when to report/notified....

[MissRed]

Hi. im an lpn. i would like to know when do i required to report or notied the RN(supervisor) everytime i need to document when pt. have changes of condition i always document rn notified. some rn get upset cuz it seems like i put that to save my butt and they will be responsible for it. so im kinda confused when do i need to report to rn...

[shiccy]

FWIW in our facility the RN is the only one that is able to call a physician. I do not know if this is a "State Law" issue, or just hospital wide. I would assume that it'd be the latter b/c aids, even if trained properly are NOT allowed (even though state says they *are*) to place foleys. I have no problem with either. I'm sure there was an issue earlier on in the company history that made this issue a necessity.

I'm in Ohio if you were wondering.

[MissRed]

shiccy. you are right. in my facility only RN are allowed to call the doctor.

[agldragonRN]

hi. thanks for the info. im just wondering what intervention did you do everytime your pt have elevated fsbs? esp. ongoing high glucose? do u just call the md? i usually chart my intervention and just notified rn. and did not called the md.

well, assessing the patient for s/s of hyperglycemia (headache, blurry vision, fruity breath, etc...) , calling the md, and following the orders are all interventions for elevated blood sugar. i see that you are not allowed to call the md at your facility. that sucks and gives so much work for your supervisor. in that case, definitely chart every time you inform your supervisor because if a call to md is warranted and she did not call at least charting shows that you informed her. but your responsibility does not stop there because you have to follow-up with her whether she called the md or not especially when you know that she needs to call the md. i've bugged my rn supervisor a couple of times for something because i have a supervisor that is a little bit lazy so i tell her i will chart how many times i called her. it is not a threat but i happen to work with a lazy supervisor so i gotta do what i gotta do to do my job and ensure my patient gets what ever treatment is necessary in a timely manner.

for other things like when my patient's bp drops below her normal range like 90/60, i elevate her lower extremities, takes her full vs, including her oxygen saturation and assess for s/s of hypotension then if asymptomatic i wait for few minutes to see if elevating her legs increases her bp then i call supervisor and md. sometimes the supervisor is busy on other floor so i just go ahead and call the md without informing her. i inform her when i get the chance and update her. so i don't chart "supervisor made aware" to pass the buck on to my rn supervisor. i do everything unless she wants to help or offer help. but if ever an rn assessment is needed and something bad happened to the patient, i did my job by informing the md and informing the rn supervisor so my behind "should" be covered.

angel, lpn

[MissRed]

thanks agldragon!. yeah i have a lazy supervisor as well. the sad part about it she get upset when i document everytime i notify her. god bless