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Adherence to patient safety protocols and effective communication among healthcare professionals is paramount in nursing practice, ensuring optimal post-operative care and patient well-being. However, there are cases where critical information is not communicated in a timely manner, which could jeopardize the outcome of the patient. These incidents may give rise to questions as to the conduct and decision-making of registered nurses, which could affect their professional position and career. In order to deal with these complicated legislative matters as well as protect their rights. A nurse defense attorney is readily available to provide professional assistance, ensuring unprejudiced investigation and advocating for the best interests of registered nurses in all proceedings. 

Scenario: The RN was Disciplined for Failure to Notify the Physician of the Patient’s Condition

It was the 7th of January, 2021, the RN involved was employed at a hospital in Bryan, Texas, and had been in that position for four (4) years and three (3) months.

During the incident, the RN was on duty when she failed to notify the surgeon or anesthesiologist when a patient experienced hypotension with increased heart rate after his laparoscopic cholecystectomy, and instead sped up the patient’s existing IV fluid infusion without an order for a bolus. Additionally, the RN discharged the patient from the PACU without documenting the vital signs she took from 1720 to 1755 discharge as required. Subsequently, the patient was discharged from the hospital and then later presented to another facility in hypotensive shock and was found to have three liters of blood in his abdomen requiring surgical treatment and admission to the intensive care unit. The RN’s conduct could have injured the patient and deprived the physician of information needed to institute timely medical interventions to stabilize the patient’s condition.

In the RN’s defense, the RN stated that the patient’s presentation of hypotension, nausea, tachycardia, and diaphoresis is consistent with the clinical presentation of a vagal response, which is common after surgery. Moreover, she palpated the patient’s belly which she found to be soft and tender, with no signs of postoperative bleeding such as distention; he also had no other signs of bleeding such as bruising, abdominal pain, or increased capillary refill time. Meanwhile, the RN stated that she had sought a second opinion from the charge nurse, who agreed with her assessment and confirmed that she should administer a fluid bolus to relieve the patient’s symptoms, which is not uncommon practice in the PACU. Moving on, the patient’s blood pressure immediately recovered after the bolus, and the patient asked to go home. So she took him off the monitor and assisted him to the bathroom to get dressed at 1730 and then out to the parking lot to be driven home. Afterward, when she returned to the patient’s room, she realized that another nurse had come by and turned off the monitor the patient had been connected to, which erased all the patient’s vital signs since the last time she saved them at 1700. Since the RN could no longer access the patient’s vital signs, she charted that his systolic blood pressure was in the 120s, and his heart rate was in the 90s because she did not want to falsify his records by making up the numbers she could not exactly remember. The RN further stated that she had appropriately assessed the patient and determined that discharge criteria had been met per policy and physician orders. Finally, she added that the patient reported feeling fine and did not exhibit any symptoms of hypotensive or hemorrhagic shock, or any other issues that warranted calling a physician.

The above actions constitute grounds for disciplinary action in accordance with Section 301.452(b)(10)&(13) Texas Occupations Code and is a violation of 22 TEX ADMIN. CODE §217.11(1)(A),(1)(B),(1)(C),(1)(M),(1)(P)&(3)(A) and 22 TEX. ADMIN. CODE §217.12(1)(A),(1)(B)&(4).

Consequently, the RN lost the case without valid evidence to prove her side of the story. The failure to hire a Texas nurse attorney to help her with her case has led the Texas Board of Nursing to discipline the RN’s license.

Equip yourself with the knowledge and expertise for a successful outcome by consulting a knowledgeable and experienced Texas RN/LVN license attorney. Attorney Yong J. An is an experienced Texas nurse defense attorney for various licensing cases over the past 18 years and represented over 600 nurses before the Texas BON. The Law Office of Yong J. An is available 24/7 through text or call at (832) 428-5679.