witness statement?

TazziRN, RN · Apr 10, 2007

Perhaps because the pt is sicker than anyone realized and there's a stink about why it took so long to get the pt to the hospital? You didn't make it clear but I'm assuming you work LTC?

allnurses Guide · Apr 10, 2007

Perhaps because the pt is sicker than anyone realized and there's a stink about why it took so long to get the pt to the hospital? You didn't make it clear but I'm assuming you work LTC?

I'm a little unclear too . . . . if our LTC patients need transferring in the middle of the night, we wake up the ER doc. That is his job. He makes the decision on whether to transfer to the ER or to give orders for the LTC nurse to carry out. Our LTC is part of our "campus".

steph

TazziRN, RN · Apr 10, 2007

I'm a little unclear too . . . . if our LTC patients need transferring in the middle of the night, we wake up the ER doc. That is his job. He makes the decision on whether to transfer to the ER or to give orders for the LTC nurse to carry out. Our LTC is part of our "campus".
steph

We have an LTC too, but the PMD is still notified first unless it's an emergent situation. Our ER docs to not have any privileges outside the ER except to respond to codes or precipitous deliveries.

allnurses Guide · Apr 10, 2007

We have an LTC too, but the PMD is still notified first unless it's an emergent situation. Our ER docs to not have any privileges outside the ER except to respond to codes or precipitous deliveries.

We just had a "situation" regarding this . . . . funny. Anyway, we call the PMD during the day but after 6 p.m. we use the ER doc, who does have privileges or whatever you call it.

Had a patient in our LTC facility vomit 300 ml frank blood - I called the ER doc (I was the ER nurse and nursing sup - a combined role in my hospital) and he ordered the patient to be transferred to our ER so I sent out our ambulance.

All the docs are on the same page with this - do not call a PMD in the night.

Actually I left out a part of the protocol. . . . the LTC nurse calls the nursing sup who calls the ER doc.

steph

TazziRN, RN · Apr 10, 2007

Oh......wow, it's way different here. Our LTC is in the building, so there's no ambulance ride, just roll the resident down to the ER. And our docs are available 24 hours unless they're out of town.

allnurses Guide · Apr 10, 2007

Oh......wow, it's way different here. Our LTC is in the building, so there's no ambulance ride, just roll the resident down to the ER. And our docs are available 24 hours unless they're out of town.

We actually have two LTC's . . .one is attached and through the double doors about 5 feet from our nurses' station. The other is 17 miles away in another town. The bleeding pt was in the other town.

Our docs have an understanding about after hours calls.

steph

TrudyRN · Apr 10, 2007

It sounds like you did the right thing. Perhaps the night nurse did not. I can't really say without reading the chart.

How is the patient now?

I guess you could just ask your DON what's going on.

I hope both you and the NN did good assessments (VS, BS, abd exam, other basics, such as mental status, gross neuro status, response to abd being palpated, urine output and color, lung status) and that these were charted.

burn out · Apr 11, 2007

I think the real issue is why the patient assuming he was competent was not taken to the hospital when he asked to go? Calling the PMD was just a procedure to follow and any of them would have said to have the patient taken to the ER especially if it was 3 am. It sounds to me like this patient was made to suffer longer than was necessary and if he had n/v for 3 days could have been critically ill.

allnurses Guide · Apr 11, 2007

I think the real issue is why the patient assuming he was competent was not taken to the hospital when he asked to go? Calling the PMD was just a procedure to follow and any of them would have said to have the patient taken to the ER especially if it was 3 am. It sounds to me like this patient was made to suffer longer than was necessary and if he had n/v for 3 days could have been critically ill.

Yep, the truth is a resident of a LTC facility is not a prisoner and has rights. The right to call 911 is certainly one - family can also avail themselves of this if they wish.

I too wonder about n/v/d for 3 days - could very well have been critically ill.

How is he?

steph

heartofgold · Apr 12, 2007

Thanks for all the feed back. Sorry I left out a couple of things in the begining. Yes, I do work in LTC. Yes, this Pt. is totally with it x3. And definetly has every right to call 911. Apparently "I" was the only nurse to assess this Pt.'s complaint and document on it. None of the other nurses had done anything to correct the sittuation, only document on the back of the MAR that prn Imodium was given. Yesterday the DON told me that the Pt. is okay, and nothing was found. She also told me that the family is upset because it took so long for something to get done about it, and the nurses that were caring for this Pt. has been written up for it. I know I am a new nurse, and don't really know the ropes -yet. but I am just discused with the way these nurses handled the situation, something should have been done MUCH sooner.