The bedpan incident, this is long

Published

Most of u know I mostly work weekends. Sat. I went in and listened to report, went to start meds and was called to res. room. On her bottom was a bedpan shaped area. It matched our bedpans to a tee. Some of the top layer of the skin was beginning to come off. I was horrified. Figured that it must have happened over night, but the aides said no, they had heard about it before. After much investigation I discovered that most remembered they had heard about it Thursday. Many had seen it. NO ONE had charted or reported anything about it. Our CNA's are able to chart. It had been mentioned in report once but no one wrote it down. Nothing had been done about it. Of course I ordered her turned every hour side to side, peri care every hour and began my documentation on a seperate sheet of paper. A 3-11 lpn remebered being told about it and had seen it but FORGOT to chart it. :angryfire I spent the entire weekend talking to people, along with my meds, patient care, staff problems and everything else. The skin care on this wing must have been bad all week there were so many red bottoms that I took to carrying barrier cream in my pocket. The nurse manager on this unit is a pain, a know-it-all and pretty much worthless. I called her yesterday to find out what kind of tx she thought we should do, answer was barrier cream! She used to be our skin nurse. When I asked her if she remembered hearing about it she said no. I had already had 1 cna tell me he had reported, to her, on Friday about it. Another CNA verified it. An LPN going off shift on Thurs. remembers hearing about it but didn't work the next day. This poor patient has ms, a g tube can't move herself and is the sweetest woman. When I explained to the manager that the top layer of her skin was coming off, she said what do you mean? "Well the woman is black, the skin is coming off and it is pink underneath." Her sister came in after I left a message that the res. had a sore. A new CNA showed her the ulcer(is this what it would be called?) and told her how we thought it had happened. I worked 7-3 Sat. and came back in at 11 that night to work til 3p. I was so behind all day Sunday that I wrote myself up for not getting 3 patients their am meds given. A res. was upset about an aide they thought was mean and cried all weekend. Another was very angry because he knew the med aid during the night hadn't given him ativan but something that looked like an aspirin. Well after investigating that I discovered that she hadn't signed one out and that count was on so, obviously she didn't give him his scheduled one but tried the PLACEBO effect. At this time I decided this was all going to hit the fan so I called the DON to forwarn her. I figured she scream at me cuz I called a nurse in an hour early to help me finish up and everything else that went on, by now it was 6pm. She was very nice and told me to stop and go home. I said I still had charts to do so she said get out as soon as you can. At 730pm I was walking out the door when someone said don't forget u need to sign out all those 11am meds. A med tech I had written up 2 weeks prior had to pass these and didn't sign them out. I don't know why. But I left the "nurse manager" a note that I would be in Mon. to fill sign them. I documented everything that happened all weekend and put a copy in our don's box. What else could I have done? How much trouble will we get in for all of this? Know what? I still love my job! :rotfl:

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OMG....I do the weekend thing too. And see alot of what you describe...a mess.

As far as the bed pan thing...How long was she left on it? Was it like the total ring. I would do the incident report and document it as a stage 2 pressure ulcer. Depending on where it is a dressing might not stick, we use xenaderm alot for these areas.

As far as signing for a med tech 2 weeks ago...I wouldn't. Don't they have to sign for their own meds?

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Most of u know I mostly work weekends. Sat. I went in and listened to report, went to start meds and was called to res. room. On her bottom was a bedpan shaped area. It matched our bedpans to a tee. Some of the top layer of the skin was beginning to come off. I was horrified. Figured that it must have happened over night, but the aides said no, they had heard about it before. After much investigation I discovered that most remembered they had heard about it Thursday. Many had seen it. NO ONE had charted or reported anything about it. Our CNA's are able to chart. It had been mentioned in report once but no one wrote it down. Nothing had been done about it. Of course I ordered her turned every hour side to side, peri care every hour and began my documentation on a seperate sheet of paper. A 3-11 lpn remebered being told about it and had seen it but FORGOT to chart it. :angryfire I spent the entire weekend talking to people, along with my meds, patient care, staff problems and everything else. The skin care on this wing must have been bad all week there were so many red bottoms that I took to carrying barrier cream in my pocket. The nurse manager on this unit is a pain, a know-it-all and pretty much worthless. I called her yesterday to find out what kind of tx she thought we should do, answer was barrier cream! She used to be our skin nurse. When I asked her if she remembered hearing about it she said no. I had already had 1 cna tell me he had reported, to her, on Friday about it. Another CNA verified it. An LPN going off shift on Thurs. remembers hearing about it but didn't work the next day. This poor patient has ms, a g tube can't move herself and is the sweetest woman. When I explained to the manager that the top layer of her skin was coming off, she said what do you mean? "Well the woman is black, the skin is coming off and it is pink underneath." Her sister came in after I left a message that the res. had a sore. A new CNA showed her the ulcer(is this what it would be called?) and told her how we thought it had happened. I worked 7-3 Sat. and came back in at 11 that night to work til 3p. I was so behind all day Sunday that I wrote myself up for not getting 3 patients their am meds given. A res. was upset about an aide they thought was mean and cried all weekend. Another was very angry because he knew the med aid during the night hadn't given him ativan but something that looked like an aspirin. Well after investigating that I discovered that she hadn't signed one out and that count was on so, obviously she didn't give him his scheduled one but tried the PLACEBO effect. At this time I decided this was all going to hit the fan so I called the DON to forwarn her. I figured she scream at me cuz I called a nurse in an hour early to help me finish up and everything else that went on, by now it was 6pm. She was very nice and told me to stop and go home. I said I still had charts to do so she said get out as soon as you can. At 730pm I was walking out the door when someone said don't forget u need to sign out all those 11am meds. A med tech I had written up 2 weeks prior had to pass these and didn't sign them out. I don't know why. But I left the "nurse manager" a note that I would be in Mon. to fill sign them. I documented everything that happened all weekend and put a copy in our don's box. What else could I have done? How much trouble will we get in for all of this? Know what? I still love my job! :rotfl:

