Question

A nurse was sued for failure to take appropriate nursing action when she improperly administered a tube feeding. Toward the end of the shift, the nurse remembered that she had to give a client a tube feeding. In a hurry to get home, she did not check the position of the tube before administering the feeding. She poured the feeding rapidly into the nasogastric feeding tube and continued to do so even though the feeding fluid was coming out of the client’s nose and mouth, and he was gagging and in respiratory distress. Despite the client’s distress, the nurse left the room and went home. An orderly came into the room after report and sought assistance for the client, who was now unresponsive. The client died a short time later.
For your post, describe what actions by this nurse were inappropriate, and what you would do differently.  Be specific, and explain your rationale for your alternate actions.

Answer 1

Inappropriate actions by the Nurse :

1. Nurse through out her shift did not remember administering tube feeding , this indicates recklessness of her duty.

2. Not checking the tube placement before administering the feeding, it's her initial responsibility to check the tube.

3. Hurry to go Home , she is very hurry to go Home with out fulfilling her responsibility.

4. Pouring the fluid rapidly in to the tube, this should be administered slowly.

5.Even though the client is gagging before her in respiratory distress she left the client and went home which is unfair and should be taken into legal consideration.

What you would do differently?

1. I would not have forgotten to tube feed the client.

Rationale:

Because it's my duty and responsibility. If really there is a chance of missing it, I would maintain a check list for the things that to be completed.

2. If I am in such a hurry or in an emergency I would have handed over this responsibility to the shift Nurse.

Rationale : As I am at the end of my shift, there may be chance of missing some things which leads to emergency situations. So instead of making things so complicated and worse it's best to hand over to the shift Nurse.

3. Even though if it is my end of the shift, I would have extended my duty.

Rationale : Even though my shift was completed atleast if If I can extend my timings in taking care of the client slowly until the next shift Nurse arrives I can hand over to her and there would not be any risk to the client health condition.

4. Though I am at the end of the shift I would have checked the placement of the tube or if I would have given the feeding slowly.

Rationale : We are the ultimate responsibility for every action and we are not dealing with the client but their lives.So it's my responsibility to check the placement of the tube, if not atleast I would feed the client slowly so that I would know the displacement if the tube initially before it goes worse.

5. After knowing that the client is gagging I would not ran away from the situation.

Rationale : When the client is gagging and the fluid is coming out the condition it self shows me that the client is in danger. So Leaving client in such situation is not ethical to me and immediate emergency treatment must be done.