Tube Feeding Question

[kasi]

I am an RN in LTC. Residents with tube feeding have the HOB up 45 degrees. The NAC needs to take care of this person every 2 hours to do peri care and change their brief. In order for them to this, the tube feeding needs to be turned off to allow the resident's bed to be put down to turn them. I delegate the task for the NAC to turn off the T.F. machine, but that I will be coming in a few minutes to make sure all is well and that the machine is turned back on properly. Sometimes I am with them to turn it off myself depending if I am right in that area of the facility. I have had no problems with delegating this task. But, another NAC claims that I am wrong for delegating this task and would like to turn me in. She states it is illegal for me to do this. Am I wrong for delegating this task?

[PHTLS]

Yeah, it all depends on your hospital's policy. To be honest, even if the patient is lying flat with the pump on, the risk of aspiration isn't all that high provided, of course, that the pt. doesn't stay supine for hours.

When I was a care partner (CNA) at Kaiser Permanente, there were times I forgot to turn the pump off (during bedside care) because I was so busy (I'm a Zombie on night shifts too), but the patient(s) I was taking care off never aspirated or vomited feedings out. You can pretty much get away with carelessness like this for minutes until you raise their heads up again.

Next time, just tell everybody to put the pump on hold/pause. An alarm usually goes off if you forget about the pump and that's a cue for the licensed nurse to take care of it.

[*PICURN*]

I worked as a CNA in nursing school and sometimes I wouldn't even GET report from the RN, they would just expect us to go in and take vitals at 0800 and when they got a minute they would give us our "CNA report" (as in diet, incontinence, any kind of specimens they wanted us to get, etc). Luckily I was in nursing school and already knew that if the patient had a feeding tube (pretty easy to recognize the NGT) I would push "hold" on the feeding, change the patient, and then restart the feeding.

Most likely isn't in the CNA's "scope of practice" but you would think it would be common sense.

[Chad_KY_SRNA]

To my knowledge it is outside of the CNA's scope of practice to do anything to the tube feeding. When I first got certified, I was told that CNA's dont mess with tube feedings. It has become neceesary that some CNA's turn off the residents tube feeding, unhook the feeding tude from the pump, and take the resident to the shower room, bring them back, transfer them to the bed and them plug them back in and turn them back on. I would check out the legality of it and cover my a$$.

[CoffeeRTC, BSN, RN]

This is turning into a intersting thread. I've never really given it second thought. Our aids just do it. When giving care or showers..they press hold then restart. For showers they will disconect and plug the gtube. I will restart it. Half the time they are reminding me about down times and restarting. I still check the pump during my rounds and prn.

[LPN1974, LPN]

My goodness, why is she creating all that fuss?

I agree with the other poster that said NA's should know where the off switch is in case of an emergency to turn it off, and it's turning it back on that they should not do.

In some places NA's are doing things that LPNs have been doing, I've seen where they say they are giving medications, doing treatments, trach care, respiratory treatments, foley catherizations......and THIS aide fusses about turning OFF a feeding pump???

SHE should be reported for insubordination if she refuses to turn it off.

You are the RN....you are the supervisor, don't let her bully you like that.

Delegating the task to turn OFF a feeding pump is NOT a big deal.

She just doesn't need to mess with turning it back on.

Take it on up the chain of command to see what needs to be done, IMO.

[donmomofnine]

This is turning into a intersting thread. I've never really given it second thought. Our aids just do it. When giving care or showers..they press hold then restart. For showers they will disconect and plug the gtube. I will restart it. Half the time they are reminding me about down times and restarting. I still check the pump during my rounds and prn.

same thing at my facility. Never really gave it a thought, either!

[donmomofnine]

This is turning into a intersting thread. I've never really given it second thought. Our aids just do it. When giving care or showers..they press hold then restart. For showers they will disconect and plug the gtube. I will restart it. Half the time they are reminding me about down times and restarting. I still check the pump during my rounds and prn.

same thing at my facility. Never really gave it a thought, either!