Pt chokes and turns blue, nurse ignores and calls 911

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Specializes in Tele, ICU, Staff Development.

Dear Nurse Beth,

Recently I and two other LPNs were working together. Nurse #1 had a patient choking and was told twice by stna that they were turning blue. Nurse #1 was sitting at the nurses' station, did not get up or call a code, but called 911. This resident was a full code and later died. Myself and Nurse #3 had no idea this had happened until the ambulance showed up. Was this the wrong protocol? I struggle with this daily as the facility I work at thought nothing of it.

Dear Struggling,

I am struggling as well to even believe this happened. There are so many things wrong. There is no protocol anywhere that would advocate ignoring a patient in extreme distress.

How can a nurse be so callous as to not respond when told her patient is choking and turning blue? 

Did the nursing assistant perform a Heimlich if it was indicated? Take vital signs? I would have a conversation with my manager and ask what is expected under these circumstances.

Best wishes,

Nurse Beth

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Specializes in Peds, Med-Surg, Disaster Nsg, Parish Nsg.

WOW!!  I am speechless...

Such blatant neglect and disregard for a life that possibly could've been saved by rapid response.

 

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Specializes in Tele, ICU, Staff Development.
On 11/9/2020 at 12:15 PM, tnbutterfly - Mary said:

WOW!!  I am speechless...

Such blatant neglect and disregard for human life that possibly could've been saved.

It's hard to imagine, but even if the culture of the facility is such that they "thought nothing of it" and tacitly condone this behavior, surely a manager would never say that. I'm thinking if the OP sits down with the manager and asks what should be done, she'll find out what the expectations are. At least in word if not in action.

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Specializes in Dialysis.

I'd be surprised if the family of this patient doesn't take legal action. Wow, just wow...

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There is probably a well entrenched attitude of "do nothing" or "do as little as possible" in this facility, or at least with this employee.  Most likely the attitude has been years in the making.  Had there not been a tragic outcome, it would just be chalked up to business as usual.  Unfortunately, this is not as rare as one would expect.  There are many who only worry about collecting their check each pay period.

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Specializes in retired LTC.

This was prob a LTC/NH facility. They don't have RRT teams. Usually an intercom page goes out for "Nsg supervisor to East Wing STAT".  Or "code blue East Wing". That usually gets everybody who can help to come running.

All facilities usually have an 'emergency/crash/code cart'. Nothing special on it but it most prob had suction avail for immed use. Should have been brought to the scene.

Like others have said, the OP needs to bring this episode up with Admin. Corrective actions for the involved staff implemented as indicated and gen'l education is needed. This was NOT one of those 'learning situations'.

CPR/AED/Hemlich certs are usually REQUIRED for staff. So an investigation into why the staff failed to approp intervene is absol indicated.

If this was LTC/NH, the receiving hosp (or Rescue) may consider it a 'sentinel event' to report to the DOH and as a 'coroner's case'. More sequellae from them may follow (above & beyond a litigious family).

 

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Another angle is that when I am told things by a coworker (haven't quite heard anything this bad) which sounds like it could be part of the case here, I always direct that person who is a direct witness to follow the proper procedure for reporting such a thing. Fill out an incident report or whatever the facility's formal process is. I make it clear that they are obligated to do so and I let them know I will follow up to make sure it is done.

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People can die pretty fast that's why if they need CPR one is suppose to do it right away. Sometimes by the time help comes it's too late, so team effort is necessary. Check or know the pts status, call a code team, someone should have assessed the pt and started CPR till the code team arrives. Learn from this because as long as you are working as a nurse there is a chance you may need to give CPR or call a code etc. Unfortunately in certain settings experience doesn't come often and people use it as an excuse to not do anything but as a nurse you can always be held accountable even if it doesn't appear that way.

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