Sadly, another family is grieving the loss of a loved one and another licensed nurse is being charged criminally for the death. It just seems to be happening more often or the media is more tuned in and run the story. Let’s face it, it is a sensational story, a headline that draws the eye, but at the end of the day we are talking about people, not stories. The most recent article published in the Iowa Capital Dispatch says that a nurse allegedly failed to suction the airway of a U.S. Army veteran leading to his death.

According to the article, the nurse, a 69-year-old Iowan was not an employee of the facility but rather an agency nurse hired through a local staffing agency. When questioned, her response was “staff wanted me to suction him, and I told the staff no, I was told that I would not have to do anything with the tracheostomy”. Was that true? Was she told she wouldn’t have to suction him? That is unclear, however, she observed a resident in respiratory distress and chose to do nothing and leave the room. Hmmmm…. being a nurse myself, I find that hard to believe but I am not sitting as judge and jury.

Bottom line, since the COVID pandemic, use of agency staff has increased dramatically as nurses are not looking to be employed in healthcare settings, they are either burned out or afraid. That doesn’t change the fact that we have frail elders depending on us for their care, whether it be basic ADLs or suctioning a tracheostomy. Ask yourself these questions:

• Do you know what your agency staff are told when they come in for their shift?
• Do you have a comprehensive agency staff orientation process in place?
• Are you setting expectations that nurses are responsible for doing nursing duties without exception?
• Are you being honest with the agency you utilize regarding the acuity of the residents in your center?
• How are you verifying competency of agency staff to perform higher acuity tasks?

From experience I can tell you that our own staff may be a part of the problem. Do they hand off the keys and leave or are they giving a report on each resident including their care needs? I have worked through staffing challenges, I have donned my scrubs and come into the building on midnights to take the keys. My staff member literally set the keys on the counter and picked up her things to leave before I even got to the nursing station. As she passed me in the hall, I told her I was the administrator, she said “oh I thought you were agency”. Wrong answer. She was unemployed immediately. There needs to be protocol and everyone including agencies needs to understand expectations. Don’t be a victim or worse, don’t let your residents be victims. Take good care of your staff, don’t settle for mediocre from your own or agency staff and always remember, at the end of the day your residents depend on you! Stay well and stay informed!