What are the boundaries to help a pt that is not assigned to you?

puppytrix · Jun 5, 2009

I agree... who wouldn't help another patient? I will always check with the primary RN before giving meds, but if another patient needs something, I will "add them in" with my prioritizing. If I'm covering another RN's break or for whatever reason, I will do what I can... in the order I choose as appropriate. I guess I don't know what my LEGAL responsibility is, but my thought is: if I am a qualified person who fails to perform something necessary, I could be held responsible. But, again, I see many people use that excuse "well, it's not my patient" and it is a sad thing to see. We are IN THIS for the patients. Or, at least we should be.

dream'n, BSN, RN · Jun 5, 2009

We are employees of the hospital not our individual assigned patients. In an urgent or emergent situation I am certain that the BON would hold any nurse (assigned or unassigned) with knowledge of the situation responsible if they failed to provide the care that a prudent nurse would. For example, if an unassigned patient calls for help because they are falling and the nurse that witnesses the situation just walks off, that would be a legally punishable act (and ethically horrible.) Think of it this way; if your mother was a patient, fell, and was injuried while an on duty nurse (unassigned) was standing there refusing to assist, you would have strong legal grounds to file suit against the hospital AND the nurse.

rngolfer53 · Jun 5, 2009

I agree... who wouldn't help another patient? I will always check with the primary RN before giving meds, but if another patient needs something, I will "add them in" with my prioritizing. If I'm covering another RN's break or for whatever reason, I will do what I can... in the order I choose as appropriate. I guess I don't know what my LEGAL responsibility is, but my thought is: if I am a qualified person who fails to perform something necessary, I could be held responsible. But, again, I see many people use that excuse "well, it's not my patient" and it is a sad thing to see. We are IN THIS for the patients. Or, at least we should be.

What about the patients assigned to you? There's a legal duty to them, and neglecting them while taking care of a non-emergent need of an unassigned Pt would certainly make some lawyer salivate if something goes wrong.

Nurse523 · Jun 5, 2009

Thank you for your responses! I greatly appreciate it!

I will be more specific because it appears that going on to other topics.

Then textbook saids:

"If a nurse shows that he or she was not (1) assigned to that particular patient on the date that the negligence allegedly occurred, or (2) working the day or time the negligence allegedly occurred, no duty will be imposed on the nurse. Because no duty will be imposed on the nurse, negligence

allegations will fail. Although courts have been willing to construct parameters around a nurse's duty to his or her patient,

when a patient establishes that a specific nurse rendered care, the nurse will have assumed a duty to provide reasonable

care for the patient. A nurse's failure to provide reasonable care subjects the nurse to civil liability for negligence, where the patient proves that the failure caused damage or injury.

So what is reasonable to go help or not help a pt that is not assigned to you? I just finished my 3rd year nursing and my faculty advisor has stressed that if a pt or the pt's family member is driving you nuts (i.e- My daughter is in pain, please come here now and help her!) you are accountable even though you may not be assigned to that pt. Everyone on the unit is accountable for the well-being of the pt and the pt's family. I don't know, I think also the factor of knowing your unit's culture is important. In one unit, it may be ok to go help the pt, on another unit, that can not be ok and like someone mentioned in a post, the nurse is invading the pt's privacy bc they are not the primary care giver or the pt is not delegated to you.

**canoehead, BSN, RN** · Jun 6, 2009

I'll take a shot, though I'm not a lawyer.

If a patient is endangered, or likely to suffer because of a lack of immediate intervention, I think we are all obligated to respond, or make sure someone else responds to take care of the problem. If you walk by and see someone about to fall you are obligated to go in a prevent the fall. You can hit the callbell and pass it off to the assigned nurse when they come in, but you cannot continue walking and tell them to check on the patient. By the time they get to the room the patient would have already fallen.

I don't think we're obligated to walk into a situation that presents harm to us. Someone is throwing chairs around, we would gather a team before entering.

If the patient needs a commode chair we can let them know their nurse will be informed, and respond when they can. I think that would cover you legally, but morally not so much. Their assigned nurse might not get in there immediately, so in the interest of serving the patient I usually do it myself, and tell the assigned nurse what I did. I hope they'd do the same for me, and the unit just runs a little smoother when we help each other. Plus you get a little karma point from the patient so tomorrow when you need to stike twice for an IV they forgive you a lot faster.

cardiacRN2006, ADN, RN · Jun 7, 2009

I guess I don't know what my LEGAL responsibility is...

But, that is what the OP is asking. She's not asking what the MORAL responsibility is, she's asking about the legal responsibilities.

A perfectly good and valid question. And asking it doesn't imply that she doesn't want to help! She just want's to know what her liabilites are.

FLArn · Jun 9, 2009

If the OP is specifically requesting LEGAL advice he/she needs to contact an attorney who specializes in health care law or the BON as we are not (if I understand the TOS) to give legal advice on this site. Therefore the individual responders' views of moral responsibility is all we have available to offer.

SunnyAndrsn · Jun 9, 2009

Could you be a bit more specific? I didn't read through all of the replies yet, but off of the top of my head, I think safety, ABC's, and assisting with pain management...for example, call light is on, you're available to answer it and their primary nurse is not. They need pain meds...you'll need to find their primary to let them know, but in the meantime, assisting with repositioning, an ice pack, or other non-pharmacological interventions to help the pt. become more comfortable seems appropriate.

Assisting with toileting would also be approriate.