pct debate - page 5

Has anyone heard of PCT *patient care technicians* ? PCT 1 is a CNA PCT 2 can do blood sugars, catheters, etc PCT 3 can start iv's etc I live near Chattanooga and I work as a PCT..in another... Read More

  1. by   angelbear
    sbic56 You said what I was thinking.
  2. by   Vsummer1
    Originally posted by tiger
    val--i think you are taking this a little far. in your first post-you may not have said it, but insinuated, that anyone less than an rn is like a monkey. trained to tasks only. and now you are grilling lpnga. it is like you are trying to get some satisfaction or recognition. it is kinda sad. imho.
    Hmm.. recognition for what? I am just a lowly student. I was just merely repeating what my instructor would ask before I so much as attempted to give a common drug, such as ibuprofen, to a patient. Because, quite frankly, I have only been "trained" in every type of procedure you all state you have been, and I have only "performed" every one of them on patients several times. But I don't yet hold the license so I must be able to answer all these questions at the drop of a hat in order to perform a procedure, or give a drug. I merely thought that you too would be able to answer the questions that I must answer in order to do these things... oopss i forgot, I am only posting this for satisfaction and recognition of my status as a lowly, struggling student.
  3. by   Brownms46
    First this was a discussion about unlicensed or PCT/CNAs.
    Second here is an statement taken from the Florida Nurse Practice Act:

    <The professional nurse and the practical nurse shall be responsible and accountable for making decisions that are based upon the individual's educational preparation and experience in nursing. >

    Now in my view if you made the decision to delegate a task to a PCT, and that PCT performed that task wrong, you're responsible for your decision to delegate that task to that PCT.

    Also in one of the links I provided it said this:

    Can the task be performed improperly without life-threatening consequences? No -> Do not delegate

    Are the results of the task reasonably predictable? No -> Do not delegate

    Now in order for the task to be reasonably predictable, you would have to know that there was no way for the resident to fall and break a hip...if you decided to leave the room.

    Is appropriate supervision available? No -> Do not delegate

    Can the task be performed improperly without life-threatening consequences? No -> Do not delegate

    The above is from the Washington BON

    The following is from Mass BON:
    Generally, appropriate activities for consideration in delegation decision-making include those:

    which frequently recur in the daily care of a patient or group of patients
    which recognize that UAP do not have a knowledge base upon which to make nursing judgments;
    which do not require complex or multi-dimensional application of the nursing process by a licensed nurse;
    for which the results are predictable and the potential risk is minimal; and
    which utilize a standard and unchanging procedure.

    http://www.state.ma.us/reg/boards/rn/advrul/ruldelg.htm

    The following is taken from MA. BON


    Responsibilities and Functions - Registered Nurse

    A registered nurse shall bear full and ultimate responsibility for the quality of nursing care she/he provides to individuals and groups. Included in such responsibility is health maintenance, teaching, counseling, collaborative planning and restoration of optimal functioning and comfort or for the dignified death of those they serve. A registered nurse, within the parameters of his/her generic and continuing education and experience, may delegate nursing activities to the registered nurses and/or health care personnel, provided, that the delegating registered nurse shall bear full and ultimate responsibility for:

    (1) making an appropriate assignment;

    (2) properly and adequately teaching, directing and supervising the delegatee; and

    (3) the outcomes of that delegation.




    the delegating licensed practical nurse shall bear full responsibility for:

    (1) making an appropriate assignment,

    (2) adequately teaching, directing and supervising the delegatee(s), and

    (3) the outcome of that delegation:


    Now I was attempting to answer the question posted. From what I read, it seemed to say that the licensed nurse is held accountable for the decision she/he makes. In other words, if you don't feel comfortable delegating a task to an unlicensed person..don't.
    Last edit by Brownms46 on Mar 13, '03
  4. by   caroladybelle
    Thank You Brownie!!!!!!!
  5. by   askater11
    I've worked at three facilities.

    The first one...went from transition from CNA's to PCT's. At first the PCT's drawing blood wasn't bad....they got a long orientation to drawing blood. At that time I was an CNA so I know how the orientation was. (very good) Then they started getting an hour our two verbal orientation then drew blood a few patients and were out on their own.

    The second place I worked the PCT's did the lab draws, ekg's and blood glucose fingersticks.

    The biggest problem I've found was with lab draws. I had many patients complain about certain PCT's and their lab techniques. Patients even complained to our supervisor .... but there was no changes.

