thin ice nursing

allnurses Guide · Nov 3, 2005

Your facility MAY cover you in the event that you are charged with any negligence (because uhhh, your patient stopped breathing and you didn't code them!), but ultimately YOU are responsible for these patients and their safety. The only advice I really can give you is to find another job in a place where you are given the tools to care for your patients safely.

katie'sangel, BSN, RN · Nov 3, 2005

OK it's me again, Katie'sangel, and Here's a perfect example of the common problem I have on this unit:

I'm having difficulty getting my patient's air way clear because I don't have the right suction equipment! The details here aren't important, but here's the bottom line. Am I responsible when the facility/myemployer doesn't give me the equipment I need to take care of my patient safely?

This guys a No code, hospice patient, but he's been admited to a in-pt-unit on a hospital ward so he can get better care than he'd get in his home.

I worried some family member is going to sue us for not taking care of the patient. The only defense I'l have is that I've told my supervisor repeatdly about the lack of appropriate supplies

Employment laws and nursing laws are designed to assist a employee to stay at their job. the answer isn't "just quit"

got any other ideas?

Cute_CNA, CNA · Nov 3, 2005

Document everything that you think could be a problem, and document all of your patient interventions. CYA.

Time to contact the BON? And is there a risk management team?

I think you should still try to find another job where your license isn't at such a risk. What specific laws are keeping you where you are at?

rn/writer, RN · Nov 3, 2005

OK it's me again Katie'sangel, and Here's a [u']perfect example[/u] of the common problem I have on this unit:
I'm having difficulty getting my patient's air way clear because I don't have the right suction equipment! The details here aren't important, but here's the bottom line. Am I responsible when the facility/myemployer doesn't give me the equipment I need to take care of my patient safely?
This guys a No code, hospice patient, but he's been admited to a in-pt-unit on a hospital ward so he can get better care than he'd get in his home.
I worried some family member is going to sue us for not taking care of the patient. The only defense I'l have is that I've told my supervisor repeatdly about the lack of appropriate supplies
Employment laws and nursing laws are designed to assist a employee to stay at their job. the answer isn't "just quit"
got any other ideas?

Forget employment laws for now and look into the laws governing what is required of the facility. If the hospice is not in compliance with those laws, someone needs to find out about that.

If the hospice IS meeting all of its legal requirements (which would seem to suggest a philosophy that says these folks are going to kick it soon anyway, so why provide resuscitative measures), then you have to decide what you can live with and act accordingly.

prmenrs, RN · Nov 3, 2005

Document the heck out of everything! When you notify the supervisor something's not working, do it in writing, copy to the CEO or whatever the biggest "suit" in the place's title is. Go up the chain of command. Keep copies in a file somewhere secure (use initials/room # to maintain pt. confidentiality).

Some governing body must license the facility: the state dep't of health, JACHO, ?? Blow the whistle!!! Take your documentation w/you!

You know you are in an untenable situation. If you do blow the whistle, be prepared to work elsewhere because your facility will probably make your life a living he**. It doesn't sound from your description like it's a safe place for the patients or you. Very sad.

babynurselsa, RN · Nov 3, 2005

If there is no P&P manual you will not have a leg to stand on in court to cite that you acted within your facilities guidlines in any given event. THis could leave you flapping in the breeze if something were to go to court. If someone in admin pulls a manual out of thin air in this event and wahtever intervention you performed is contraindicated, what then?

Is your hospice a part of the hospital that you are located or are you just renting space. If you are actually a part of the hospital then I would be ordering equipment from CS. It is that hanging in the breeze thing again. "Well if she needed sx equipment then why didn't she just order it???"

If not don't you have a DME company that is contracted? Again then order it.

I would request a meeting with someone, Nurse manager, or someone up the food chain and ask them these questions.

I would not rely on the employment laws and nursing laws to protect your personal liablility in this situation. Nursing law is there to protect the patient not make your job tenurable.

I guess it boils down to what are you willing to be responsible for and answer for.

Some facilities will just cut whatever corners that they can as long as there is no "squeaky wheel."

BabyRN2Be · Nov 3, 2005

Babynurselsa is right. This is just a set up for trouble.

I'd do a lot of documenting. Wow. I'd really be concerned if I worked in a place like that.

ceecel.dee, MSN, RN · Nov 4, 2005

I'd be very concerned about working in this situation.

There must be a doctor who acts as chief of the hospice area. Speak to him about some of these concerns. Start with the basics, like suction equipment (definately a comfort measure, as well as a life saver). If you are able to get his attention and develop a good rapport with him, you may get him in your corner about some of the liability issues, and that may lead to P&P development.

I agree with you...quitting is not always an answer, especially for people in small communities or rural areas.

Good luck!