Anna Flaxis, ASN 22,158 Views
Joined Oct 15, '10.
Posts: 2,852 (67% Liked)
The preceptor delegated medication administration to a PCA, and also used medication from a different patient on their current patient, also it was not prescribed yet either.
So Yes, I am CERTAIN the preceptor went outside her scope.
also it was not prescribed yet either.
I think that the failure to recognize early signs of deterioration is a worthwhile issue to explore, but before you implement process improvement measures, it is important to find out what is at the root cause. Many different variables can factor in. What is the staffing matrix for the unit? What is the skill mix (RNs, LPNs, CNAs, Techs, ancillary staff, etc.)? What about experience; how many veteran nurses and new grads are there? How many RNs hold certification in their area of practice? What about education; does the facility provide inservices on a regular basis or offer classes either on the company intranet or in a live format? What about relations between nursing staff and physicians; what is the typical communication process and what, if any, barriers or glitches occur? At what percentage are core measures being met? And lastly, you should compare the rates of sentinel events/poor outcomes/code blues etc. at your facility with that of a few other facilities similar to yours. Is this really a problem, or are you doing better than you think?
Is it bigger than a bread box?
Yes, my managers sided with me on the out of scope of practice, but did still choose the preceptor over me and it makes perfect sense, they've invested a lot of time, money and energy into them more than me and human nature tends to value the those opinions we've built a relationship with over a newer relationship, just part of our nature. Also I would be the most expendible due to being the most new and less skilled of the two. While it may not add up to you, that is okay. It is what it is, and I do need to move on. While I do feel that I would have thrived with a different preceptors whom I worked with side by side in different situations and they taught me well on certain skills, that doesn't really matter either since doesn't change the outcome now. The reason I had written the original post is more due to trying to figure out how to move on, and figure out how to pursue my next job since it was already difficult to get a job as a new grad, let alone someone who was let go.
I do not wish to complain I have found most nurses the most kind, sensitive, caring, people I have ever known. I want to know if I'm being overly sensitive or if my nurses (this time) were a bit out of line? I was in a rehab hospital for a hip replacement. Getting from bed to commode to toilet was an issue, but once there I had grab bars and felt myself quite safe. I assured the nurses that I would obey the rules and not get up on my own. I was extremely constipated and wanted some time and privacy to force a bowel movement. Time and again I had to specifically ask that the nurses leave and close the door. Often I was popped in on and asked how I was making out. Quite frankly the interruptions stopped the process in its tracks, I had to ask the nurse to leave, to close the door and begin my efforts all over again.
Am I being an overly sensitive prude or did I deserve a little more consideration?
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