Am I in jeopardy??

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:confused: I work in a small rural hospital and I have a great concern about where the line should be drawn as far as protecting my license. We are chronically understaffed in my opinion. On several instances, I am supposed to be charge nurse on the med/surg floor and watch a laboring patient in the L&D. How do I take responsibility for both of these duties at the same time? Is this right for this to be asked of me? I do not feel comfortable with it and made that aware to my DON and it hasn't happened in awhile. I just need advise on what I might should do if it happens again or am I just whining???? The DON seems to think so.....:smackingf

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No, I don't think that is right for you to be responsible for both of those duties. That is crazy. Your instincts and common sense are telling you that this is not right or feel comfortable. I hope your DON takes your concerns very seriously.

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I would make myself very familiar with the Texas BNE "Safe Harbor" Act

http://info.sos.state.tx.us/pls/pub/readtac$ext.TacPage?sl=R&app=9&p_dir=&p_rloc=&p_tloc=&p_ploc=&pg=1&p_tac=&ti=22&pt=11&ch=217&rl=20

and then I would look around for another job. Life is too short to be worried about someone doing that to you all the time.

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Specializes in ICU, ER, HH, NICU, now FNP.

Safe Harbor Rules

Safe Harbor Forms

(Note that these apply to Texas only for you out of Texas folks)

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I work in a rural hospital too where our floors are understaffed but they do not put a L&D pt on the med-surg floor. They will put some pregnant patients on the floor but not if they are in labor.

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Specializes in Peds Cardiology,Peds Neuro,Pedi ER,PICU, IV Jedi.

Sounds as if your DON needs a swift kick in the gluteal area. You worry about YOU. Don't worry what others "think"...they're not the one's doing YOUR job. And as others have said, if it continues - seek employment elsewhere.

vamedic4

sitting next to a gorgeous intern

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Specializes in Critical Care.

(FYI: for those not in Texas, Safe Harbor is a provision of the Texas Nurse Practice Act to protect against unsafe staffing.)

Two words, already mentioned here: safe harbor.

It's not supposed to cost you your job, but it might.

However, see my quote below: being a good nurse is not always the same as being a good employee. The BNE won't yank your license for being a "bad" employee, but they will in a heartbeat if you choose to be a good employee over being a good nurse.

To answer your question: yes, you ARE in jeopardy. Being in charge of 2 different units is unsafe. You knew that or you wouldn't have asked. The only solution: your license is more valuable than any job. And that license REQUIRES that if you are faced with the decision to EITHER be a good nurse OR a good employee: you choose being a good nurse.

Remember though, IF you declare safe harbor, you have to follow through with the nurse initiated peer review paperwork by the end of the shift. Make copies, keep copies, give copies to multiple supervisors, and send interoffice email to each of those supervisors stating that you gave them copies of the peer review request for a safe harbor review, print a copy of THAT email and take it and a copy of the safe harbor peer review home with you. If you have a standing peer review committee, give a copy to the head of that committee that day or the next: as soon as possible.

Discuss it with as many people in the chain of command as possible, but don't discuss it with anyone else. The more 'official' people that know about your peer review (safe harbor is, in effect, a request that your nursing supervisors be subject to peer review for their staffing decisions), the less likely they can sweep it under the rug.

What safe harbor does is shift the burden for the consequences of a short staffed shift to management. Everytime I've seen it used, a change in assignment is made. The liability is too high for management not to respond. I've seen DONs come in to work the night shift before as a result of safe harbor. But, this is key: if you have to invoke it, follow through with the paperwork even if the staffing situation is resolved, for 2 reasons.

1. If you don't follow through, then it didn't happen which means, if you are terminated, you cannot claim that the reason was a claim of safe harbor. If it isn't on paper, it didn't happen.

2. If you have to actually declare safe harbor, you want the staffing situation to be peer reviewed as it was BEFORE help was brought in so that a determination can be made by the peer review committee as to whether or not such a situation can be expected of you again in the future.

Safe Harbor is not a light decision. But, neither is the protection of your license.

(The first time I saw it used, the hospital I worked at did not have a standing peer review committee. One was created as a result.)

~faith,

Timothy.

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