I have been placed on "Investigational Leave" from my job for being a patient and staff advocate. Please read and feel free to give advice/input.
While checking in on a pt., on the unit which I am one of the asst. mngr/pt. care coordinators, I hear the nurses talking about a pt. who is on Isoniazid(INH) for her recent (3months ago) (+)TB test, and CXR which was "questionable." This patient was admitted with Shortness of breath, and informed the nurse that she'd been on INH for TB, and that she'd also been having a productive cough, mostly yellow for 2wks, as well as night sweats and chills. After gathering this data, the nurse called the house officer, who initially ordered the patient to be placed on isolation, but when she asked him if he'd rather the patient go to the telemetry floor or critical care, because our unit does not have a negative pressure isolation room, he stated to her "Then she does not need isolation."
I was working on the other end of the unit, which expands when the hospital is overcapacity, and had previously assisted with two other patients on the unit, which I was coming to check up on when I heard this. After gathering some data, including that the patient has a questionable lung mass, has been "coughing her head off," has had chills and nightsweats with a productive cough for about 2wks." I called our Director of Infection Control, (unbeknownst to me, and my clinical educators, removed), who readily returned the call and was given the information I had at hand, and he quickly said absolutely this patient needs to be in isolation ASAP. So being a patient advocate, and staff advocate, I call the nursing supervisor, and house officer informing them of this decision, as no one in the hospital could seem to make an educated guess at whether the pt. did or did not need isolation. After my shift, my director of my department reams me, and tells me that this is going to get me in big trouble, because I consulted another doctor without an order. When I tell her that it was my understanding that Dr. X was our director of infection control, she informs me that he IS NOT, and hasn't been for about a year. She tells me I've overstepped my bounds, and she will have to do some investigating of this incident.
The BIG QUESTION???? Did I overstep my bounds, ensuring that this patient with some obvious possible signs of infectious TB was placed on isolation in efforts to protect the staff and other patients??? Note this patient was in a room with a roommate, and did cough numerous times during the 10-15 minutes I spent in the room with she and her daughter explaining everything to them, during which time she DID have a surgical mask(which I placed on her as I entered the room and verified who she was) on, in efforts to prevent any possible further exposure.
While checking in on a pt., on the unit which I am one of the asst. mngr/pt. care coordinators, I hear the nurses talking about a pt. who is on Isoniazid(INH) for her recent (3months ago) (+)TB test, and CXR which was "questionable." This patient was admitted with Shortness of breath, and informed the nurse that she'd been on INH for TB, and that she'd also been having a productive cough, mostly yellow for 2wks, as well as night sweats and chills. After gathering this data, the nurse called the house officer, who initially ordered the patient to be placed on isolation, but when she asked him if he'd rather the patient go to the telemetry floor or critical care, because our unit does not have a negative pressure isolation room, he stated to her "Then she does not need isolation."
I was working on the other end of the unit, which expands when the hospital is overcapacity, and had previously assisted with two other patients on the unit, which I was coming to check up on when I heard this. After gathering some data, including that the patient has a questionable lung mass, has been "coughing her head off," has had chills and nightsweats with a productive cough for about 2wks." I called our Director of Infection Control, (unbeknownst to me, and my clinical educators, removed), who readily returned the call and was given the information I had at hand, and he quickly said absolutely this patient needs to be in isolation ASAP. So being a patient advocate, and staff advocate, I call the nursing supervisor, and house officer informing them of this decision, as no one in the hospital could seem to make an educated guess at whether the pt. did or did not need isolation. After my shift, my director of my department reams me, and tells me that this is going to get me in big trouble, because I consulted another doctor without an order. When I tell her that it was my understanding that Dr. X was our director of infection control, she informs me that he IS NOT, and hasn't been for about a year. She tells me I've overstepped my bounds, and she will have to do some investigating of this incident.
The BIG QUESTION???? Did I overstep my bounds, ensuring that this patient with some obvious possible signs of infectious TB was placed on isolation in efforts to protect the staff and other patients??? Note this patient was in a room with a roommate, and did cough numerous times during the 10-15 minutes I spent in the room with she and her daughter explaining everything to them, during which time she DID have a surgical mask(which I placed on her as I entered the room and verified who she was) on, in efforts to prevent any possible further exposure.