I love my job too, Dinkymouse. Or is it more of a love-hate relationship? I've been at my facility for almost two years now. I left twice, for a couple weeks each time, but came back. We are so understaffed right now (nurses and aides), but even working by myself with 60 pts, alarms going off, phone ringing off the hook, demanding patients and family members, addressing critical labs, taking off phone orders, documenting, documenting, documenting, documenting, med passes, flushes, breathing treatments, dressings, and doctors showing up...I love it.

I can't believe someone could leave a pt on a bed pan long enough to cause the skin to peel. Oncoming shifts have a tendency to come up to me after my crew leaves and ask....who had this room...then proceed to tell me they left a dirty brief in the garbage, or OMG!!...didn't empty the trash, or didn't replace the trash can liner, etc. I couldn't begin to imagine what they'd say if they found someone still on a bedpan.

I tend to ***** alot about my facility (along with every other nurse there), but after reading these posts I've come to the conclusion that I work in a top rate long term care facility. We just won a safety award for our state...Okay, then right after that had four staff injuries. We have the top skin care program of any facility in our corporation...we currently have two stage IV decubs out of a census of 100...and those were hospital generated. When we see red skin we get right on it. We have a weekly comittee that pictures any skin conditions, addresses them, and follows up on them. Last year we only had three minor deficiencies during survey.

The staff development coordinator, DON, and administrator all have open door policies. If there is a problem with a staff member they look into it, or advise you to start documenting incidents to create a paper trail so that action may be taken. If there's a problem with staffing...this one doesn't want to work here or there, and threaten to leave if they don't get the area they want (and that happens from time to time), I have the authority to tell them to clock out and go home. The charge nurse has the final say in assignments...and administration will back any nurse that has to do that.

Hmmm. I rambled again. Enough said.

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I just came back from signing out my med holes. They made that nurse manager the investigator for the incident.!!!!!!!!!!!!She had me diagram how it looked sat and sun. She had seen only one side didn't know there were 2. I specificly charted both sides. We think we have the culprit. A night cna that has a reputation at other facilities of neglect.

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Specializes in Family.

Kudos to you for holding it all together!!! I'm not sure if I could.

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Sounds like one of those "drive you to drink" shifts. Too bad I don't drink:crying2:

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Sounds like one of those "drive you to drink" shifts. Too bad I don't drink:crying2:

Neither do I. The nurse who didn't report it got fired. I am picking up some of her shifts.

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Neither do I. The nurse who didn't report it got fired. I am picking up some of her shifts.

Is the nurse who didn't report it the one who left the patient on the bedpan?

If not, what about the person who did?

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Specializes in Family.

Just thought of a tip regarding this pt. Try using baby powder on the bedpan for a while to help keep her skin from sticking to it so badly.

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The cna's all deny of course but I know someone will go. The babypowder is a good idea. I put a cath in last night until the sore is healed. The poor resident is in agony. She can't communicate well but you can tell when she likes u because she gets this really big "ornery grin". It has been missing of course. She grabbed my hand and said, "don't go" I just couldn't walk out of that room then even though I was behind. :cry: I stayed after I punched out and rubbed her arms and talked to her til she fell asleep. I got a few good smiles from her though.

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My Mom has MS.....she too is very much "helpless"

You sound like a very good nurse and a decent human being... :kiss

I pray there will be a nurse like you to care for her when she needs it....

Annor

The cna's all deny of course but I know someone will go. The babypowder is a good idea. I put a cath in last night until the sore is healed. The poor resident is in agony. She can't communicate well but you can tell when she likes u because she gets this really big "ornery grin". It has been missing of course. She grabbed my hand and said, "don't go" I just couldn't walk out of that room then even though I was behind. :cry: I stayed after I punched out and rubbed her arms and talked to her til she fell asleep. I got a few good smiles from her though.
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Specializes in LTC, home health, critical care, pulmonary nursing.
the med aid during the night hadn't given him ativan but something that looked like an aspirin. Well after investigating that I discovered that she hadn't signed one out and that count was on so, obviously she didn't give him his scheduled one but tried the PLACEBO effect. A med tech I had written up 2 weeks prior had to pass these and didn't sign them out. I don't know why.

This is why I think med techs are a wretched idea.

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