Patient Neglect?

[Kaysmom8]

Hello,

Recently a co-worker of mine went to the supervisor several times about a wound on a resident's foot that was getting worse with a foul smell and discharge. The wound was being treated with medihoney, the supervisor told her not to worry about it and that the medihoney was working just fine. To make a long story short another supervisor got involved after 2 weeks or so and it has been confirmed that this resident has osteomyelitis and the family decided to seek no further treatment since the resident is a hospice patient. The family has no idea that this could have been prevented if only a certain supervisor addressed the issue properly. Now my co-worker is upset because she didn't document at all that she had alerted anyone of this new finding (she is a new nurse). This whole situation makes me mad to think that this resident suffered and that had the family allowed a possible amputation all because of a supervisor who is well known for spending her time smoking outside or texting on her cell. My co-worker was told that she should have went over the supervisors head and called the doctor when she noticed that the issue was not being taken care of but other nurses have done this in the past and this supervisor gets really mad and throws a huge fit. Thanks for letting me vent...

[toomuchbaloney]

Hopefully all of the nursing staff, but specifically the new co-worker, has learned something valuable from this unfortunate scenario.

[beckyboo1, BSN, RN]

I guess I don't understand why this nurse, or anyone else aware for that fact, didn't call a doctor. We are to advocate for our patients, whether it ticks of a supervisor or not. Why would you need the supervisor's permission to call the doctor anyway?

[ktwlpn, LPN]

It's been decreed in my facility that it is my responsibility to take any action I may deem appropriate no matter what my supervisor may say. It's also up to me to make sure everything I report has been followed through appropriately by those above me. I always document whenever I relay info to anyone but that does not relieve me of my responsibility. This is a tough situation for any nurse to be in. The head you go over does throw a fit because of their ego but it's not about them, it's about the patient. We are to inform the supervisor when we need to call a physician as a courtesy to the doc, we try to consolidate all of our concerns a much as we can to minimize the number of calls we make.

We have a wound care protocol,as should you. A wound can change in hours, someone should have been notified immediately when signs of infection were noted. Someone may try to make your co-worker take the fall for this, I hope she learns from it. She could go to another supervisor, staff dev or adon /don for a de-briefing-that's what I would do.I would make sure whomever I discussed this with knew the recent history.

I have had many resident's last days be a misery because of wounds like this when the family does not want to put them through the trauma of aggressive tx. It's good that hospice is involved because they need aggressive pain control. It's possible this wound was not preventable (PVD?) and also likely the family would not have wanted to pursue IV antibiotics or even long term oral antibiotics like clindamycin due to side effects.

Hospice will support the resident, family and staff through this, it sounds like you will benefit from that.