Wednesday, May 23, 2012

Judge: PBSO deputies violated nurses’ rights by demanding blood tests in suspected DUI cases, By Jane Musgrave, May 20, 2012 #nurseup

NurseFriendly posted an update 7 seconds ago

Judge: PBSO deputies violated nurses’ rights by demanding blood tests in suspected DUI cases, By Jane Musgrave, May 20, 2012:”Palm Beach County sheriff’s deputies have been violating the constitutional rights of nurses by threatening them with arrest if the hospital workers didn’t draw blood from suspected drunken drivers, a federal magistrate has ruled.

In a case involving a nurse at the Veterans Affairs Medical Center in Riviera Beach, Magistrate James Hopkins said Sheriff Ric Bradshaw and any ”officer of reasonable competence” should have realized they can’t put a medical professional in handcuffs for refusing to conduct a blood test.

”The Sheriff’s Department knew or should have known implementation of the policy would inevitably lead to violations of the Fourth Amendment for false arrest,” Hopkins wrote in a 27-page opinion this month.

The ruling stemmed from a lawsuit VA nurse Marjorie DePalis­-Lachaud filed last spring against the agency, two years after she was put in handcuffs and forced to sit in a patrol car after she explained to deputy Kenneth Noel that hospital policy prevented her from drawing blood without a doctor’s order.

http://www.palmbeachpost.com/news/judge-pbso-deputies-violated-nurses-rights-by-demanding-2366534.html

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Kindly sign our petitions:

Petition: Amanda Trujillo, RN & Banner Del E. Webb Medical Center, Sun City, Arizona: Position Statements Requested

http://www.change.org/​petitions/​nurseup-com-issue-position-stat​ements-on-the-amanda-trujillo-​rn

Petition: Arizona State Board of Nursing: Remove Amanda Trujillo’s nursing license from ”under investigation” status | Change.org

http://www.change.org/ ​petitions/​arizona-state-board-of-nursing-​ remove-amanda-trujillo-s-nursi​ng-license-from-under-investig​ ation-status

Contribute to Amanda’s Legal Defense Fund:

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Nurseup.com, A Nursing Advocacy Organization
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West Deptford, New Jersey 08051
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Tuesday, May 22, 2012

Nursing Home Rehabilitation Stay Proves Terminal. Was Quality of Care Given An Issue? #nursefriendly #nursecasestudy #nurseup

Nursing Home Rehabilitation Stay Proves Terminal.
Was Quality of Care Given An Issue?
Lloyd v. County of Du Page, 707 NE.2d 1252 - IL (1999)

Original url: http://www.nursefriendly.com/nursing/clinical.cases/071199.htm

See also: Medical, Legal Nurse Consultants, Clinical Nursing Case of the Week, Clinical Charting and Documentation, Nurses Notes, Courtrooms, Disability, Discrimination, Employment, Expert Witnesses, Informed Consent, Medical Malpractice, Nursing Practice Acts, Pensions, Search Engines, Torts and Personal Injury, Unemployment, Workers Compensation, Workplace Safety:

Each week a case will be reviewed and supplemented with clinical and legal resources from the web. Attorneys, Legal Nurse Consultants and nursing professionals are welcome to submit relevant articles. Please contact us if you'd like to reproduce our material.

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Summary: Nursing homes are frequently a patient's destination for
rehabilitation following surgery.  Common conditions fitting
this bill include large bone fractures, hip replacements and stroke.
Following these acute episodes, the patients are too unstable to
go home and not "sick" enough to have their hospital stays
reimbursed by insurance companies.  The purpose of admission
to a nursing home is to help the patient regain lost function,
strength and health.  In this case, the patient would remain in the
Nursing Home till her death of complications.

The patient was admitted to a state owned nursing home
following repair of a femoral fracture.  Her treatment plan
emphasized Physical, Occupational therapy and Nursing care
to provide for rehabilitation.

She had successfully undergone surgery to repair a fractured
femur.  The length of stay projected was six weeks.  During
this time, the patient's condition would worsen rather than
improve.

This is not an isolated incident.  Media attention is continuously
focusing on conditions in nursing homes.

