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RN Responsibility Refresher

Nurses   (3,337 Views 7 Comments)
by drknyko drknyko (Member)

886 Profile Views; 13 Posts

Hi guys, a newbie to RN World! Just graduated and making the world a little bit better one at a time! Anyway, caught in a bit of conundrum, I hope you guys can help. Here's the story:

I work nights at my hospital and yesterday morning a patient supposedly fell to the floor. Now the nurse, which is an LPN (very important part), asked me to help the patient get back to the bed, so of course i said yes. I went into the room, asked the LPN if he fell or not and he mumbled something and we went on to put the patient back to the bed. I told him you should tell the Charge and write an incident report. Then I went on my merry way to MY 6 patients. Then, working tonight, the charge confronts me, asking me if i knew about a patient who fell and I said yes. She proceeded to ask me if I had done anything else than help the LPN, and I said no. So, for 15 minutes I am being scolded for not making sure the LPN told her and for not making an incident report. She is making an incident report NOW including my name.

Now, when she scolded me, my mind was getting pain meds for a patient, but then when I had time to reflect on it, she basically was telling me that since I am an RN, I should have been on top of the situation just because he is an LPN. She was asking me if anything was done, vital signs, paging the MD, and I am wide-eyed. I do not remember reading as one of my responsibilities as an RN to babysit an LPN. It's not like he is new, he has been working for a few years now and I just got off orientation a month ago. I'm not syaing he's a bad nurse either; he's helped me a couple times.

So, we probably would have to speak to the RN manager tomorrow, what should I do? Say? Am I liable for anything that happened to the patient? Any advice? Thanks!

Edited by drknyko
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630 Posts; 5,020 Profile Views

I would look at your facillity policy and procedure. Reminding the LPN to make an incident report and report it seems IMO enough in every place I have worked. If the LPN then didn't do it...it seems like he should be the one to be written up. I am assuming you weren't charge...nor the work area was divided with RN assisting LPN in IV's etc.

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13 Posts; 886 Profile Views

"An Incident report should be completed at the time of the occurence or discovery by the individual with first-hand knowledge of the event..."

That's what I can only find about patients falling and/or preventing it. Nothing that says the RN have ANY responsibility for an LPN's actions about reporting the incident. It also says that the report must be completed by the individual who discovered it anyway. He discovered it first then asked me to help him.

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HouTx has 35 years experience as a BSN, MSN, EdD and specializes in Critical Care, Education.

9,051 Posts; 44,828 Profile Views

All licensed nurses have are accountable for their own practice. In this situation, the LPN is responsible for taking the correct follow-up actions. IMO, you would only need to act if there was an aspect of the situation that was beyond the LPN scope of practice -- maybe assessing neuro changes or responding to an emergency change in status. Otherwise, you would not reasonably be expected to become involved if you were not her direct supervisor. I assume that there was an RN Supervisor somewhere in the organization at the time? If so - this would fall into her lap, not yours.

If your DON feels like all LPN staff members need continuous supervision, she will have to adjust the staffing model to reflect it; like changing to a team-based model, with RN & LPN on each team.

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P_RN has 30 years experience as a BSN, RN and specializes in ORTHOPAEDICS-CERTIFIED SINCE 89.

6,011 Posts; 33,273 Profile Views

What did the LPN have to say? Did he forget to do it or refuse to do it?

To me the report is for the lawyers to have a head's up. All that was needed was patient found on floor. To the best of your knowledge that was all YOU knew. The LPN could have added patient found on floor, side rails up x 4, assessed for injury, patient stated he was in a hurry to the bathroom etc, etc. None of that was known by you.

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13 Posts; 886 Profile Views

I spoke to the LPN and he said because his other pt was in a risk of having a HTN Urgency, and numerous other bad things happening at the same time with his pts, he forgot to make/tell the charge. Well, anyway, they reprimanded both of us and I was being assertive that his actions were not MY responsibility. But, they sidewined it in a way that I maybe PARTLY responsible since my license says RN. What should I do now?

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