    Regarding EKG's....that makes me not as nervous but nervous. With 12 leads... I got orientated to 12 leads...I couldn't believe the discrepancies between where the PCT's said to put the leads. I had the same person orientating me to EKG's for 50 total EKG'S all seemed fine....but then out on the field I couldn't believe the discrepancy fellow PCT's were saying the lead should have been.

    One more concern....with these poor PCT's stretched to do so much...there wasn't much time for hygeine care or basic care...that was very neglected. Perhaps better staffing would've helped that. I did also find that no matter how I explained a stat EKG....meant STAT and why it meant STAT it was never getting done. (that's why I orientated to EKG's...if they wouldn't get to it...I would) I first spoke to the PCT...then to management about STAT EKG's...nothing changed...

    Now I started at a new hospital. CNA's do basic care and that's it. They can collect U/A or stool cultures but that is it. The patients are actually getting turned q 2 hours. The direct care is not being neglected at all.

    I love our PCT's/CNA's...and going from a CNA to a PCT...I did see the problems. Personally I would turn the patients every 2 hours...but after all the added task the time just wasn't there.
  6. by   lpnga
    vsummer......not going to continue playing your games...so find someone else to be mad at...I am also a student for my pre reqs..

    thanks for all the replys I was just wondering if other people have heard of pct's and what alll they did because in a different post everyone thought I was crazy....

    No I don't know everthing about nursing...vsummer so i can't answer every med you ask but I can do alot of them.......

    I am just happy that other people have heard of pcts and the task they perform...in the LTC i work in if we do...let a pt fall and break a hip....it's our fault.......not the RN or LPN we don't have enough nurses in out facility to take care of every pt
  7. by   askater11
    vsummer what do you do in nursing? Are you an instructor?
  8. by   DeniseLDRN
    I was reading this thread and thought I would give my 2 cents....



    My grandmother was in end stage renal disease and was to go for a Colonoscopy the following day. The doctor wanted her to drink the "go lightly" to cleanse her out. My grandmother drank some of the "go lightly", but then refused to drink the rest. At 3am that night 2 PCT's came into my grandmothers semiprivate room, and tried to force a NG down. Scarred the living crap out of my poor dying grandmother, and her roomate. The PCT's also left huge bruises on my grandmother arms and hands where they tried to hold her down, to get the NG in. MY mother and I were furious about the incident, my grandmother died a month later. My mother was going to do something about it, but was overwhelmed by grandma's death. I was very upset to find out that a PCT could place an NG, obviously more education is needed!

    Deniseldrn
  9. by   hogan4736
    I know an RN who had placed an EWOL (sp?) or lavage tube - 32 FR, down a patient after he overdosed...She met resistance while pulling the tube out, so she YANKED on it, subsequently ripping the esophagus, and the patient died...she had been a nurse for 10+ years, and stil is...

    Careful who we pile on just because of a job title.
  10. by   catrn10
    Honey I just reread one of your posts and I know exactly where you work, and the hospital in Georgia and also the one in Chattanooga. I believe one of the hospitals is commonly know as Die County to the local folk. That would be the one I told my family to drive past on the way to Chattanooga if anything bad happened. Been there, worked there, never again. However, the nursing home you are at does a darn good job with their patients. At least they are clean, with no bedsores. And the facility doesn't smell, and the programs for the residents is good.
  11. by   MishlB
    Originally posted by lpnga
    yes some aides don't know as much about meds as needed..even me..I only pass to those pts I know the meds they are given and the side effects.....that is my big concern I hate to take meds..I wont even take advil for a headache...i would like to be offered a longer class on it
    So you just decide which meds you have the information about and pass those? Doesn't anyone else smell the cow patties around here??? Puhleeez.
  12. by   Vsummer1
    Originally posted by askater11
    vsummer what do you do in nursing? Are you an instructor?
    No, just a lowly student in an RN program... I don't do anything without an instuctor LOL
  13. by   lpnga
    denise.

    I am so sorry....I would have said something to the pcts but if I am uncomfortable I will ask for help and i must say that some pcts do try to force people to do things..in the LTC facility I work SOME pcts and nurses make the residents go to sleep at 5:30 and sometimes they don't want to..i must say I have never tried to make someone go to sleep..I feel that I am in their home and I would not want someone telling me that it is my bedtime and for me not to wake up until 8 in the morning.....
    yesterday this one little lady did not want to put her clothes on to go to bed and it was almost 9 o clock at night and I tried to talk her into going to bed she was in the hall asleep but told me no she was waiting on Jesus to come and get her and she was not going...I let her have her wishes and took her back out in the hall where she sat in her chair............i did not work today..so i don't know if she ever went to bed............I also always report a bruise..that makes me so mad....i love my pts...

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