"A TIME investigation has found that senior citizens in nursing
homes are at far greater risk of death from neglect than their
loved ones imagine. Owing to the work of lawyers, investigators
and politicians who have begun examining the causes of
thousands of nursing-home deaths across the U.S., the grim
details are emerging of an extensive, blood-chilling and for-profit
pattern of neglect."2

The patient's skin was intact and she was continent on admission.
She would develop multiple pressure ulcers on her bony
prominences.  These are frequently the consequence of inadequate
turning and poor nutrition.  Monitoring of both of these factors
are direct responsibilities of nurses and nursing home personnel.
If either is inadequate, a duty is owed to the patient by the nurse
to inform the physician.  The physician, once made aware, is
then charged with taking additional measures as needed.

The patient would have a Foley catheter inserted supposedly
for urinary incontinence.  Documentation would later show
that need for catheterization had not been established.

The patient had been fully continent on admission.  Her
rehabilitation plan called for her to ambulate to the bathroom
when needed.  An assessment of her ability to go on her own
was nowhere to be found at the time of her Foley catheter
insertion.  Development of a urinary tract infection is a known
complication of catheter use.  The patient would develop a
UTI soon after.

"In the last year, complaints against nursing homes in Texas
are up over 60%. Medication errors, under-staffing, unsanitary
conditions, neglect, lack of care, substandard care and injuries
from dangerous products, are but a few of the dangers. The
administrators of these facilities contend that the level of care
is excellent in Texas nursing homes but, state investigators and
Texas juries have been sending a different message."3

On the initial trial, the court dismissed the claims.  They based
this on the fact that the nursing home personnel were "state"
employees and supposedly immune from liability.

The patient's family appealed.

Questions to be answered:

1. Could the nursing home personnel in a public facility be
held liable for negligence in the care of the patient?
Specifically, could they be sued for not maintaining the
standards of care required by the state?

2. Were the "incidents" leading up to the patient's deterioration
reasonably "foreseeable" by a prudent caregiver in a
similar situation?

On appeal, the plaintiff presented multiple pieces of evidence
documenting neglectful incidents.

This documentation included fractures during transfers (one
requiring re-hospitalization and extensive surgical repair),
the development of skin breakdown, the development of
infections of the respiratory, urinary and gastrointestinal tract.

Each of these events suggested that care for the patient could
be falling below accepted standards.  Each of these events
could be identified as necessitating further therapy and
increasing the patient's length of stay.

In reviewing the Tort Immunity Acts of Illinois, it was
determined that liability could be assessed for acts of
negligence or omission in the patient's care.

It was clear from physical, mental and health status changes
that the patient was deteriorating.  These changes, specifically
the multiple injuries during transfers, development of skin
breakdown and infection could be traced to negligence in the
omission of required care.  Any time the treatments prescribed
by the physician are not carried out, or if it is not documented
that they have been carried out, the possibility of omission and
negligence is raised.

It is highly unlikely that if the treatments and care prescribed
had been given that the gross deterioration would have occurred.
In this case, documentation of care was not present.  Documentation
of "likely results of neglect" was present.

This underscores the necessity of properly documenting the care
you give.   Many facilities are adopting "charting by exception"
policies.  These are dangerous in that they may not account for
basic care given.  In saving time and nursing costs for a facility,
not fully charting care given can raise the question of a nurse's
omission and negligence later in court.

If the temptation to chart care that is not given is present, keep
this in mind.

If time for giving proper treatments and care is not there,
falsifying records is patently illegal.  It is an offense that
could cost you your license if reported to the State Board.

In the case of a lawsuit, it is much cheaper for a facility to
scapegoat a nurse, than defend one.  If reporting you to the
State Nursing Board, or threatening to will give their attorney's
a bargaining chip to keep an employee "quiet," about existing
conditions they'll use it.

"Generally, the nursing-home industry likes to settle lawsuits
quietly and often hands over money only in exchange for
silence."2

A nurse must decide if saving facility money by spending
less time charting or on patient care is worth possible liability
or loss of licensure down the road.  It is highly unlikely that
a nursing home or hospital will defend a nurse named in a
lawsuit.  This chiefly will happen only when the facility's
assets are at stake.

If conditions in a nursing home are visibly substandard, a
nurse must ask if it is wise to continue working in the facility.
Ask yourself.  Is the administration receptive to suggestions
for improvement?  Do they raise concerns over overtime and
time involved to complete care and charting?

