PACU Stand By to cover ICU patients????

  1. Hi, I wonder if anyone would be able to help me with this problem.

    I work in PACU. We do have mandatory stand by time, wich is 8 times a month for a 12 hour period. This was increased from 7 times a month without consulting with staff due to a sudden shortage. We open a new pavillion and a lot of RN's transferred there.

    While I could accept the stand by time to cover for emergency surgeries I am starting to get really mad because the tendency is that we are not really covering emergencies but whatever the hospital, manager or doctors want to do.

    I think the situation is intolerable but I have been unable to find realiable info on an internet research.

    I explain the details:

    We do 8 12 hour call per moth.
    It is very frequent that when we are on call in a weekend we do have to work a fulll shift to do nothing but scheduled, elective surgery. So we work our three 12 hour shift and if we are on call, we are oblied to do an extra shif to cover non-emergency surgeries.

    On top , we have nights when we do have to attend emergencies, remember that we do 8 on call a month so that is 2 on call every week plus our full time employment.

    Not happy with the level of abuse. The manager of PACU and the hospital is requiring us to attend to the hospital to cover ICU patients that have no beds in the physical ICU and are overflowing to the recovery unit. This is in our on call time. So we are actually covering the shortage of beds and staff for the ICU as well on the time that we are supposed to be covering only emergencies.

    Of course, emergencies do happen and when that is the case, we are requested to recover the patients out of OR while, the night supervisor sits, and thats what she literally does, just sit as an inert body, whit the ICU patients. We have to catch up with charting, meds, vitals and anything to be done with those patients.

    I want to formally complain an do something about this abuse and lack of respect but I would like to put my alegations together and get the right legal information about this.

    I should mention that I work in California.

    Thank you very much for your help.
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  2. 11 Comments

  3. by   AfloydRN
    And they wonder why there's a nursing shortage. My best advice is get out.
  4. by   nservice
    This is called mandatory overtime!!!
  5. by   burn out
    That is how it is at my hospital and the problem is really on of logistics because the ICU is holding patient for MEed Surg and tele but there are no beds available. Many times lately we have ICU patients stacked in pacu and er or we have to divert them to other hospitals because we have no beds available. It is kind of like being stranded on the toilet without any toilet paper., a real crapper.
  6. by   Indy
    Good grief that's a lot of overtime! That's two whole shifts a week! :angryfire
  7. by   harley007
    I can't imagine how you do what you do as your situation is so much, much worse than mine. But our dept. does have similar problems. I work in a large interventional cardiac cath lab that naturally includes on call duty - you are aware of this at time of hire. But our issues are patients being scheduled on Saturday for a routine cath. Many times it one MD with 2-5 of these cases in a row. If we have a true hot MI emergency patient arrive - we juggle, with this bare minimum on call staff, to finish the "routine" on call case and then are expected to finish the scheduled routine cases after the true emergency is handled. Total weekend call is a 48 to 60 hours straight. So, if we get bombed with acute MI's we are functioning on little or no sleep, because of the routine cases that are allowed to "schedule" when the lab is closed. My favorite ones are the MD's that transfer "allegedly" acute MI patients in from smaller near by hospitals. We jump like this is the real deal and there is the patient in no distress, a 0/10 pain scale and then they state they were told to wait at the small hospital until Monday but their MD found this great way to "get it done today" Our unit is one the hardest to staff in the whole hospital due to the skills needed, on call duties and the stress level of such acute care. They even pay us bonuses for working there. But, we want to give our all for that patient circling the drain with an MI. It feels so good when we are able make it all work. To know we not only saved this patient but by our quick response maintained their quality of life by getting it together so fast we saved more of their heart muscle. Are we on the top of our game after all of these "scheduled emergent" patients? I think not Management? - forget about it! So, goes the game ... Best of luck to you, I don't know how you stand it.
    Last edit by harley007 on Jan 13, '07
  8. by   Marie_LPN, RN
    Ours doesn't do this.
  9. by   hollyvk
    Quote from Silentfoster
    Hi, I wonder if anyone would be able to help me with this problem.

