Circulating Rn expected to admit and recover patients.

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    Just wanted to get some feedback from other OR nurses out there. I know a fellow nurse who works for a surgeon who has 2 operating rooms within his practice. During a case he has an anesthesiologist, medical assistants or techs assisting with procedures. He expects her to fill out circulating paperwork even though she is not present during the case. Positioning, final count etc! She believes she is not liable since she fills out the paperwork but does not sign her name. The surgeon tells her no one else in the procedure is allowed to fill out these forms. She is busy pre-op pts and recovering pts. I told her she is crazy for doing this that she can lose her license.

    Just wanted to hear some feedback about this.
    Thanks
    Last edit by nycrncares on Mar 1, '11
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    depends on what state she lives in but if he states already that she is the only one legally allowed to fill out the paper work.... her name is on it... I guarantee you that if it goes to court the anesth and surgeon are going to say she was there. She can loose her license if something goes wrong. They can not do this case without an RN in the room. The wording is loose in some states on the regulation of this though, texas regulation states that an RN must be immediately available for each operating room with a patient in it... What does that mean though, what is immediately available? Lawyers can swing that in either direction.... I would NOT do it.

    I have seen and would do it another way though... one patient at a time, admit the patient, preop them, do the case, recover them and discharge them. There is also regulation now that patients must have a ride home within 24 hours of recieving sedation of any kind, someone that is a responsible adult party willing to state that they take responsibility for this person for the next 24 hours.... They can NOT leave alone..... I am guessing that a surgeon that does these proceedures like this will also send patients home on a freakin bus....

    Definately would not do it....
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    thanks for your input. It is in NYS. The surgeon has 2 ORs going at once. 2 anesthesiologists. But just 1 RN. She is not able to be in the room since she is recovering other pts and preop pts as well. So wouldnt the liability fall on the MD, if something went wrong? I told her to discuss with him that she is not allowed to fill out circulating record unless she is in the room at all times. She makes great money at this practice and does not want to jeopardize her job, but I told her to worry about her license!
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    i would NOT work under those circumstances. Can't document what you didn't see/do. I'm sure the surgeon sees it as a HUGE cost savings, but no one else is going to protect the nurse's license. "The doctor told me to do it" won't protect the license of the nurse. I hope her malpractice premium is paid/up to date.
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    In my OR, we have to document certain anesthesia information. I document "XXX per anesthesia...not witnessed by RN...signed"
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    If she was not there for the counts and documents the counts as correct anyway, isn't that falisifying documentation? I am sure that the lawyers would have a field day with that if there happened to be a retained instrument/sponge. I am aghast that this is allowed, and even more concerned that your friend sees nothing wrong with it. THIS IS NOT SAFE PATIENT PRACTICE. The money might be good for now, but this is her livelihood that she is placing in jeopardy.

    I see multiple things wrong with this scenario. The fact that she does not sign her name means absolutely BEANS. The doc has only one nurse there, and he already said that she is the only one that can document, right? Sooo....the blame falls to her should something go wrong and the false charting comes to light in court.

    I encourage your friend to look into the laws of your state by looking at the BON website. She can keep doing this for only so long...kind of like when you continually run a red light; eventually you will get caught.
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    Thanks for all the feedback. Luckily after much pressure from fellow RN's my friend left the practice. She said he was an arrogant *&%& anyway!


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