As media attention and lawsuits increase, more nurses will
find themselves involved in legal actions.  If it's determined
that poor conditions existed yet nothing was done about
them, the cost in liability could be high.

"Palo Alto attorney Von Packard has studied the death
certificates of all Californians who died in nursing homes
from 1986 through 1993. More than 7% of them succumbed,
at least in part, to utter neglect--lack of food or water,
untreated bedsores or other generally preventable ailments.
If the rest of America's 1.6 million nursing-home residents
are dying of questionable causes at the same rate as in
California, it means that every year about 35,000 Americans
are dying prematurely, or in unnecessary pain, or both."2

Many states have "elder abuse" legislation mandating abuse
be reported.  Whistle blower legislation is slow in coming.
Currently the employer's interests are put first rather than the
patient's or employees in most cases.  Protections for nurses
that do report abuse are questionable in their effectiveness.
The risk of employer retaliation is high.

The chances of a nursing home or hospital defending you
against the State Board of Nursing when your license is
at stake over an incident are almost none.  In fact, it is
common for complaints to be filed by the facility where
a nurse has worked.

Unless you have a personal malpractice insurance policy,
you will be forced to pay for this representation out of pocket.
For less than the cost of a typical day's pay (around $70-$90
per year), most personal policies will provide representation at
no additional cost to you.

Related link Sections:

Direct Patient Care Links on: The Nurse Friendly
http://www.nursefriendly.com/nursing/linksections/directpatientcarelinks.htm

Ethics:
http://www.nursefriendly.com/nursing/directpatientcare/ethics.htm

Foley Catheterization:
http://www.nursefriendly.com/nursing/directpatientcare/foley.catheterization.htm

Informed Consent:
http://www.legalnursingconsultant.org/legal.nurse.consultants.lnc/informed.consent.medical.legal.htm

Mechanical & Physical Restraints:
http://www.nursefriendly.com/nursing/directpatientcare/mechanical.physical.restraints.htm

Medical Legal Consulting Nurse Entrepreneurs:
http://www.nursefriendly.com/nursing/ymedlegal.htm

Operating Room (Surgical) Links on: The Nurse Friendly
http://www.nursefriendly.com/nursing/directory/spec/operatingroom.htm

Nursing Homes, Long Term Care Links:
http://www.nursefriendly.com/nursing/nursing.homes.long.term.care.htm

Wound Care:
http://www.nursefriendly.com/nursing/directory/business/woundcar.htm

Sources:

1. 39 RRNL 12 (May 1999)

2. Time Magazine.  October 27, 1997. Fatal Neglect. Retrieved July 11, 1999 from the World Wide Web: http://cgi.pathfinder.com/time/magazine/1997/dom/971027/nation.fatal_neglect....

3. Law Offices of James K. Burnett, P.C. 1999.  Nursing Home Negligence. Retrieved July 11, 1999 from the World Wide Web: http://www.nursinghomenegligence.com/
 

The Uniform Resource Locator (URL) or Internet Street Address of this page is
http://www.nursefriendly.com/nursing/clinical.cases/071199.htm
Send comments and mail to Andrew Lopez, RN

Created on July 11, 1999

Last updated by Andrew Lopez, RN on Wednesday, December 28, 2011


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For more information on Nursing & Patient Advocacy, Entrepreneurship: http://www.nurseup.com/

Kindly sign our petitions:

Petition: Amanda Trujillo, RN & Banner Del E. Webb Medical Center, Sun City, Arizona: Position Statements Requested

http://www.change.org/​petitions/​nurseup-com-issue-position-stat​ements-on-the-amanda-trujillo-​rn

Petition: Arizona State Board of Nursing: Remove Amanda Trujillo’s nursing license from ”under investigation” status | Change.org

http://www.change.org/ ​petitions/​arizona-state-board-of-nursing-​ remove-amanda-trujillo-s-nursi​ng-license-from-under-investig​ ation-status

Contribute to Amanda’s Legal Defense Fund:

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Andrew Lopez, RN
Nurseup.com, A Nursing Advocacy Organization
38 Tattersall Drive
West Deptford, New Jersey 08051
856-415-9617, Fax: 856-415-9618, info@nursefriendly.com, @nursefriendly