    I work in PACU. We do have mandatory stand by time, wich is 8 times a month for a 12 hour period. This was increased from 7 times a month without consulting with staff due to a sudden shortage. We open a new pavillion and a lot of RN's transferred there.

    While I could accept the stand by time to cover for emergency surgeries I am starting to get really mad because the tendency is that we are not really covering emergencies but whatever the hospital, manager or doctors want to do.

    I think the situation is intolerable but I have been unable to find realiable info on an internet research.

    I explain the details:

    We do 8 12 hour call per moth.
    It is very frequent that when we are on call in a weekend we do have to work a fulll shift to do nothing but scheduled, elective surgery. So we work our three 12 hour shift and if we are on call, we are oblied to do an extra shif to cover non-emergency surgeries.

    On top , we have nights when we do have to attend emergencies, remember that we do 8 on call a month so that is 2 on call every week plus our full time employment.

    Not happy with the level of abuse. The manager of PACU and the hospital is requiring us to attend to the hospital to cover ICU patients that have no beds in the physical ICU and are overflowing to the recovery unit. This is in our on call time. So we are actually covering the shortage of beds and staff for the ICU as well on the time that we are supposed to be covering only emergencies.

    Of course, emergencies do happen and when that is the case, we are requested to recover the patients out of OR while, the night supervisor sits, and thats what she literally does, just sit as an inert body, whit the ICU patients. We have to catch up with charting, meds, vitals and anything to be done with those patients.

    I want to formally complain an do something about this abuse and lack of respect but I would like to put my alegations together and get the right legal information about this.

    I should mention that I work in California.

    Thank you very much for your help.
    My first question is whether your facility has union representation for nursing. (From your description of the situation, I'm guessing you don't).

    So my next question is do you think it's time to contact the CNA http://www.calnurse.org for some info on whether these activites violate any state or federal wage & hour laws and what union representation could do in this situation.

    Certainly you can complain to the powers that be in nursing administration about the situation; you can even threaten to quit. But chances are that such efforts will have a nil effect. Nursing admin is banking on the reluctance of nurses to leave bad situations, especially if they've been at the facility for awhile and are vested in both the employment benefits and the culture of the place.

    This scenario of "If we build it, they will come [to staff it]" occurs on a regular basis--new facilities or current facilities opening new wings/pavillions/units that aren't fully staffed initially (that's what travelers are for).

    But if you want to get nursing admin's (and hospital admin's) attention, starting the ball rolling for union representation is SURE to do it.

    Best of luck to you in this situation,
    HollyVK, RN, BSN, JD
    Last edit by hollyvk on Jan 14, '07
  10. by   TazziRN
    Our place does utilize the PACU for ICU overflows, but only if there are ICU nurses to staff it. PACU nurses are expected to help out in emergencies but only until an ICU nurse can come in. If I were you I would find another place to work. They're abusing you.
  11. by   Silentfoster
    But,

    Can anyone recommend a way to find out exactly, by writting, what does the law and regulation say about all this?

    Because I would be more than happy to contact a union rep, but I am the kind of person that likes to study the moves well and have the information first hand.

    But I do not have a clue about how to obtain legal information on detail.
    Whatever would do, a book, a legal database. I want to present my allegations in an organized manner and tie every knot so they cant fool me.
  12. by   hollyvk
    Quote from Silentfoster
    But,

    Can anyone recommend a way to find out exactly, by writting, what does the law and regulation say about all this?

    Because I would be more than happy to contact a union rep, but I am the kind of person that likes to study the moves well and have the information first hand.

    But I do not have a clue about how to obtain legal information on detail.
    Whatever would do, a book, a legal database. I want to present my allegations in an organized manner and tie every knot so they cant fool me.
    Contact the CNA, they can advise you on these issues and explain any applicable state or federal laws.
    http://www.calnurse.org

    You are lucky enough to live in a state that has a GREAT state nurses' association--please use it!

    HollyVK (who left the golden state for the state of mountains and poor RN working conditions)
  13. by   TazziRN
    Silent Foster, call your union rep. That's what their job is.

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