some of the enzymes or chemicals or whatever will build up in the bloodstream and be detectable.
The reason it's done twice is because they CAN detect some of these conditions with the first test, and if you wait until the second test (typically done at around 2 weeks of age) before treatment, there could already be irreparable brain damage.
Specializes in Nurse Leader specializing in Labor & Delivery.
I asked her if the patient was pushing legal and she said yes. She also said that after speaking with several others who encountered the patient, including the OB and pediatrician who had to agree to the AMA
Um, no. That's the whole point of the AMA. They DON'T agree to it. If they "agreed to" them leaving, then it's not AMA.
klone, MSN, RN
14,857 Posts
Actually the tests, if done too early, will have a high incidence of false negatives. It takes a certain amount of food in the system for a minimum amount of time before some of the enzymes or chemicals or whatever will build up in the bloodstream and be detectable.
The reason it's done twice is because they CAN detect some of these conditions with the first test, and if you wait until the second test (typically done at around 2 weeks of age) before treatment, there could already be irreparable brain damage.