Opinions please re: Phase I

  1. 1
    Ok, what do you all think about the common practice (more like Mal-practice) of one RN being in PACU with a patient. This of course is usually on a weekend or at night when resources are at the most minimal.
    How do you justify this in court when it comes up which we all hope it never does. Doesn't anyone worry about their patients or their OWN safety. We recently had an RN alone with a patient who was assaulted. She didn't even write an incident report. Dumb yes. We are discouraged by peer pressure to not make an issue of working alone with critical and noncritical phase I patients. Kind of a "don't call me if I am 2nd call unless you have a dang good reason".
    Any opinions/thoughts/advice?
    Thank you
    ekkis likes this.

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  2. 16 Comments...

  3. 1
    20 people read this but no opinions?
    I don't believe it. Nurses ALWAYS have opinions
    canoehead likes this.
  4. 1
    i work at a freestanding ambulatory surgery center. our administrator doesn't hesitate to schedule cases after 5PM (whatever the doctor wants, right?) i often am left alone with this patient. our administrator says as long as there is another nurse in the building it's OK. she's the other RN with no PACU experience! it's totally unsafe-these are general anesthesia cases-but that's her policy. i guess i grin and bear it. it sucks though. she's in her office doing paperwork! our anethesiologist is somewhere in the building too.
    sharann likes this.
  5. 2
    We have strict protocols that there must be 2 RNs in the PACU whenever we have a patient. From my understanding this is ASPAN's written policy. Sometimes this means making anesthesia or the circulator stay with us until the other nurse gets there.
    Dolce and ekkis like this.
  6. 0
    Thanks. I bet we have them too written somewhere so when something goes wrong we can be accused of not following policy.
    I will check into it.
    Would a GI lab or Cath lab nurse work alone during or after a procedure? They always seem to be in pairs right?
  7. 1
    I worked with the OR nurse available, somewhere in the OR, in the PACU for about 6 yrs. Had to use ICU charge RN etc sometimes when an emergency surgery was in progress.

    One time at 9am on sat. had 3 pts by myself, 9yr old appy, an intubated combative ortho pt, and a d & c OPS.
    The D & C went to the corner, sedated the intubated pt and got the peds out in 30 mins.

    That morning I still remember.

    beachgirl26r likes this.
  8. 0
    The standard is "Two Nurses" in the area of recovery. But if the hospital doesn't support ASPAN standards you have the right to request/demand your Circulator or your Anesthesia Provider to stay. At my hospital we go to ICU and recover. The problem with that is you have to have access to everything. But it's a good back up.
  9. 0
    Aspan standard states "2 nurses in the recovery area". It's always a battle. Your hospital doesn't have to comply with the standards. If they refuse then you fall back on "Best Practice Act". Which means you will have to justify why no one stayed. Either have the Circulator or Anesthesia stay. At the hospital where I currently work I call in my back up or we go to ICU to recover (if there is a room). You can't do Pedi's in ICU or out patients.
    But they are a good resource.
  10. 0
    We follow ASPAN standards and always staff 2 PACU RN's - none of this "use a charge nurse from another floor" or an "OR nurse" as back up. Sometimes it takes a sentinel event before hospitals are willing to put out the money to safely staff. You'd think that if they went to court, prosecutors would site ASPAN standards, and question why the hospital wouldn't follow the best practices that's been established and published as industry standard? I wouldn't want to be put in that situation.
  11. 0
    Has anyone contacted Risk Management ppl to discuss standards VS practice?
    Perhaps the push for change will come from that quarter .. .

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