Hey folks, I'm a relatively new nurse (RN for almost a year) and I'm currently working in the psychiatric field. I recently became concerned because I've been asked to do something that explicitly goes against hospital policy.
Hospital policy states that an RN has the authority to initiate behavioral restraints if the patient is at risk of harming his/herself or others.
The policy further states that a physician must assess the patient "face to face" within one hour of the restraints being applied and write an order.
Here's where the problem comes in: our particular unit, despite being part of a large hospital system, contracts outside doctors who are not completely available all the time. They must be paged at night and frequently do not respond to pages. In many cases, even if a page is returned, the doctor would probably be unlikely to arrive to the unit within an hour.
My nurse manager has instructed me that the physicians will not be coming in to conduct the face to face assessment and that a rotating schedule of nurse managers will come to conduct the assessment. I am not sure if this is outside of the scope of practice (or against the law) but it certainly is a direct violation of hospital policy. I'm worried about punitive action being taken against me if I bring this issue up with her again.
I contacted the state board of nursing and they said to try to address the issue through my hospital standards group, but I'm concerned for what I should do in the meantime.
Does anyone have any thoughts or advice on this topic??
Do you have to have a special membership for a PM? Because I don't think I've gotten anything. But I just might not know how to access them.
EDIT: figured it out.
Last edit by talrico on Dec 1, '11