I have a MD who just likes to be contentious. This issue has never come up before but came up this week. We had a code blue in the waiting room (primary care clinic) for a patient's family member. We stablilized the patient until EMS showed up and updated EMS on vitals, etc.
Afterwards, the MD said we shouldn't be providing this care. I said we should and always have. He then asked, "well, how do we document the care we provided" and I was stumped. Normally, we've just recorded it on a piece of paper and provided a timeline to EMS.
What do you all do for code blue for non-patient in a non-hospital setting where they can't/won't be admitted? Thanks!
So when you do a pronouncement assesment you go ahead and call the funeral home and family on your own with no call or advisement from an RN or MD without any further verification?
LVN's (LPN's) cannot do that here in California. It has to be the RN who pronounces. And then yes, we can call the funeral home. We let the hospice team know (but not in the middle of the night - no one wants to wake up for that kind of call). We fax the info to the coroner.
LVN's (LPN's) cannot do that here in California. It has to be the RN who pronounces. And then yes we can call the funeral home. We let the hospice team know (but not in the middle of the night - no one wants to wake up for that kind of call). We fax the info to the coroner.[/quote']
I can see that, an RN can pronounce and actually sign the death cert in certain circumstances, I do not believe an LPN can sign a death cert and pronounce without any kind of verification from higher medical direction, never have worked hospice, so not absolute, have worked EMS and it is sad to see 50 people standing around doing NOTHING to help when we arrive on scene, because of ignorance or just not wanting to get involved!
Good Samaritan laws (to my knowledge) do not protect the provider if the provider is currently working and the individual is within a medical facility, including a primary care office.
Depending on state, as long as the provider is not getting compensation for care of that person they should be covered under good samaritan law, again depending on state. Then we are still only talking about bls care, not open chest heart massage, etc..
I can see that, an RN can pronounce and actually sign the death cert in certain circumstances, I do not believe an LPN can sign a death cert and pronounce without any kind of verification from higher medical direction, never have worked hospice, so not absolute, have worked EMS and it is sad to see 50 people standing around doing NOTHING to help when we arrive on scene, because of ignorance or just not wanting to get involved!
I'm sorry. I wasn't clear. I can pronounce but the doctor has to sign the death certificate. The mortuary or funeral home takes that by his office most of the time. Small town.
We're not signing death certificates that's the job for the doctor or the coroner but are clearly stated "he's dead"
It does state in that one sentence that it is within the scope of RN,RPN and LPN to pronounce if set by guideline of policy, (which would basically be the same as standing orders, which would be set forth by MD and facility policy), but also states that even an RPN cannot pronounce in an unexpected death, since an LPN is working under an RN or even RPN how does this clear your point. As stated in original post the situation was unexpected death of non patient, which was pronounced by an LPN! Expected death and DNRs are completely different, than a non patient un expected death. Don't ya think?
Anyway, I totally concede the point, I apologize to anyone and everyone if my posts seemed angered or over wrought, was not my intention. I love all my fellow nurses, but am somewhat passionate about helping people that are in need,especially in pre hospital setting, sure didn't mean to turn it into this. So take care and probably last post on AN!
Anyway, I totally concede the point, I apologize to anyone and everyone if my posts seemed angered or over wrought, was not my intention. I love all my fellow nurses, but am somewhat passionate about helping people that are in need,especially in pre hospital setting, sure didn't mean to turn it into this. So take care and probably last post on AN!
There was nothing wrong with your posts. Stick around.
Sam, Canadian LPNs are very different creatures from their American co-title holders. We do not "work under an RN" anymore than the RNs working along side us, we all work under the direction of the Charge Nurse. In many LTC facilities, there are only LPNs overnight.
You are the one who stated that an LPN was standing around doing nothing for the patient on the ground. My point is maybe that LPN knew the patient, knew their code status and that was it.
Take a step back, accept that you are a new nurse and you don't have the knowledge of a crusty old bat yet.
Spidey's mom, ADN, BSN, RN
11,305 Posts
LVN's (LPN's) cannot do that here in California. It has to be the RN who pronounces. And then yes, we can call the funeral home. We let the hospice team know (but not in the middle of the night - no one wants to wake up for that kind of call). We fax the info to the coroner.