I was hoping to get some feedg back on this....The hospital I work in just had an incident when a Nsg Asst took an Oral temp go a number like 100.1,then the MD took the temp rectally (I am not sure how much time after)and got 102something. Well I am new to this institute but THAT MD was a big shot with a very big mouth.NOW all nurses must take our own vital signs.All of them not just the postops unstable pts all of then I am a new RN and that makes my rounds almost double in time .I took boards in Sept and it was all delagation. If nsg asst cant do v/s then I feel my patient load should be lessoned. It is so frustrating trying to get things done and have to recheck temps .(please note I would never delegate the important things BPs for meds apical pulses ect)I am interestedin your thoughts
Dec 16, '00
Welcome to our profession. A profession were the practicioners have little control on how they must practise. We had run into similar delegation problems, either the assistants are qualified to do something or they are not. Eventully people realized the would need more RN's and this they weren't going to do. We soon returned to being able to delegate appropriately.
It's another example of administrators choosing not to defend appropriate nursing practise and kow-towing to MD's. It has been my expirience that most MD's don't have a clue as to what it entails to deliver quality nursing care to hospitalized patients (no dis to home-care etc. just never worked there).
Dec 16, '00
it's not even that far off! An oral of 100.1 is a rectal of 101.1 So if half an hour or so later the doc got 102-then as the above reply states, the temp may just have been spiking. It has to go up sometime-the doc just hit it right.
At any rate-if the N.A. has been qualified by the hospital to do vs, then the hospital should be backing up its employees-not caving to a big shot.
Dec 16, '00
Unfortunately, this kind of knee-jerk reaction is very prevalent in many institutions. My questions are: Has the issue been addressed by the Nurse Manager and the Chief Nursing Officer? Has there been any dialogue about the issue or was there a policy handed down from nursing administration in reaction to the powerful MD? If this one incident resulted in a global policy change, I would be very hesitant to trust any of the nursing leadership at your hospital to champion the needs of the nursing staff. Of course, there are probably more details involved. I suggest you start questioning the change in policy based on the FACTS, not emotion and move forward from there.
Dec 17, '00
This is ludicrous! The nursing asst. didn't do anything wrong. Was there an order to do an oral temp? How long after the oral temp did the MD take the rectal? The patient's temp could have been on it's way up. You would have had the asst take a repeat temp anyway. The MD just beat you to it and made a Federal case out of what he got. The indicator was there. They just didn't give you a chance to do your job. I would fight this. Good luck!
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