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Nursing CEOs, Chief Executive Officers, @hospiceheroes @pedagogymedical @swaddledesigns #nursefriendly

NurseFriendly posted an update right now

Nursing CEOs, Chief Executive Officers, @hospiceheroes @pedagogymedical @swaddledesigns #nursefriendly

http://www.nursingentrepreneurs.com/nursing.ceos.chief.executive.officers.htm

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For more information on Nursing & Patient Advocacy, Entrepreneurship: http://www.nurseup.com/

Kindly sign our petitions:

Petition: Amanda Trujillo, RN & Banner Del E. Webb Medical Center, Sun City, Arizona: Position Statements Requested

http://www.change.org/​petitions/​nurseup-com-issue-position-stat​ements-on-the-amanda-trujillo-​rn

Petition: Arizona State Board of Nursing: Remove Amanda Trujillo’s nursing license from ”under investigation” status | Change.org

http://www.change.org/ ​petitions/​arizona-state-board-of-nursing-​ remove-amanda-trujillo-s-nursi​ng-license-from-under-investig​ ation-status

Contribute to Amanda’s Legal Defense Fund:

http://apps.facebook.com/fundrazr/activity/99fa97b4502c40939c18ae0da407793c?type=endorsement

Andrew Lopez, RN
Nurseup.com, A Nursing Advocacy Organization
38 Tattersall Drive
West Deptford, New Jersey 08051
856-415-9617, Fax: 856-415-9618, info@nursefriendly.com, @nursefriendly

Facebook: https://www.facebook.com/​groups/nurseup/ (Most Active)

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Nursing Blogs #Nurse #Bloggers @ShahinaLakhani @hospiceheroes @sablefoods @nursekeith #Nursefriendly #Nursing

NurseFriendly posted an update 1 second ago

Nursing Blogs #Nurse #Bloggers @ShahinaLakhani @hospiceheroes @sablefoods @nursekeith #Nursefriendly #Nursing

http://www.nursefriendly.com/nursing/nursing.blogs.htm

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For more information on Nursing & Patient Advocacy, Entrepreneurship: http://www.nurseup.com/

Kindly sign our petitions:

Petition: Amanda Trujillo, RN & Banner Del E. Webb Medical Center, Sun City, Arizona: Position Statements Requested

http://www.change.org/​petitions/​nurseup-com-issue-position-stat​ements-on-the-amanda-trujillo-​rn

Petition: Arizona State Board of Nursing: Remove Amanda Trujillo’s nursing license from ”under investigation” status | Change.org

http://www.change.org/ ​petitions/​arizona-state-board-of-nursing-​ remove-amanda-trujillo-s-nursi​ng-license-from-under-investig​ ation-status

Contribute to Amanda’s Legal Defense Fund:

http://apps.facebook.com/fundrazr/activity/99fa97b4502c40939c18ae0da407793c?type=endorsement

Andrew Lopez, RN
Nurseup.com, A Nursing Advocacy Organization
38 Tattersall Drive
West Deptford, New Jersey 08051
856-415-9617, Fax: 856-415-9618, info@nursefriendly.com, @nursefriendly

Facebook: https://www.facebook.com/​groups/nurseup/ (Most Active)

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Twitter: http://www.symplur.com/​healthcare-hashtags/nurseup/

Nursing Authors on Twitter, @avoidmederrors @patiyer @theresabrown @theyoganurse @hopefulhealer @cgino8 #nursefriendly

NurseFriendly posted an update right now

Nursing Authors on Twitter, @avoidmederrors @patiyer @theresabrown @theyoganurse @hopefulhealer @cgino8 #nursefriendly

http://nurseup.com/wordpress/2012/04/nursing-authors-published-nurses-on-twitter-avoidmederrors-patiyer-theresabrown-theyoganurse-hopefulhealer-cgino8-nursefriendly-nurseup/

******************************​************************

For more information on Nursing & Patient Advocacy, Entrepreneurship: http://www.nurseup.com/

Kindly sign our petitions:

Petition: Amanda Trujillo, RN & Banner Del E. Webb Medical Center, Sun City, Arizona: Position Statements Requested

http://www.change.org/​petitions/​nurseup-com-issue-position-stat​ements-on-the-amanda-trujillo-​rn

