treating a visitor of your pt? reprimanded for not doing it....

[rehab nurse]

am i right or wrong here? just fyi, i work in a subacute rehab attached to ltc.

during report, had a nurse manager come in, tell me pt "had fainting spell" and to go see her. i get up, go in the pt's room, ready to do VS and assess, etc. four family members in the room with pt, one of whom is lying in bed next to pt. i say "what happened?", pt sitting up, a/o, no c/o. i go to take a BP on her, and another family member says "no, it's not her, it's my sister". sister laying in bed, says she has a "heart problem" and is vague with her symptoms. i say "sorry, i am not allowed to take your VS, but i will call an ambulance for you". rest of the family says, "no thanks, she's been complaining for the last hour, but we don't know why the nurses can't just give her a BP pill and check her VS every so often.":uhoh3: offer again to call ambulance, declined offer. so i go to nurse manager who's supervising building for the weekend, who goes to talk to family, and then writes me up for not taking the woman's vs. :stone

am i completely wrong here?

[Nickle]

OP, I think you did the right thing, for all the same reasons given by the other poster's who have validated your actions.

This thread has given me a lot to think about in terms of liability; I will no longer be taking family member's BPs "out of curiosity." Instead, I'll politely redirect them to the outpatient pharmacy downstairs, which has one of those automatic BP self-check machines.

I have one question for everyone: would it have been appropriate to call 911 anyways? I suspect the family would have been less likely to refuse transport if the EMTs/paramedics were right there. Then the issue of liability is out of the staff nurse's hands; if they refuse again, the ambulance team can document that.

[fp nurse]

I work in a doctors office, if we have someone walk in that is not are pt we will call 911 for them. If need be will perform basic life support untill they get there.Where would you document info about this pt? I think legaily you can not treat this pt without a consult pending?

[fp nurse]

you go girl. way to stick to your guns. Standing up to both of them takes guts. I honestly think i would have gave in. People like you make me proud to be a nurse.

[fp nurse]

The word "assessed" has me concerned. I know in many states, LPN/LVN's are *not allowed* to assess patients, it's in their nurse practice act.

So, what does yours say???

~IMBC[/QUO

You seem very upset with a LPN doing a assessment. Please keep in mind alot of state laws are different. I can and do perform assessments. Which is completely within the nurse practicing act.

[rehab nurse]

wow....i never had so many replies to a thread i started!

i got a lot of good information from all of you. i find it very interesting the differences in opinion everyone brings here. i especially find it interesting how other countries are not so worried about being sued as we are here in the US. everything i learned (and am learning now) in school, has always been to cover yourself and protect yourself from being sued and/or losing your license.

at work, the NM who wrote me up is going around and trying to find others who agree with her way. she won't talk to me. i did fight the write up, and it has been thrown away for the time being, as we have no policy. i told the DON to contact an attorney as she comes up with a policy for this, and she agreed to do just that.

work is becoming terrible. morale is down, and i am burning out quickly. i have fmla for my migraines and back pain, and i have been missing a lot of work lately. as soon as i walk in the door to that place, i can feel the tension. i always feel on edge, and as if i have to defend every decision i make. i will be glad to be done with school so that i have other employment options. i love being an lpn, but i hate how so many people assume you're an idiot because you're not a "real nurse". that's the attitude at my facility. i just wish i could control my stress better. i hate feeling like this all the time.

i just wanted to pop in here and say thanks to those who took the time to respond to me, i really, truly appreciate your time to tell me how things are done at your place of employment.

back to the books for me~exams coming!!! :balloons:

[talaxandra]

I'd like to hear more about how things differ in the ER from the US to the UK. How is your employment different? I hate to say socialized medicine because I don't really understand it completely.

I'm an Aussie - we also have universal health care, and a low rate of medical litigation (though it's growing..) And we don't treat visitors - at least not where I work (acute care), for all the reasons other members have listed.

I've taken relatives down to cas for assessment, I've directed them to the chemist downstairs (to buy analgesics etc), and have suggested that they speak to a doctor about whatever it is that they asked me about.

There's just too much that can go wrong. Well, that and I'm concerned about how much faith some people have in nurses' opinions, especially if the advice matches what they want to believe. Don't get me wrong, I think nurses as a group rock, and often dispense valuable and informed advice. But I had a 'check out chick' at a bakery once tell me that she'd found breast lump "but it'll be okay, right?"

"The majority of breast lumps are benign, but even young women get breast cancer (this was pre-Kylie) - the only way to know for sure is to have it assessed. You need to see a doctor as soon as possible."

[Rosie40]

At my hospital we are not allowed to take BP's check blood sugars on visitors for the simple reason that if there is really something wrong and I make a mistake, the hospital and me can be sued. Our olicy is that if a visitor is ill for whatever reason, we take them to the Emergency Department.

[hiwale]

I am currently in an RN program and have worked as an LPN for 7 years. I believe you are correct with your decision. You should fight against this write up. It is the RN responsibility to assess the situation and not the LPN. Did your NM know that it was your patients family member and not the patient? When the event occured did you tell your NM/ supervisor about it? It is not your responsibility to care for other family members. It is actually a liability for the company you work for if you were to care for someone in this case a family member when you are being paid to care for the patient. If I were in your situation I would write up the incident on the computer and print it out. Then I would give it to my nurse manager, if that didnt help I would give a second copy to my DON. Also request that a copy of the letter be placed in you file at work. I hope this helps you. It is really an ethical and legal issue. Always trust your own judgement.