Med Nurse Requirements

[Carey7]

What exactly is required by JCAHO with regard to the duties of the med nurse? What are the surveyors looking for? Due to short staffing, I am being pressured into doing patient care duties during my med pass and I was under the impression that that wasn't allowed. I'm so frustrated.

[Nanette]

JCAHO does not specify duties of any position. They state standards of care, the hospital policies and practises determine how the organization is meeting the standard. For example, the standard says something like 'there must be an adequate number of staff to care for the patients'.

JCAHO will look at your policies for giving care and see that you are following them.

If your policy says you need X# of staff for X# of patients and you consistently do not have that staffing, you could be in violation. JCAHO does not dictate the way you determine the numbers, just that you have a system.

If you have a policy that states what you are not allowed to do and you are doing it, you could be in trouble.

Is what you are asked to do within your state's scope of practise??

When an organization asks us to challenge the way we do things, it is scary, frustrating and difficult at times. I would suggest you carefully think out your problem and possible solutions.

Go to your manager with patient care concerns, not just focused on your feelings. No one wants to promote unsafe care, if you have concerns please go to your manager and have a conversation.

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[Carey7]

Thanks Nanette.

I hate to be a narc, but we rarely ever have enough staff. In the skilled care wing, we have 43 residents, and more often than not, have 2-3 CNAs...or have two CNAs for the whole shift and one who comes in for a few hours.

I can't understand how the administration can get around that when the surveyors visit. And another question...why don't the surveyors visit unannounced? If they weren't announced, they would see how things *really* are.

I would hate to see our home closed down and the patients displaced. Iit isn't a bad home and I love my residents. There are ALOT of people who care....mostly the people who do patient care. But working the staff into burnout isn't a good thing.

Our problem is the administrator who never sets foot outside of her office and has no idea what goes on, and if she does, she is too complacent to do anything about it, the activity director who puts activities on paper and doesn't follow through( she is supposed to do one on one visits with the patients but we never have witnessed her doing that), and the director of nursing who is a very good person and listens to what we have to say, but he is in the middle of the mess and in many ways his hands are tied. *sigh*

[Carey7]

Nanette, you wrote: If you have a policy that states what you are not allowed to do and you are doing it, you could be in trouble. Is what you are asked to do within your state's scope of practise??

I only know what was stated in the employment agreement, which said among other things that..other than my duties as a med nurse, I am to answer call bells. I DO answer call bells, but I am in the halls with my med cart continually and I see every call bell that goes on in the hall that I am working in. If I answered EVERY call bell, I would NEVER get my own work done! I feel guilty because the CNAs are so busy and I want to help, so sometimes I give a resident a bedpan...using proper hygiene afterward of course. But I'm swamped with my own work...givng the meds and doing the multitude of paperwork.