Petition: Arizona State Board of Nursing: Remove Amanda Trujillo’s nursing license from ”under investigation” status | Change.org

http://www.change.org/ ​petitions/​arizona-state-board-of-nursing-​ remove-amanda-trujillo-s-nursi​ng-license-from-under-investig​ ation-status

Contribute to Amanda’s Legal Defense Fund:

http://apps.facebook.com/fundrazr/activity/99fa97b4502c40939c18ae0da407793c?type=endorsement

Andrew Lopez, RN
Nurseup.com, A Nursing Advocacy Organization
38 Tattersall Drive
West Deptford, New Jersey 08051
856-415-9617, Fax: 856-415-9618, info@nursefriendly.com, @nursefriendly

Facebook: https://www.facebook.com/​groups/nurseup/ (Most Active)

LinkedIn: http://www.linkedin.com/​groups/​Nurseupcom-Nursing-Healthcare-A​dvocacy-4366517

Twitter: http://www.symplur.com/​healthcare-hashtags/nurseup/

Tell Your Surgical Providers About Your Medical Conditions, Pat Iyer, @avoidmederrors #nurseup #nursefriendly

 A Court ruling says patient should have revealed her medical conditions. The surgical team was held not liable for her death of a stroke after a hip replacement.

A 71-year-old woman who died after suffering a post-operative stroke neglected to inform caregivers about her chronic vascular disease before undergoing elective hip-replacement surgery at a Mississippi hospital. Because the hospital and surgical team were unaware of the increased risks before the procedure, a state court of appeals has cleared them of wrongdoing.

Jean Triplett, then 71, had her hip replaced at River Region Health System in Vicksburg on Jan. 6, 2004. The surgery was completed without incident, and Ms. Triplett appeared to be on the road to recovery the morning after, showing “no signs or symptoms of distress,” according to court records. Later that morning, however, Ms. Triplett’s speech became slurred and her left-side extremities weakened. She suffered a stroke, and passed away 2 years later on Oct. 25, 2006.

After Ms. Triplett’s death, a legal battle over the exact cause of the stroke ensued between her family and River Region. The family claimed the surgery was to blame, while the hospital contended it was “embolic in nature,” a result of Ms. Triplett’s many years of smoking and underlying right-side stenosis.

In 1997, doctors had diagnosed Ms. Triplett with bilateral carotid stenosis and recommended she undergo bilateral carotid endarterectomy, which she refused. Two years later, when her health worsened, the lifelong smoker agreed to undergo a right carotid endarterectomy, but declined the same procedure on the left side of her neck, despite multiple warnings from cardiovascular surgeons that failing to undergo the surgery would leave her at increased risk for stroke.

Then in 2003, when the pain in her hip became too much, Ms. Triplett decided to undergo surgery to replace the degenerative joint. Before the surgery, she neglected to tell orthopedic surgeon William Porter Jr., MD, that she suffered from a severely occluded (blocked) stenotic internal carotid artery. In addition, she did not inform family practitioner Lamar McMillin, MD, of the condition during her pre-op physical. On the day of surgery, she also failed to alert anesthesiologist John Adams, MD, and nurse anesthetist Patty Stone, CRNA, that she was at heightened risk for stroke, even after the two alerted her that death was a risk of anesthesia. Read more.

The serious nature of anesthesia must be explained to all patients. There are no minor anesthetics: each can cause injury. Medical crises and complications may occur during or after surgery, without any link to the surgery. Heart attacks, strokes, or blood clots that travel to the lung can occur coincidentally. if the surgical team- anesthesiologist and surgeon- are unaware of risk factors, they cannot take the steps needed to minimize the risks. In these crisis situations, where unknown factors are at play, the providers can only react to events, working to sustain the patient’s airway, breathing, and circulation.

Tell your surgical team about any medical conditions you know of. A medical clearance may detect previously known conditions. Your healthcare providers want you in tip top condition before you undergo surgery.

Reprinted by permission of  Pat Iyer, MSN, RN, LNCC & AvoidMedicalErrors.com

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Learn more!

