Professional dilemma

[gdc67]

I work as an agency nurse in UK as a PACU or recovery nurse. Most hospitals have a policy that we are not allowed to give ANY intravenous medication to our patients with or without a skills certificate. I do not have the certificate but have been a nurse since 1986 and at the present hospital I have been giving IV medication until recently when we were told to follow the policy and refrain from IV meds.

My patient was vomiting and I left a student with the patient after reassuring her and located the Dr who ordered an IV anti emetic which I gave. The patient seemed sensitive to the drug which I stopped and when back to tell him and he ordered an IM anti emetic which I also gave and it helped.

A few days later my manager shows me a letter from a colleague, who had an intubated patient BEHIND a closed screen, that detailed me giving IV medication fully knowing that it was against the rules. I was a bit annoyed and shocked at the idea that someone would feel the need to forget that nursing is a caring profession and it is OK to be vindictive towards co workers. A few days before the letter came up, another patient was vomiting and very distressed and it took about 5minutes of running around for them to find someone with a IV certificate to give when we were all very skilled AND capable to do and in the end they dragged an anaesthetist out of theatre to give the IV dose.

A professional and personal dilemma....any views appreciated

[tyvin, BSN, RN]

Why don't you get the certificate?

[gdc67]

We cannot do iv with or without it but when i joined this placement they said if i am competent and confident i can give iv but the rules had changed and no one updated them. just not worth the effort n aggro. rather do less n get paid more.

[love-d-OR]

Then in that case you should do less. Don't give the medication! I find it ironic that you are refusing to get the certification because you don't want to do more work for the same pay, yet you are complaining about being reported to your manager for going outside your 'scope of practice.' This is not a personal vs professional dilemma. Quite frankly, it sounds like laziness to me. If you want to practice at your full potential, then get the certification. I see no wrongs here... Just my humble 2cents

[rn/writer, RN]

I think she's saying that even with the certification they're still not supposed to give IV meds. If that's the case, then the hospitals you work with need to come up with some kind of back up plan that will allow the patients of agency nurses to get these meds when they need them.

Bottom line is that you broke the rules. Maybe it's petty on the part of the person who reported. Or maybe they're concerned that the hospital could get in trouble and be fined or have some other punishment.

The whole thing sounds like poor reasoning and poor planning to me. If pool or agency nurses that came to the floor where I work were not allowed to give any IV meds, the patients would be the ones to suffer. What is behind this? Did some agency nurse commit some grave error so now the rest of you are having to pay the price.

I realize things are different from one side of the pond to the other, but this just seems ludicrous and inefficient. Nevertheless, you'll do no one any favors if you get yourself in trouble over it. Please, be careful.

[gdc67]

thanx for replies...im def not lazy ;-)...and spoke to the manager who said the rules have changed in the hospital to NO AGENCY NURSE TO GIVE IV AT ANY TIME. they do not accept an outside IV certification and they refuse to allow us to do theirs according to the hopsital nursing manager.

yes it is difficult to follow in PACU where iv is essential...does the same apply in ICU i wonder?...where there are many part time agency staff...as you will have to different carers for a distressed patient in my case...and the logic is wrong for sure...

and each hospital even if they run by the same trust or company has a different set of rules...

[AOx1]

I would refuse a placement at which I was prevented from performing an essential component of my role, causing me to leave a fresh post-op patient to hunt down someone else. Both the patient in theatre whose anesthetist leaves and the patient who must wait for meds are being deprived of care. Unfair and potentially unsafe. Would be fun to explain if your patient had coded under student supervision. This rule sets nurses up to fail and I wouldn't accept such a placement.

[kessadawn, BSN, RN]

I don't understand the point of hiring nurses to work in high-acuity areas, with patients that likely require multiple IV meds, but not allowing those nurses to give IV meds. That is just ridiculous. And it's not fair to those of you hired to work there.

[gdc67]

hello again...the patient was awake and talking and quite ready to be discharged to 2nd stage recovery room...and the nausea and vomiting was un expected...so she was fine...but the pettiness of it riled me up and I was not thinking about the rules other than settling the patient...yes i have worked at places where you are warned of the NO IV policy with or without certification and so mentally you are prepared to do very little for the post op care...

but then the other workers moan that we do less and get paid more but its not agency rules and yes I like to get involved in the politics as i find most of them are a bit over the top and pointless as far as nursing efficacy and patient care goes...pettiness and back stabbing is quite rife among most staff here sadly and more so if the agency nurse has far more experience than the full time staff...but we make a choice to freelance because we have the experience and attitude to care for patients.

[love-d-OR]

My sincere apologies gdc67, I re-read your post and realize I misunderstood what you were saying. I'll remember not to post anything after a night out with the girls

[miss81, BSN, RN]

Are you an RN? LPN or a tech? I don't understand how you can be a Registered Nurse and not give IV meds. Pulling a doc out for the OR to give an IV med seems crazy to me. You say the nurse next to you had an intubated pt, how can anyone care for an intubated pt and NOT be able to give meds?

[gdc67]

You cant reason with UK hospitals trusts sadly..their rules are silly and set by people who have little idea of what nursing actually entails i think..i am an RN since 1995....the issue has now reached new heights as i spoke to the manager and it is now in the hands of the hospital bosses whether i go or not...all i did was give an useful injection on a doctors order...who saw the patient 2minutes later...and now i feel like a maimed someone.

the manager is quite aware of the pettiness among her usual staff and my co worker who reported me only works 2 days a week...and they always want to be the ones doing the REAL nursing duties, what ever that entails in their small minds, to booster their egos in front of the patients...oh he is just an agency nurse and he is not allowed to do certain things is a common answer to patients...i have been there for a year and 6months...and probabaly have the most experience of them all collectively...:-)..but there you go...