Kidney Dialysis: Nurse Should Have Connected Cardiac Patient To Heart Monitor, Court Rules
Legal Eagle Eye Newsletter for the Nursing Profession
February 1997
Quick Summary: During dialysis a nurse must closely monitor the patient’s vital signs. Taking vitals every twenty minutes is not often enough.
The patient came to dialysis from the cardiac telemetry unit. His full chart came with him. Someone had disconnected his heart monitor. The dialysis nurse should have known he was supposed to be on a monitor and reconnected him to one before dialysis began. SUPERIOR COURT OF NEW JERSEY, 1996.
There apparently was a territorial dispute going on between the cardiologist and the nephrologist over issues concerning this patient’s care, before he had a heart attack and died during dialysis, which turned into a finger-pointing contest after the family filed a medical malpractice/wrongful death lawsuit in court.
The Superior Court of New Jersey laid part of the blame on the patient’s dialysis nurses and their employer the hospital. For any cardiac telemetry patient, a nurse is required to appreciate that it takes a doctor’s order to discontinue the heart monitor, and if the patient is found not on a monitor the nurse must put the patient back on a monitor.
This is especially true before starting dialysis, but applies to nursing and other patient-care personnel anywhere in the hospital, according to the court.
A dialysis nurse must appreciate the importance of closely monitoring a patient’s vital signs during dialysis. A dialysis nurse must look at the patient’s whole chart for the bigger picture, not just carry out the kidney specialist’s specific dialysis orders. While implying it was a good idea, the court did not go so far as to rule it a nurse’s absolute legal duty to put a patient who does not have a heart monitor on a monitor for dialysis.
Vital signs must be monitored closely during dialysis, the court said. Every twenty minutes, however, with a patient not on a heart monitor, is not often enough. Any irregularity in a dialysis patient’s heartbeat must be reported to a physician immediately. Weiss vs. Goldfarb, 684 A. 2d 994 (N.J. Super., 1996).
More from nursinglaw.com
http://www.nursinglaw.com/dialysis.htm
http://www.nursinglaw.com/EMTALA-dialysis.htm