Patricia Iyer MSN RN LNCC, Patricia Iyer Associates, Avoid Medical Errors, LLC and Med League Support Services, Inc.:”Patricia Iyer Associates provides legal nurse consultants with the critical information they need to succeed in their roles. Avoid Medical Errors teaches the public what they need to know to stay healthy and to be informed patients and not victims of medical errors. It provides a free magazine for the public, Avoid Medical Errors Magazine. Med League Support Services, Inc. assists attorneys with the medical issues of their cases. We specialize in medical malpractice and personal injury cases, and supply expert witnesses and medical analysis in the form of timelines, chronologies and medical summaries.”
260 Route 202-31, Suite 200
Flemington, NJ 08822
Phone number: 908-788-8227
E-mail Address: patriciaiyer@gmail.com

http://www.nursingentrepreneurs.com/iyer

Nursing Associations: Please Issue Position statements on the #AmandaTrujillo, RN #nurseup #nursefriendly

NurseFriendly posted an update right now

Nursing Associations: Please Issue Position statements on the Amanda Trujillo, RN:”We respectfully request that Nursing Associations Issue Position statements on the Amanda Trujillo, RN & Del E. Webb Medical Center, Sun City, Arizona situation.
Nurses who pay association dues every year. If you were in Amanda’s position, would your professional nursing association Support You?
For Amanda the answer from the American Nurses Association, Arizona Nurses Association was a resounding NO! Go get a lawyer they said.
When they fired Amanda Trujillo, RN and filed charges against her with the Arizona State Board of Nursing in retaliation for Patient Advocacy, they sent a chilling message to Patient & Healthcare Advocates everywhere. She was fired because she angered the wrong doctor, something that can happen to any nurse on a given day.”

http://www.change.org/petitions/nursing-associations-united-states-national-state-issue-position-statements-on-the-amanda-trujillo-rn

******************************​************************

For more information on Nursing & Patient Advocacy, Entrepreneurship: http://www.nurseup.com/

Kindly sign our petitions:

Petition: Amanda Trujillo, RN & Banner Del E. Webb Medical Center, Sun City, Arizona: Position Statements Requested

http://www.change.org/​petitions/​nurseup-com-issue-position-stat​ements-on-the-amanda-trujillo-​rn

Petition: Arizona State Board of Nursing: Remove Amanda Trujillo’s nursing license from ”under investigation” status | Change.org

http://www.change.org/ ​petitions/​arizona-state-board-of-nursing-​ remove-amanda-trujillo-s-nursi​ng-license-from-under-investig​ ation-status

Contribute to Amanda’s Legal Defense Fund:

http://apps.facebook.com/fundrazr/activity/99fa97b4502c40939c18ae0da407793c?type=endorsement

Andrew Lopez, RN
Nurseup.com, A Nursing Advocacy Organization
38 Tattersall Drive
West Deptford, New Jersey 08051
856-415-9617, Fax: 856-415-9618, info@nursefriendly.com, @nursefriendly

Facebook: https://www.facebook.com/​groups/nurseup/ (Most Active)

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Student claims school administrators made her bare her breasts, May 18, 2012 By Betsy Webster #nurseup

NurseFriendly posted an update 6 seconds ago

Student claims school administrators made her bare her breasts, May 18, 2012 By Betsy Webster:”The girl tried to escape and repeated that she would not consent to such a search. The school nurse, Ernestine Bowren, and Barteck then ”coerced” the student into lifting up her shirt and bra, according to court documents. The girl was forced to expose her breasts.
Again, no drugs or drug paraphernalia was found.
The girl was distraught.
”Within 20 minutes of the incident, and after (the girl) had returned to class, Ms. Barteck pulled her out of the classroom and threatened (the student) with suspension if she told anybody about the strip search,” according to court records.”

http://www.wect.com/story/18556248/student-claims-turner-administrators-made-her-bare-her-breasts

Shaking my head over this one. What was the administrator thinking, what was the nurse thinking? If you suspect drugs, you call the police and let them investigate.

