working with an incompetent nurse.. need advice!

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I am a Certified Nursing Assistant and am having a serious moral dillema over a nurse I work with. I am conflicted on whether or not to report or...or who to report her to. A few months back one of the aides told me that one of the residents blood sugar completely bottomed out like he was unconsious and when she went to get this certain "nurse" all she did was give her a cup of orange juice and told her to make him drink this and she would be right back. Luckily this aide was going through nursing school and knew what to do to make his blood sugar go back up. The nurse didn't return to even check on the resident until many minutes later. Then recently two other aides had a more traumatic expirience. We had a resident who was in his 40's with congestive heart failure he was limited to 1200 cc or whatever of fluid per day and was also a bad diabetic. well his blood sugar fell into the 40's and he was coming in and out of consiousness. the certain nurse in question told the aides to make him drink glass after glass of orange juice, cranberry juice, and apple juice to try and bring his blood sugar back up. Doing what they were told the aides made him drink many large cups of these juices. This is all while the nurse told them to sit with this man until he got better. She also made them spoon feed him large amounts of apple sauce to try and get his sugar back up. This man is a full code and one of the aides told the nurse why don't we send him out and the nurse simply replied he will be fine, and she also said We will just wait till the next shift nurse comes to deal with it!!! Then this man started vommitting stuff that looked like coffee grounds and started having horrible diarreha. The nurse thought nothing of it and said next shift could deal with it. Right when the next shift nurse got there this man died even after CPR. I was not there but I can't help but feel this is a truly wrongful death. I don't know what to do.. I feel like I need to just quit my job if I have to work with this nurse who I believe knows not what she is doing!!! Please.. from everything I told you does this sound wrongful.. couldn't making a man with CHF chug many glasses of fluids be bad? I mean I am not a nurse but I think something she did contributed to his death.. I know he was in poor health, but I think incompetance played a huge role.. This is bugging me to a point of were I can't stop thinking about it.. This man was young.. Please give me much needed advice.. Thank You

Specializes in Case mgmt., rehab, (CRRN), LTC & psych.

In addition to what the other posters have said, be aware that observers tend to embellish or exaggerate details when the subject of the story is an individual whom they personally dislike.

In other words, some of the CNAs may not be too fond of the nurse in question, so their negatively slanted perceptions of her might color their views regarding the instances of allegedly incompetent practice.

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As others have said, I wouldn't report anything that I didn't witness.

I would also be concerned with your ability to back up your facts and separate them from emotionally charged hearsay when you make statements such as "Luckily this aide was going through nursing school and knew what to do to make his blood sugar go back up. The nurse didn't return to even check on the resident until many minutes later." This would make me question what exactly the aide did that the nurse should have done. Did she not follow hypoglycemic protocol? How do we know that what the aide/student did showed better judgement? How many minutes before the nurse returned - 5, 15, 45? Was it because she felt the pt was stable enough with the aide until it was time to re-check the blood sugar?

Also, people can lose sight of time and objectivity during a stressful situation, and the way they phrase things as a vent to a co-worker may be different from how they would present a factual, well-thought out account of the event.

There seem to be too many gray areas here, and you would likely do better to stay out of situations you were not directly involved in.

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Specializes in ICU, ER, EP,.

please only report what you actually see. I have seen many assistants try to take a nurse down but only have personal differences or work issues that drive them to this. While I would never suggest this was your incentive, please be wary of others who want to get you on board.

nUrses that work in a position to delegate, are commonly accused of false accusations by very well meaning assistants that just want the best care for the patients they care for. Not everyone understands the indepth training that nurses incur or their understanding to the specific situation at hand.

While I never diminish a concerned aid, I know that there are three aides second guessing the nurses decision and talking behind their back.

keep it in stride, and report what you see, and never be afraid to do so. We all make bad judgements, hopefully we make the best ones as a team.

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Specializes in LTC.

She ( the original writer ) said that the nurse in the first instance told the CNA to give an UNCONCIOUS pt a glass of orange juice. Flags don't get any redder than that. Something is clearly off here.

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Okay...I kinda beleive the OP. First off, I do work in LTC, so I know what can go on and sometimes does. I've seen or heard of many a nurse like this. Often times they are working an 11-7 shift because it is slower paced.

Now...since it is second hand and she didn't see it first hand...She needs to try to get the ones who did see it to report it.

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Specializes in Emergency Department.

It is permissible to have a conscious hypoglycemic patient orally ingest a high glucose drink or paste as a conservative measure to elevate her glucose level.

However, you can never administer an oral drink to an unconscious patient, and we all know why.

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one of the residents blood sugar completely bottomed out like he was unconsious and when she went to get this certain "nurse" all she did was give her a cup of orange juice and told her to make him drink this and she would be right back. Luckily this aide was going through nursing school and knew what to do to make his blood sugar go back up.

Sorry, but I don't know what the aide could have possibly done--legally--within her scope of practice to make that blood sugar go up besides give OJ or feed him. I highly doubt she started a line, gave D50 or anything like that. And if she did, then her butt is in a sling.

I am also on the fence about the unconscious part, mostly because how it is written "completely bottomed out like he was unconscious". Was he really? Or was the story embellished by the other aide to add severity to the situation when she told the story?

I am not trying to be mean, but I hate to see someone picked apart when things just don't add up. And there's more than one line in the post that doesn't add up.

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Specializes in Case mgmt., rehab, (CRRN), LTC & psych.
Sorry, but I don't know what the aide could have possibly done--legally--within her scope of practice to make that blood sugar go up besides give OJ or feed him. I highly doubt she started a line, gave D50 or anything like that. And if she did, then her butt is in a sling.
Instead of delegating the care of a possibly hypoglycemic resident to a CNA or other unlicensed assistive person, the nurse could have briefly assumed the care to ensure that the patient was okay.

When I have a hypoglycemic resident in the nursing home where I am employed, I will administer 8 ounces of juice orally if they are awake and conscious, and recheck the FSBS in 15 minutes and 60 minutes to be assured that the glucose level is rising. If the resident is unconscious, I'll give an injection of Glucagon IM or SC per MD order and recheck the FSBS per protocol. If the resident does not regain consciousness after a prescribed amount of time, I will call the physician to obtain a telephone order for transport to a local ED.

Again, I'll emphasize that none of us know all of the details of the story that has been presented, so I will not pass judgment on any individual.

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Do you personally hold a grudge against this particular nurse? Just make sure that you want to report her because you know in your heart that she did something wrong and that you are concerned about the patients and not because you have something against her in general. If something truly bothers you, go to your boss directly and report what you actually witnessed.

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Specializes in medical.

The whole story you described sounds very fishy. I think you want to report the nurse badly, but don't know how to do it. Just stay away from it- you didn't witness the event and you are not a nurse, therefore you don't have sufficient knowledge to judge what the nurse did wrong.

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