UAP charting assesments in the ICU

  1. I will be slightly vauge but the facts are true and I have first hand knowledge of them.

    UAP's (unlicensed assistive personal) are being used in the ICU. they are taking a patient assingment and charting assessments. mangments take is that the UAP doing this are nursing students and will eventually be nurses anyway.
    the nurses of course have liability concerns with it. mangment swears that nurses will not be responsible for mistakes made.
    the state board of Nursing has knowledge of the goings on and are doing nothing. I think this is a slippery sloap if nursing students could do this couldn't any lay person
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  2. 17 Comments

  3. by   canoehead
    This is insane. If they are taking assignments who is making all the clinical decisions? If there is no nurse coassigned with them who gives the meds and treatments?

    I think we need more information as the situation doesn't even make sense- let alone sound safe.
  4. by   alansmith52
    I agree. I nurse is "attached" but the UAP is giving everything but push meds and blood. Mngmt claims the nurse is not utimatly responsible but is only "attached" as a resource. its not like having an aid. they've made it clear that their not aids. they are to take patient assingments.
    yeah. I don't get it either. durring their orientation a nurse had to sign thier check off sheet. so "we know they are competent". they are litteraly writting "nurses notes".
  5. by   canoehead
    Sheesh, I suppose they could do tasks but the overall decision making and putting all the info together has to be done by an RN (by law) and who is doing that part? Especially in an ICU a UAP may not even know enough to realize they don'tknow (If you know what I mean) Are these UAP's able to read an EKG? Do they call docs and take orders? Do the docs depend on their assessments when making treatment decisions?

    Has anyone called the Board of Nursing to report all this?
  6. by   Rena RN 2003
    students are still held to the title of RN. anything we do in clinical, be it assessments or pass meds, we are still held to that degree of education. that being said, our instructor signs off on anything that we do so ultimately it is her responsibility to see that we havent' overlooked anything to do with that patient. should any suit be brought by the patient receiving care, my @ss is in a sling just like my instructor. we would be responsible for the care that patient received....but i'm just a student, what do i know. i'm sure i could continue to work on the maniquins at school (omitting any hands on patient care) and be ever so prepared to work next to any one of you upon graduation. i'll see ya in june, 2003.
  7. by   alansmith52
    its a new program, not in effect long enough for a bad outcome. I would say yes the doc would be rellying on their assessment. they are third sem nursing students so they might have some ekg skills. and I think I saw one call a doc the other day. we only have to of these people as of yet
    matt
  8. by   fedupnurse
    Why doesn't this shock me???????
    Those stinking suits will do anything to save a buck or two! Someone from that unit needs to photocopy those notes and the assignment sheet and forward it to the state BON and the DOH. This is illegal! At least in NJ. Our regs state there must be a
    REGISTERED NURSE
    assigned to patients in the ICU. Heck, LPN's aren't even allowed to do assessments, why on earth should a UAP be permitted to. Nursing student or not. No RN license, no assessments. Please make formal complaints to the BON, DOH and risk management. Perhaps a patient or their family should be told to ask to see the nursing licneses of those caring for them. We are supposed to produce them upon request. Tell that to Risk Management!!! They will have a total stroke over this one! Perhaps the insurer of the hospital should also be informed!
    Good luck!
  9. by   alansmith52
    I agree. its outragious. and these arn't students in clinicals mind you. these are students in a differnt school who are employed in our unit. the thought is that they will become endeered with our unit and stay after they graduate.
  10. by   fedupnurse
    Maybe you can get a friend to write a letter to the editor and suggest people at that hospital, any hospital really, should request to see the nursing license of their care providers. "I forgot it doesn't hold water" because the nursing office must keep the number on file. I'd run from that facility as fast as possible because your license is at serious risk!
    Best of luck.
  11. by   talkall
    when i did my itu placement as a student i was supper numery in other words i was not aloud to take patients or be counted in the nombers i was not aloud to handle controled durgs and could not touch the vents. i know i'm in scotland but from a students prespective i would have been too scared to do anything anyway i just dont have the knowledge or skill.
  12. by   AmiK25
    I am a student nurse extern in an ICU. I am allowed to do assessments and give any meds other than IVP. I am not allowed to titrate vasoactive drips, etc...I do have a patient assignment, but there is always an RN assigned with me (together, we have two patients-I usually assume care for one and the RN for the other). I absolutely feel the patients are getting safe care in my ICU. The reason is this: if I have ANY questions about what is going on with the patient or something I see, I ask the nurse. The nurse always comes in during or just after my assessment and assesses the patient his/herself. I know that I am expected to keep the nurse informed and to ask about anything I am unsure of. When the doctors make rounds, the RN always comes in the room with me to talk about any nursing issues, etc.. I am not allowed to take verbal/telephone orders. In my hospital, I am held responsible for anything I do that I have been "checked-off" to do. If I do anything I am not allowed to do, the RN is responsible.

    If you are worried about patient care, my advice would be this: make sure the students know that you are available for questions, etc... Make sure they know it is inappropriate for them to give any care or make any decisions they are unsure of or not allowed to do without first seeking advice from an RN.

    I know it is a difficult situation for nurses to be in. The nurses on my unit have been wonderful and I am gaining wonderful experience. I honestly feel when I graduate, I will be prepared to give good nursing care to my patients.

    Anyway, just wanted to give you a student's perspective. Hope it helps.

    Ami
  13. by   BadBird
    It sounds to me like the attatched nurse will be attatched to a lawsuit!!!!!!!!!!!!! I would not want to be the charge nurse in a situation like that. Good god, what's next drive through surgery?
  14. by   Cascadians
    Oh boy. The foistering of life-and-death responsibility on the inexperienced keeps increasing. It's one thing to shadow an RN and be taught and return-demonstrate tasks, but quite another to be handling care on a complex patient in an ICU, with different patients often.

    If the student nurse does not fear this, it is simply because s/he has not yet experienced the horror of making a mistake, or having a crisis with no help around, or having a family taking "lawsuit notes" while watching every move, or suddenly finding oneself short-staffed and having to take 2 or 3 or more patients on, way over one's head, left swimming against a raging current circled by sharks.

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