******************************​************************

For more information on Nursing & Patient Advocacy, Entrepreneurship: http://www.nurseup.com/

Kindly sign our petitions:

Petition: Amanda Trujillo, RN & Banner Del E. Webb Medical Center, Sun City, Arizona: Position Statements Requested

http://www.change.org/​petitions/​nurseup-com-issue-position-stat​ements-on-the-amanda-trujillo-​rn

Petition: Arizona State Board of Nursing: Remove Amanda Trujillo’s nursing license from ”under investigation” status | Change.org

http://www.change.org/ ​petitions/​arizona-state-board-of-nursing-​ remove-amanda-trujillo-s-nursi​ng-license-from-under-investig​ ation-status

Contribute to Amanda’s Legal Defense Fund:

http://apps.facebook.com/fundrazr/activity/99fa97b4502c40939c18ae0da407793c?type=endorsement

Andrew Lopez, RN
Nurseup.com, A Nursing Advocacy Organization
38 Tattersall Drive
West Deptford, New Jersey 08051
856-415-9617, Fax: 856-415-9618, info@nursefriendly.com, @nursefriendly

Facebook: https://www.facebook.com/​groups/nurseup/ (Most Active)

LinkedIn: http://www.linkedin.com/​groups/​Nurseupcom-Nursing-Healthcare-A​dvocacy-4366517

Twitter: http://www.symplur.com/​healthcare-hashtags/nurseup/

Sunday, May 20, 2012

Nursing Assistants Leave Client Alone, Patient Receives Second Degree Burns During Bath. #nurseup #nursefriendly #healthcare

Nursing Assistants Leave Client Alone, Patient Receives Second Degree Burns During Bath.

Molden v. Miss. State Dept. of Health, 730 S.2d 29 -MS (1998)

Original article URL: http://www.nursefriendly.com/nursing/clinical.cases/092699.htm

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Summary: Registered and Licensed Practical Nurses frequently delegate responsibilities and tasks to Certified Nursing Assistants and Unlicensed Assistive Personnel. It is clearly recognized that they are responsible for the actions/inactions of those they supervise. In this case, two nursing assistants recognized injuries to a patient while giving a bath. When they failed to notify the nurse of the injuries, they would be reported and lose their certifications.


The patient was a long resident in a nursing home facility, admitted for long term care treatment. As part of her routine the resident on the day in question was to receive a whirlpool bath from a Certified Nursing Assistant. The patient was transported by an assistant to the bathing room. Once the patient was in the whirlpool the second assistant left. The two nursing assistants working under the "supervision" of an LPN.

"Licensed nurses (Registered Nurse/Practical Nurse) within the scope of their practice are responsible for all nursing care that a client receives under their direction. Assessment of the nursing needs of a client, the plan of nursing actions, implementation of the plan, and evaluation of the plan are essential components of nursing practice. Unlicensed personnel may be used to complement the licensed nurse in the performance of nursing functions, but such personnel cannot be used as a substitute for the licensed nurse."2

While preparing the bath, the nursing assistant "tested" the water with a double-gloved hand. Assuming it was the correct temperature the patient was placed in the bath. The CNA realized at that point that some supplies were missing that were needed to bathe the patient. The lone CNA stepped out of the room to obtain more supplies leaving the patient alone for several minutes.

During the bath the patient did not complain of pain or give any obvious signs of distress. The assistant continued with the bath. When the other assistant returned they took the patient out of the bath and prepared to take her back to her room. At that point the "transporting" nursing assistant noted that the patient's foot was "bleeding." It would turn out that patient's legs were in fact peeling from scalding second degree burned received during the bath.

Both of the CNAs noted and agreed that the patient had been burned. They also discussed that it should be reported to the nurses on duty. The nurse who had given the bath stated a report would be given to the nurse. This was never done.

The other CNA that transported the patient back to the room simply reported to the nurse that the "patient was ready" for the day's dressings/treatments.

When the nurse went in to do the treatments, she noted the patients scalded extremities and immediately reported both the aides. As a result the Department of Health (which issued certifications) was contacted and revoked the licenses of both CNAs.

Their conduct, it stated, was grossly negligent and resulted in serious injury to the patient.
The aides would appeal.

Questions to be answered:

1. Was the accepted standard of care expected of a Certified Nursing Assistant observed by the two persons in their handling of the patient?

2. Was the patient placed in unnecessary jeopardy from the time the injury was noted to the time the nurse discovered the incident.

