Ethical Dilemmas of Agency Nursing - page 2

Hello All! I'm an Ohio LPN who's been working agency for almost 3 years now. (Just 1 agency) What started as something I would be doing as I transitioned looking for a staff job, turned into my... Read More

  1. by   precious33
    Is this TB patient in isolation?.Because not only are the nurses exposed but the entire residents and visitors to that faciliity.We have to protect ourself.
    They are saying because you are booked you cannot cancel but facilities cancel nurses sometimes almost immediately.That is why upon employment we need to lay out exactly what we need base on our right to be protected and our right to be obligated to family in times of needs/emergency.
    We are working for these agencies without us there will be no agency so we need to state our needs and our wants.
  2. by   bethin
    Just a CNA speaking here, but isn't the purpose of hospice to make the patient as comfortable as possible? What's the point of him receiving hospice if hospice doesn't want him to have pain pills at night or to take an ambien? I bet if you got hospice out of the picture and just had the MD order proper pain meds he would be alot more comfortable.

    IMO it isn't up to hospice to decide when the patient needs the pain med. If he needs it to help him sleep so be it. The poor guy is on hospice - which to my understanding means that you are terminal.

    In our hospital hospice is quite liberal with pain meds, ativan, ambien, etc and it is ordered that they are to be given routinely no matter what.
  3. by   graysonret
    I worked as a nurse with Hospice for 3 years, and, quite frankly, I don't understand this. Withholding pain meds? And violating doc orders? We NEVER withheld pain meds from a patient. In fact, pain control was one of the primary goals and if we had to go up in dosage, we did. If the patient needed a sleep med because of pain, it was given. If the doc wrote an order and it was within appropiate dosage and time, it was done. A doc didn't write an order, and some nurse decide everyone needs to ignore it. I can imagine the team meeting on this patient must have been quite would have been to me. This is an issue that needs to be addressed. Something is going on here...and it's wrong.
  4. by   nurseinnystate
    Oh boy, is this ever an interesting situation. I just love how they say "you aren't suppose to do this because you are agency".... BULL..... I was working in a facility one day when the state was there. This woman walked on the floor with the Director of Nursing. She proceeded to ask me a question and want the answer. The director piped in and said, "She's just an agency nurse."....... the State woman then said, "So what, a nurse is a nurse, you have her on staff right now caring for your residents, therefore is responsible for each and everything your facility hired nurses are." Inside i just giggled to myself because that is how lawyers, judges, state personnel, and the outside see it..... therefore we best be aware and act in that manner...... YOU absolutely were correct in writing in that communication book. You absolutely had the right to communicate...... this was an important issue that needed resolving and you wouldn't be a good nurse if you ignored what you knew about the patient. That hospice nurse, if she were being professional would have appreciated your input...... where do people learn that if someone disagrees or has another point of view that it is a personal slam...... it's not....... we as nurses are problem solvers and you were just doing your job as a nurse....... they have no right to dnr you because you communicated somthing . you saw that they were assuming one thing , when you SPOKE to the patient so had another point of view.......that facility can put you in CHARGE? but not allow you to write in the BOOK?......... they should be ashamed of themselves....... that is where your manager of your office is vital to your career...... My agency is there for us to the best of their ability to defend us or attempt to..... I wonder if they could put some pressure on the facility to change their mind? Show them this can't hurt right?........keep your chin up.......... remember the first person they try to blame is the "agency nurse"....its one of the very few downfalls of this line of work....... Best of luck to you and keep me posted because i do truly care about your outcome..... perhaps we can all learn from this in one way or another.

  5. by   bluesky
    Quote from LadyNASDAQ
    You should never take a problem like that into your own hands. You pass it off to your Recruiter and they decide what should be done.
    The problem is this... you are not an employee. You are now thinking staff vs. agency. Your job is to do the job and go home. You are now getting into politics and shouldn't be involved with their problems and issues. Whatever the Hospice Nurse does, she is responsible for and it's possible the family has some input with what was ordered. Whatever happened, it's always a learned lesson and then you move on.
    Wow. Sorry but I couldn't disagree with you more. An agency nurse is still a nurse and a nurse's first priority is the wellbeing of his/her patient.

    OP, I applaud you for advocating for your patient. Shame on that facility for not having a clear cut set of orders. Shame on that turfy Hospice nurse for letting her ego and her pride get the best of her.

    If you were the only LPN in that joint it was NOT a safe place for you to be anyway. Getting DNR'd was probably a blessing in disguise.