Such as check the extra oxygen tanks to be sure they are full (daily),
I personally check the O2 bottles on my main 4 gurneys (2 trauma beds, 2 cardiac beds) at the beginning of every shift I work. I make sure my ER tech checks all of the other ones. I would hate to need the O2 and have it run out, or not be there.
check the crash cart for outdates (monthly)
Who restocks the cart if it is used? I would bet the pahrmacy does. But, if your facility is like the small one I used to work at, there are more than drugs in the cart that expire. It seems to make sense that a nurse from the unit check the cart to ensure all of the fluids, etc are still good. Once again, I would hate to need something right now and have to wait because the material in/on the cart is outdated. I also feel the pharmacy should be responsible for ensuring drug correctness and not being outdated in the med drawer.
We also have a fall risk paper we are suppose to fill out on each person who is admitted. Some of the questions on there are about gait and changes in gait that are more geared for a PT person to determine than a nurse.
Every pt I ever admitted to the floor, or into the unit at my last job I did a fall risk assessment on. It comes with doing an initial assessment to the floor. What ever I can't answer, I don't. One thing you do not want to have happen is have a pt take a tumble on the way to the potty or wherever and not have the fall assessment finished to the part you can say the pt is not at risk for falls.
on admission if anyone shows S/S of infection we are suppose to fill out a paper for the IC nurse
Why not have the infection assessment as small part (yes/no) of the admisson assessment and leave a voice mail for the IC nurse to assess the pt furthur? Just a random thought.
Most of the things here I can see as something the unit manager or assistant could and should be doing. There is no reason why the cart check, if only done monthly, cannot be done by one of them. The shredding of paper can be done by the unit secretary, if you have one, just keep a box of shred to be done daily.
So, as you can see, because I work the ER I feel that some of the things you protest are actually my responsibility. It is obvious that a small med/surg floor will have different priorites. If you have CNA's or unit secretaries, use them. As a nurse you should be able to delegate the jobs that you feel can be farmed out.
Now, I will tell you why I feel the crash cart should be checked by a nurse. Last week I went to a code on the med/surg floor @ ~ 0300. This pt had a full knee replacement earlier the previous day, so he was less than 18 hours post-op. The code was called because he was unresponsive. He was a LARGE man, on his back, had been receiving MSO4 all day, IVP and PCA, and most likely sleep apnea. Upon arriving in the room less tha 2 min after the code was called, the crash cart was already there. It did not have an Ambubag on it, the scope blade the Dr. was going to use to intubate with did not have a bulb in it, and the med drawer only had a 0.4mg ampule of Narcan in it, instead of the two 2mg amps that should have been there. So we now have a man in resp distress who we can not bag, nor enough Narcan to see if that would help. So, RT runs to get a bag, the floor nurse runs to get me a handful of 0.4mg ampules of Narcan (only Narcan that was on the floor, the 2mg amps are in the cart) and did I mention, there were no pads for the defib...glad we did not need that. Luckily the first .8 of Narcan helped a little so we did not have to tube him. It took another 1.6 mg to arouse him enough to talk to us..and then more as it wore off. The policy on this floor is to check the cart daily, but had not been done for over a week.
I hold the unit manager responsible for this, we could have been in deep doo-doo very easily with this situation. So, not only should a nurse who knows what should be on there check it, but also held accountable if it isn't done. If that means assigning the task, than so be it.
I have now put on my Nomex BVD's, so flame away if the urge strikes.
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