3. Could the nurses on duty have also been held liable for the actions/inactions of the nursing assistants?
It could be reasonably expected that a nursing assistant would recognize obvious signs of injury such as "bleeding" and "peeling skin." In this case it was noted by the assistant when the patient was taken out of the bath.

The standards of practice would clearly dictate that "any change in condition" be reported to the nurse. In this case, an injury such as a burn where there was clear evidence of tissue damage was should have immediately been reported.

By not reporting the incident at all, the certified nursing assistants delayed treatment the patient's burned extremities. In a patient that already has skin damage, this inaction increased the risk of additional pain, tissue destruction and infection.

Had the incident been reported to the nurse on duty, the burns could have been assessed and treated promptly. Instead, the patient was allowed to "suffer" until discovered by the licensed practical nurse coming in to perform treatments.

The actions of the Certified Nursing Assistants put both the patient and the nurses supervising them in jeopardy.

It is ultimately the responsibility of the nurse, to monitor the safety of the patient. This includes when care is being given by a nursing assistant or other unlicensed assistive personnel under their supervision.
The family of the patient when/if initiating a lawsuit, would be well within their rights to ask:

1. Where was the nurse when the bath was being given.

2. Why wasn't the patient observed or checked on following the bath.

3. What training did the certified nursing assistants have?

It is the responsibility of the Nurse to be sure the assistants working with her patients are competent in their duties. When this is not the case, as soon as it comes to light, a duty is owed to the patient to correct the situation.

Even though the nursing assistants were working with the patient at the time, both they, the nursing staff and the facility could be held accountable to the patient's injuries.

Regardless of corrective actions that are taken, the nurse is still held responsible for any incidents that can occur.

Related Nursing Link Sections:

Care Givers, Nursing Homes & Long Term Care on: The Nurse Friendly http://www.nursefriendly.com/nursing/directpatientcare/care.givers.htm

Certified Nursing Assistants, CNA, Nursing & Healthcare Jobs on: The Nurse Friendly http://www.nursefriendly.com/nursing/jobs/certified.nursing.assistants.cnas.htm

Clinical Charting and Documentation, Nurses Notes: http://www.nursefriendly.com/nursing/directpatientcare/clinical.documentation.nurses.notes.htm

Courtroom Directory: http://www.legalnursingconsultant.org/legal.nurse.consultants.lnc/courtrooms.online.htm

Direct Patient Care Links on: The Nurse Friendly:
http://www.nursefriendly.com/nursing/linksections/directpatientcarelinks.htm

Ethics:
http://www.nursefriendly.com/nursing/directpatientcare/ethics.htm

Medical Legal Consulting Nurse Entrepreneurs:
http://www.nursefriendly.com/nursing/ymedlegal.htm

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July 11, 1999: Nursing Home Rehabilitation Stay Proves Terminal. Was Quality of Care Given An Issue? Nursing homes are frequently a patient's destination for rehabilitation following surgery. Common conditions fitting this bill include large bone fractures, hip replacements and stroke. Following these acute episodes, the patients are too unstable to go home and not "sick" enough to have their hospital stays reimbursed by insurance companies. The purpose of admission to a nursing home is to help the patient regain lost function, strength and health. In this case, the patient would remain in the Nursing Home till her death of complications. Lloyd v. County of Du Page, 707 NE.2d 1252 - IL (1999) http://www.nursefriendly.com/nursing/clinical.cases/071199.htm


June 27, 1999: Elderly Patient Repeatedly Injured In Nursing Home "Accidents." Negligence, Coincidence or Abuse? As the elderly population continues to increase, more and more families are faced with the decision to place loved ones in nursing homes. When a family member is placed in a facility, a certain standard of care is expected. In this case, a resident was injured repeatedly while under their care. When the patient died a few days after being "dropped" the family sued. Brickey v. Concerned Care of Midwest Ince. 988 S.W. 2d 592 MO (1999) http://www.nursefriendly.com/nursing/clinical.cases/062799.htm


Sources:


1. 40 RRNL 2 (July 1999)
2. Oklahoma Board of Nursing Guidelines. 1993. "Delegation of Nursing Functions to Unlicensed Persons." Retrieved September 26, 1999 from the World Wide Web:

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Created on September 20, 1999

Last updated by Andrew Lopez, RN on Wednesday, December 28, 2011

 

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