Kicked off unit when Joint Commission arrives

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Rant/ vent time.

I'm in my last semester of nursing school in a peds rotation at an excellent magnet status hospital. Firstly the facility required we pay 40 dollars to complete a few online modules and an exam. I do not understand why that wouldn't be covered in tuition and fees but I don't want to complain too much.

To the point today was our first day on the unit and our instructor chose to use this day as an orientation day for us (showing us around the hospital, learning the unit, etc.). However what should have been a 2-3 hour experience ended up taking all day with us sitting in an empty patient room going over basic locations of things, the instructor on the phone for some MAR difficulties, and going over the parking situation for some students for at least an hour. All things said and done the clinical was very boring and mundane and we did not come in contact with a single patient to even just talk to.

Fast forward to this coming Friday and we are told that the Joint Commission will be at the facility and we will not be allowed on the unit. Instead we are to attend a grand round (which we are expected to do anyways) and then for the rest of the day we will look over specific conditions and try to guess which meds would be expected.

That counts as two days of no patient contact in the slightest, and only 3 days would remain. I am feeling cheated out of my clinical time and am very aggravated by the fact. Can the staff really kick us off the unit if we are paying quite a bit to be there if the joint commission is there? I understand why they would but wouldn't it be okay to just be there for basic cna duties and our own assessment, no med passing or other procedures.

Ruby Vee, BSN

17 Articles; 14,030 Posts

Specializes in CCU, SICU, CVSICU, Precepting & Teaching.

When the Joint Commission arrives, the whole facility is under enormous pressure. And that's just if it's a routine visit. If it's a follow up visit because of some issue that didn't quite pass muster the first time, it's even worse. Instead of lobbying to be there while the floor is under such pressure, why not lobby for an extra clinical day at another time?

Specializes in Critical Care.

I would love to but given out back to back clinical schedule, the facility having a different school every day, and the overall stubbornness of our chairperson. I will ask but doubt that will be an option :/

llg, PhD, RN

13,469 Posts

Specializes in Nursing Professional Development.

I doubt the hospital is receiving a penny for allowing you to be there. Most hospitals receive nothing in exchange for allowing students to have clinicals on their units -- or even for providing preceptors for senior capstone experiences, etc. As a student, you are there only because the facility is gracious enough to donate the use of their facility to your education for free. Be gracious in return.

That said, you might have a reasonable gripe against your school for not arranging things well. It sounds like your first day or two was badly planned and they should have had a back-up plan for when TJC arrived. While nobody knows exactly which days they will come, everyone knows "about" which day they will come and there should have been communication about it -- and your school should have had a back-up plan ready. Things like parking should be discussed back at the school during a class and not be handled during "hospital time."

When TJC comes to my hospital, we don't kick the students out -- but we definitely communicate well with the schools ahead of time and everyone has plans regarding what to do and how to act when they are here.

Specializes in Critical Care, Education.

Student rotations add to the cost of hospital operations... in terms of decreased productivity & increased liability. Schools do not 'pay' anything to the host facility in my part of the country.

JC visits can be very high stress for the nursing staff since surveyors spend a lot of time asking them questions and observing their work... no need to add students into the mix.

AceOfHearts<3

916 Posts

Specializes in Critical care.

When I was in nursing school it was made very clear to my group that if TJC were to be on the unit for a visit that we would be asked/made to leave. The visit on the unit I had clinical ended up being the next day, so it was a nonissue for my group, but the entire hospital was very stressed.

I also had a lecture instructor take over a new position in charge of clinical education and simulation for a facility and when they had a surprise visit my instructor frantically called one of the other instructors to teach my class for the day. The facility was in emergency mode and he was literally not allowed to leave. There are VERY high stakes with TJC visits.

Specializes in Utilization Management.

Even if you are just on the unit doing CNA duties, you run the risk of being cornered by a JC surveyor and asked questions for which you will likely not know the answers. Count yourself lucky - most hospital employees don't even want to be around for TJC.

Specializes in Critical Care.

I know they got the 40 dollars for the modules because other clinical groups don't have to do them and it was done through their website. I know it may seem like a little... But my minimum wage job and living alone in the cheapest apartment I can find means I can't spare any expenses. Especially since my dog got hit by a car and needed surgery the week I needed to do this stuff (I know that's a personal problem but the chairperson of the program had the nerve to call that a sob story). Anyways thanks for your response! I think my best option is to ask if we can arrange to float to a different unit that day, they did say that may happen. Fingers crossed!

Specializes in Critical Care.

Haha! I was thinking about that, on the other hand it would give good experience to see how to function with TJC, but I still don't want to put the hospital and especially other nurses at risk of any repercussions. What kind of questions do they ask if I were to get cornered?

Specializes in Critical Care.

Haha! I was thinking about that, on the other hand it would give good experience to see how to function with TJC, but I still don't want to put the hospital and especially other nurses at risk of any repercussions. What kind of questions do they ask if I were to get cornered?

Ruby Vee, BSN

17 Articles; 14,030 Posts

Specializes in CCU, SICU, CVSICU, Precepting & Teaching.
Haha! I was thinking about that, on the other hand it would give good experience to see how to function with TJC, but I still don't want to put the hospital and especially other nurses at risk of any repercussions. What kind of questions do they ask if I were to get cornered?

They can (and do) ask pretty much anything. Years ago, they started a (fake) fire in a wastebasket, then dragged me into the room and asked me what I would do in that situation. Since my patient was in the process of crashing and I was just running by to get the crash cart, I wasn't impressed. I picked up the trash basket, tossed the contents into the sink, turned on the water and then ran to my code with them chasing after me all the way nattering at me.

Another time, they asked me how I knew my colleagues were competent. Since I didn't think the specific colleagues they pointed out WERE competent, I had a bit of trouble with that one . . . The correct response is that competencies are checked off, signed by the educator and stored on the unit. I said that. Kind of.

One time they asked my orientee some very specific questions about ventricular assist devices. She hadn't had the class yet and didn't know the answers. She was positively shiney, though, when she said "I don't know, but I would ask my preceptor."

They questioned her for an hour, during which she kept answering "My preceptor would talk me through that." "My preceptor would never leave me alone in that situation." "My preceptor has taught me . . . ". I was SO never out when they dragged her in, but as I sat next to her and listened to her answers, I relaxed. She did good.

Cat365

570 Posts

They can (and do) ask pretty much anything. Years ago, they started a (fake) fire in a wastebasket, then dragged me into the room and asked me what I would do in that situation. Since my patient was in the process of crashing and I was just running by to get the crash cart, I wasn't impressed. I picked up the trash basket, tossed the contents into the sink, turned on the water and then ran to my code with them chasing after me all the way nattering at me.

Another time, they asked me how I knew my colleagues were competent. Since I didn't think the specific colleagues they pointed out WERE competent, I had a bit of trouble with that one . . . The correct response is that competencies are checked off, signed by the educator and stored on the unit. I said that. Kind of.

One time they asked my orientee some very specific questions about ventricular assist devices. She hadn't had the class yet and didn't know the answers. She was positively shiney, though, when she said "I don't know, but I would ask my preceptor."

They questioned her for an hour, during which she kept answering "My preceptor would talk me through that." "My preceptor would never leave me alone in that situation." "My preceptor has taught me . . . ". I was SO never out when they dragged her in, but as I sat next to her and listened to her answers, I relaxed. She did good.

i would have a large issue with the fire in the middle of a code. You had a better response than I likely would have.

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