Only ONE person in Recovery Room?!

  1. I work at a small(er) hospital in Florida, and L&D nurses circulate and recover patients in our own PACU. I understand there is a LAW that is in effect that TWO people must be present in a recovery room (one being an RN, the other person with a pulse only) due to the fact a patient was molested about seven years ago in a recovery room. When I first started at this hospital, I questioned the nurse manager, and she blew me off...stating "oh what's the difference if you're alone with a patient in PACU or their room later, you don't need two people in recovery" Also...many, many of us nurses have absolutely no training in reading a monitor...and I was told to put "yes" on the line that states "cardiac monitor" (when it's looking for a rhythm diagnosis, such as NSR, or ST) I told my manager that I have no idea what the monitor says, and she told me that she would not pay to have me take a course to be qualified in reading a monitor. I sure wouldn't want my sister having a baby at MY hospital. Is my license in jeapordy here with these two incidents??? Anyone? Thanks!
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  2. 14 Comments

  3. by   ERNurse752
    I'm no OB or PACU nurse, but sure sounds like it to me! Yikes...talk about scary - both the conditions AND the manager.
  4. by   kyti
    ASPAN standards say two licenced personel one of whom is an RN experience in recovery. I am frequently left alone on call with just a "warm body" even if they can't help me at least they could call for help while I am working with the pt. You definatly need two people.
  5. by   jaimealmostRN
    WRONG WRONG WRONG.......if you cannot get this manager to change the policy (i.e. getting all staff to object to this UNSAFE practice and refuse to jeopardize their liscenses) then I strongly feel you should LEAVE and report this dangerous activity to the state/nursing board. Besides risking losing your liscense, will your conscience be ok after possibly losing at pt (which I really hope doesn't happen)? You seem to be a smart, educated person, why not find another hospital that is law-abiding?
  6. by   Jolie
    You could also threaten to notify JCAHO of this practice. They have pretty strong guidelines regarding consistency in the care of patients in different areas of the hospital. If the regular PACU nurses in your facility are ACLS certified, then anyone recovering a patient in L&D (or anywhere else in the hospital) must also be ACLS certified, and must follow the same staffing guidelines as the main PACU. Check the AWHONN website for guidelines on staffing and qualifications as well. If this is not addressed immediately by your nurse manager or hospital risk management, I would get out of there. Your license is too valuable, and a lawyer would have a field day in court with this situation.
  7. by   dawngloves
    You bet your a$$ your license is on the line! If you are supposed to evaluate a rhythm on a monitor and you state you did you are false documenting and if that came up in litigation guess who'd pay?.
    Bottom line, YOU!
    It blows my mind that a good deal of you work on units alone. No nurse should be on any kind of a unit alone! $hit happens and it'll happen at the worst possible moment.Lord help the legal team of that hospital when that goes down.
  8. by   L&D_RN_OH
    We are only required to have one RN in recovery per pt, although the support is required to be at the desk to answer call lights while we are in OR and RR, and the nurses station is right outside our recovery. We are all ACLS certified and have to interpret monitor strips. It seems if you are documenting your assessment of a strip that you can't interpret, you would be guilty of false documentation. I think it is a very unsafe practice to have someone who is not ACLS certified recoveing a post op pt, and definitely needs to be reported. If your NM will not listen to your concerns about YOUR license, you need to take it up with risk management.
  9. by   imenid37
    You should have at least 2 people in the PACU w/ the pt. If something were to happen, then it would mean big trouble for all involved. Why should you suffer because your hospital is just trying to eek by w/o spending the $? In the state of PA, there must be two licensed people on the unit when there is a pt. Maybe your state BON could help or the health regulatory agency in Florida. I am not sure what the nurses organization for PACU is. They have a PACU forum here I think. You could see what their standards are because even though it is OB PACU, you are held to the same standard. This makes me so po'd when I hear a hopsital is putting nurses and pt's in a dangerous situation (usually to save $). Thought their purpose was life saving, not $ saving when we all went into this. Good Luck! You really need it! P.S. if you are going to do something to report the facility, don't threaten, just do it. You don't need to make yourself a target. The facility needs to do what laws and regulations dictate, not scape goat you. The facility already knows what the standard is and whether or not they are compliant. Now educate yourself and do what you believe is necessary. I reported my former employer for a violation and belive me, I did it anonymously so my name was not out there to other employers as a trouble maker. I have never told any of my former co-workers that I reported the hospital and I would do it again if I thought it was necessary in the same manner. :angryfire
    Last edit by imenid37 on Mar 9, '04
  10. by   kyti
    ASPAN is the association for recovery nurses. Their web site is aspan.org. I believe you can view the standards online without buying the book of standards.
  11. by   imenid37
    I need to revise what I said. Our PACU staffing is minimum 2 licensed persons. One must be an ACLS certified RN and the other may be another RN or LPN.
  12. by   SmilingBluEyes
    Ya need to be aware and keep with AORN Standards, if you are doing recover room nursing. Pure and simple ........Get a copy from your Central OR staff/nurse manager. You are held to this standard, so it behooves you and those who do recovery room nursing to know it.
  13. by   nursebea02
    My First questions is why do you NOT know how to read a monitor? As an RN you should at least be able to look a strip and tell if it's normal or not.
    Second, please go above your manager if you feel you are giving unsafe care due to lack of education.
    Answer your question.. Yes, two people in recovery. ASPAN.org Look it up and give it to your manager.
    Side note.... If you are worried about your license then quit or educate yourself and stop whining about what you don't know. CEU's and books are available to keep up your skills and knowledge.
  14. by   bagladyrn
    Quote from nursebea02
    My First questions is why do you NOT know how to read a monitor? As an RN you should at least be able to look a strip and tell if it's normal or not.
    Second, please go above your manager if you feel you are giving unsafe care due to lack of education.
    Answer your question.. Yes, two people in recovery. ASPAN.org Look it up and give it to your manager.
    Side note.... If you are worried about your license then quit or educate yourself and stop whining about what you don't know. CEU's and books are available to keep up your skills and knowledge.
    That's pretty harsh! How about floating over to the OB unit and telling us the significance of the tracing on the fetal monitor? Can't do it? Why not if you are an RN? Nursing today has become so specialized that no one can keep up with all the knowledge in all areas. The hospital that has this nurse doing recovery is trying to save money by not having you (the PACU nurse) come in on call.
    My understanding is that most states require the recovery room nurse to be ACLS certified and that there should be a second person present.

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