Ccinct

I am a LPN in CT. Tonight I was working the 3-11 shift. At my facility our floor has 2 units, with 22 patients on each unit. At 5p the nurse on the other unit asked me if she could go home at 9pm. I said okay. At 9pm, one of the CNAs said she was going home too. That would mean that we would only have two CNAs for 44 patients. So I told the other nurse that I was not uncomfortable counting with her and taking the keys for the unit. I told her if she wanted to go home she should ask the supervisor to count with her (so the unit would then be his responsibility and not mine.) This other nurse btw, goes home at 9p every time she works 3-11. Tonight she was claiming that she was going home because she had car issues and her husband was picking her up. Her husband was on the unit at the time. When I told her I would not count with her she immediately began to yell at me at the nurses station. The supervisor said that I had to count with her and take the unit. I told him I was not comfortable with that for safety reasons. He wrote me up for insubordination and starting work issues. He said that because it was 9pm, that counted as the night shift and since he was the supervisor I had to do what he said. He said that since I told her at 5p she could go that that meant I had to count with her. I explained that I did not know that the 3rd CNA was leaving at that time. My question is: was I in the wrong? Was I being insubordinate? Can he legally force me to take on a whole new floor while I am already working a floor? What is the right thing to do in this situation?

There was a page in the patient's chart that said DNR/DNI and nothing else. Usually we just look at that one page because it's a quick way to find someone's code status instead of reading their whole advanced directives form. That was the page that the supervisor opened up to and showed me and I never questioned it until the resident's brother came in and told me that she was a full code. Then I went back and looked at the full advanced directives form and she was indeed a full code. There was a new supervisor on at the time and a new nurse (it was after 7a) so i had the new nurse bring it into the new supervisor who was arguing with the patient's brother about it. The new supervisor told the new nurse, "oh well that's not relevant." I feel sick to my stomach still. I knew in my heart what I should have done and I feel like I was too chicken **** to do it. I always second guess myself and this time there was big consequences. I have stupid bad anxiety and I know that no-one is a fortune teller but if anybody has some kind of educated guess about what will probably happen please let me know.

I work in a long term care facility. Last night I had a resident who has sleep apnea and is non-compliant with her bi-pap and also has a history of acute respiratory hypercapnia and hypoxia. Around 2:00a she told me she was feeling anxious so I gave her a PRN trazodone 25mg, a medication she has taken many times before. About a half hour later she became SOB so I took her SP02 and it was 70% RA. I put her on 5L of 02 via non-rebreather mask and called my RN supervisor. I am a LPN. The RN did not even go in the room to assess her because her 02 sats went up to the 90s. My supervisor just opened up her chart and pointed to the page that said DNR and told me that means we don't send her to the hospital. I firmly told her that is not true and that I want to send the patient to the hospital. By this time we had the patient on 3L via NC, her 02 sats and VS were all WNLs but she was so lethargic that she was not even verbally responsive. Her baseline is alert and oriented times 3. I called on call and asked to send her. The on call MD said no, monitor her there and get an order for PRN duo neb which I administered. I once again pleaded with the supervisor to send her and the supervisor told me no because the facility needs to save money and when we send people out it wastes money. I could not get in touch with the resident's son, her POA but at 6 am I called her brother who came to visit. At 7am a new supervisor came on who also just wanted to keep the resident at the facility and monitor her there despite the fact that she was still not verbally responsive. At 3p, the new shift came in and they finally sent her out. The called me to say that I needed to come in and write a statement. They told me that the hospital had intubated her and that I should have called 911 even though the MD and my supervisor told me not to. I also found out that the page in the resident's chart was wrong and that she was actually a full code. The other thing that I am worried about is that I signed out the Duo neb tx and the trazodone late (I had to sign them out as late entry) because I didn't have time to put them in the EMAR with all that was going on. On the one hand I feel like LPNs can't legally assess and I was just listening to the RN and the MD who told me she was fine and to monitor her at the facility. On the other hand I am worried that the state will hold me accountable and I will potentially get sued for neglect. Does anyone have any advice for me?