Pt treated bad

Document, document, document.

If you're supervisor won't listen, then go over her head. Also, contact the family and your local ombudsman. If they did, indeed give the pt someone else's lasix, they are so far outside the law, it's not funny.

hello ATNNurse,

i am nursing student but what i think maybe you could contact social worker , if this does not help department of public health... it is evident abuse. also document everything what is going on, this will help to protect you. you can also tape-record or keep some form of journal where you write what is going on during the day of your duties.

it seems there is no good leadership, managment, care about patient's well-being. i hope it will have good outcome. keep up on your good work and patient' advocacy, we need more people like you. :)

he had 2+edema from his knees down and rales/rhonchi in all lobes,

Is there some reason that this patient could not be sent to the Emergency Room with symptoms like these? I would've called 911 immediately and notified everyone later, frankly.

As you probably know, CHF is potentially fatal and is considered an emergency. Once at the hospital, labs would be done to determine what's going on as a result of the dehydration/overload--such as potential renal failure, electrolyte imbalances, and cardiac arrhythmias.

In other words, whoever's been just dosing this patient up could be severely compromising his what little health this fella has, :angryfire not to mention practicing medicine without a license.

This is outrageous...

Are you working in this patients home or is he in some sort of hospital? Are you allowed to call the doctor & speak to him or her yourself? Or leave a message on an anwerphone asking the doc to visit the next day, preferably early on.

Document, document, document.

If you're supervisor won't listen, then go over her head. Also, contact the family and your local ombudsman. If they did, indeed give the pt someone else's lasix, they are so far outside the law, it's not funny.

I do doccument my findings each day, but i have no proof he was given lasix. I dont feel I can contact the family because the day shift has her so snowed that she thinks they are just perfect and do no wrong, I did tell the daughter he seriously needed to see the Dr. but they talked her out of it because they knew the minute the Dr. laid eyes on him he would know what was going on, thats why I believe he was given Lasix to get rid of the evidence, without regard as to what they are doing to him.

he had 2+edema from his knees down and rales/rhonchi in all lobes,

Is there some reason that this patient could not be sent to the Emergency Room with symptoms like these? I would've called 911 immediately and notified everyone later, frankly.

As you probably know, CHF is potentially fatal and is considered an emergency. Once at the hospital, labs would be done to determine what's going on as a result of the dehydration/overload--such as potential renal failure, electrolyte imbalances, and cardiac arrhythmias.

In other words, whoever's been just dosing this patient up could be severely compromising his what little health this fella has, :angryfire not to mention practicing medicine without a license.

The pt has made it clear that he is not to be taken back to the hospital, and the family supports this, he is suffering from lung ca and wants to die at home, but it should be from that, not from some stupid little know nothing trying to play god. I believe that is why he was given lasix because if he was taken to the Dr. as i requested the Dr. would have seen right off what was going on with all the edema, so they had to cover themselves. what do i do about her charting his lung sounds clear and no edema when it is there? Can I take a picture of the edema in his ankles? although i dont think it would even do any good, the supervisor has made it plain she does not want to hear it.

This is outrageous...

Are you working in this patients home or is he in some sort of hospital? Are you allowed to call the doctor & speak to him or her yourself? Or leave a message on an anwerphone asking the doc to visit the next day, preferably early on.

This is in the pts home, i get there at 7pm and the Dr. is closed, the supervisor has said it is the day shifts place to call the Dr. They would have to take him to the MD office

When you're off, maybe call the Dr's office and let them know of your concerns.

if he has lung ca, perhaps he'd be eligible for hospice care.....the hospice nurses certainly would not be overloading this poor soul.

i agree about calling the doctor, and also get an order for a set of labs to be drawn; and ask the md about hospice eligibility.

these nurses sound scary.

leslie

Wow! Since the patient won't go into the hospital, the family won't try to convince him to go, the day nurses are only further contributing, and you have no support from your supervisor, I would get out of Dodge. Let your supervisor know that you can't be part of this negligent care. I would also suggest that you make sure that the documentation is in the supervisor's hands so that you are covered.

Kris

The pt has made it clear that he is not to be taken back to the hospital, and the family supports this, he is suffering from lung ca and wants to die at home, but it should be from that, not from some stupid little know nothing trying to play god. I believe that is why he was given lasix because if he was taken to the Dr. as i requested the Dr. would have seen right off what was going on with all the edema, so they had to cover themselves. what do i do about her charting his lung sounds clear and no edema when it is there? Can I take a picture of the edema in his ankles? although i dont think it would even do any good, the supervisor has made it plain she does not want to hear it.

I would suggest that the family get Hospice care for the patient. Is the patient a DNR? Might be a good idea. Even so, the family and the patient certainly need education that DNR does not mean "Do Not Treat."

Since the patient is adamant about refusing hospitalization, I guess he has every right to die from CHF; it's quick enough, but it's just not the most pleasant way to go. Maybe some education about treatment options is in order here. Of course, if he's terminal, there might not be any sensible treatment options at this point, and the patient and family are just being realistic.

If you can't prove that the patient was given lasix, then you can't prove it. Likewise, the patient with lung cancer might or might not have CHF. Just document what you see and hear. I have had more than a few patients whose legs were swollen to 3+ pitting edema after a few hours of dangling, but then went back down to normal overnight. I've also had lung Ca patients who sounded very wet,but the sounds changed from one shift to another--to the point where I nearly questioned the last nurse's assessment skills. Then suddenly there were all these rhonchi and the patient's dyspneic. After a breathing treatment, would improve tremendously.

Given the cancer, there might be some CHF going on there, but only a BNP would really tell.

I would of called the doctor while on night shift anyways. They have an answering service and he could of been notfied and had the pt. sent to the ER.

How come you didn't call the doc while there on nights? I am a straight night shifter and am not intimidated at all to call the doc at any hour. (just thinking as if a jury was watching me).

DOCUMENT !!!!!!!

as for the day shift (ignoring and possibly giving lasix without an order)

.......-----> :deadhorse