Scope of Practice

[mylove2five]

Hi everyone I'm new to the forums and had a question I hope it's in the right area. I worked for 3 years a LTC in Hobart Indiana and was terminated friday by the new adminstrator, first let me tell you I'm a very vocal and speak my mind all the time and this new admin didn't appreciate that so that was my first strike, anyhow the reason they used for termination was I was practicing out of my scope, here's the sitution I had a resident one night who appear to have stool coming from her vaginal opening, this res was non verbal and bed bound completly dependent and 92 years old, I assisted the cna in providing peri care and I inserted the fingertip of my index finger to remove the stool from her vaginal opening, it was hard to tell if the stool was just smeared there or if it was actually coming from her vaginal opening until I removed it. Well it was coming from her vaginal opening and there was a small amount of blood on the stool, I called the MD told him what I found and questioned him if it might have been a fistula, the MD visited the faciltiy every tuesday and made rounds and this was Tuesday morning at 4am the Md told me he would see the patient in the morning, I charted what I had done and what the md response was, this was on March 10th, mind you I was terminated March 24th with no previous warning, my ADON whom I spoke to daily, nor my DON spoke to me about this patient or that I was practicing out of my scope, I also know that indiana has no set scope of practice. Ok after all that does anyone know if I was wrong? Did I do something I shouldn't have done? I have filed for unemployment which of course in Indiana you have a weeks waiting peirod before you can actually file and to be honest I don't have a week to wait and will be actively looking for work tomorrow. Thanks for your input.

[busy-bee]

Did you chart that you did a vaginal exam? Did the CNA think you caused the bleeding and reported it? Exactly what did the DON say you did that was out of your scope?

[Ricu]

I'm not familiar with Indiana nursing laws but I doubt you did anything that might violate scope of practice. In fact, you did a lot to advocate for your patient. What likely got you into trouble was that "being very verbal" part. Had you given a simple explanation for your actions in a matter of fact fashion, you may not be in your current situation. This is all water over the dam now but learn from this experience. In the future, be very careful about how you deal with confrontation. Your superiors were likely just seeking information. If you feel they were trying to get rid of you, it may
have been because of other occurrances where you may have been perceived as unapproachable, difficult to work with, surly, and so on. You get the idea. Take this time to do a little self examination. Your nursing and documentation practice seem just fine. Good luck.

R

[cougarnurse]

I am sure you found a better place to work at. Yeesh!

It also takes a bit of moxey to be a patient advocate.

'Cat'