I recently read a posting about a person who was admitted to the ED for c/o chest pain and SOB. This was a person with a hx of COPD and cardiac problems. Long story short, the progression through the ED was normal treatment and meds. However, the medications left the patient drowsy. The ED physician discharged the patient once the patient stated their chest pain was gone. However, the patient was so drowsy that he was "allowed" to stay in the ED until he was able to leave without being so drowsy. Now, all I have to go off of is what was posted but it was posted that this person was going to drive themselves home. Apparently a student nurse was assigned to watch the patient till they were able to leave.
This patient was later found on the bathroom floor and said they hadn't fallen but just wanted to lie down. The student nurse was the person who found the patient. The patient was placed in a wheelchair per their own request and the House Supervisor was notified. The patient was later found unresponsive, a code was called and the patient was later pronounced dead.
Now, I have several problems with this situation. First, why did the ED physician discharge the patient when they were so drowsy? If you are so drowsy that you are unable to walk and have no transportation home and have to stay in the department until you aren't so drowsy; then perhaps you aren't well enough to be discharged! Second, this student nurse was under a registered nurse and also an instructor. Where where they in the scheme of things? And, if the student was assigned to monitor the patient, where was the student nurse during the period where the patient was on the floor and then when at some point they coded? It sounds like this patient was put into a holding area and just left there.
I can see accountability of the physician, registered nurse, house supervisor, the student and of course the hospital and if the physician was part of a group vs a hospital employee, that group as well. Oh, and let's not forget the university that the student is attending would also be held accountable.
I cannot help but feel very sorry for this student nurse. When you are a student there are a lot of situations that you can be placed in but to have a patient you're assigned to monitor die must be horrible. I would doubt that the student would be called into a lawsuit as they generally have no money to pull from. As a registered nurse, the assigning nurse and instructor I feel hold a high level of responsibility for this issue as either they were overloading the student with patient assignments or the student just wasn't doing their job. Either way it is up to the assigning nurse and instructor to monitor that student and be a patient advocate. We also hold the responsibility as registered nurses to instruct our students in a manner that they will provide good and safe care. After this situation, where does this student stand? I would be feeling pretty bad as a student and there is the chance that the student would quit nursing school due to the severity of the situation.
Let's make sure that as seasoned registered nurses that we are training our students correctly and supporting them. This will give us better trained nurses and of course safer patients. We also need to instruct the students that they do have a voice and if they are over loaded it is their responsibility to speak out.
I wish I could know the outcome of this situation but I'm sure I won't hear what it is. But I do think we can all learn several things from it.