Last night a pt smuggled blades into her room. She was found with slit wrists, bleeding all over.
I'm wondering if it's possible to refuse work on a unit. I'm designated as a Float nurse (not what I asked for), between two units that I like, and somehow I got floated to unit that is nearby but not 'mine'. Thing is, the unit is totally out of control. When we took report yesterday, the day shift nurse had tears in her eyes, saying 'I don't know what's going on anymore", because the hospital is going thru a philosophy change and some rules are being bent, some not enforced, etc. Nobody seems to know what's going on! Example, apparently a teenage pt has made multiple sexual accusations against both male and female staff. I have not been on this unit in months, and no one told me. So of course, I'm doing an assessment behind closed doors for privacy, and a nurse comes in a reprimands me and warns me about being alone with pt. In fact, her words were, 'next thing you know, you'll be looking at child molestation charges'. And NOBODY warned me!
The unit is not safe, this has been going on a long time. Tons of potantial liability b/c no one knows the new rules versus the old rules. The regular nurses say they have begged for support from admin, and haven't gotten any. Do I have to work on an unsafe unit?
If leaving this facility is not an option, then make sure your documentation is acurate of all events that are going on around you. Make sure you ask if there are any special precautions to take with certain pts. Things can easily get left out of report from the previous care giver. As others have suggested, set up a meeting to talk with NM, supervisor, DON, etc. whoever it takes to explain the situation with them. Document what was said. Cover your butt. Keep a journal at home and write what happens in your shift while it's still fresh in your memory. Get a list of new protacols for your floor and request that you recieve it in writting. Make a copy for yourself and keep it with you for reference should you need it at work. I would make sure I have every angle covered to the best of my ability.
If leaving this facility is not an option, then make sure your documentation is acurate of all events that are going on around you. Make sure you ask if there are any special precautions to take with certain pts. Things can easily get left out of report from the previous care giver. As others have suggested, set up a meeting to talk with NM, supervisor, DON, etc. whoever it takes to explain the situation with them. Document what was said. Cover your butt. Keep a journal at home and write what happens in your shift while it's still fresh in your memory. Get a list of new protacols for your floor and request that you recieve it in writting. Make a copy for yourself and keep it with you for reference should you need it at work. I would make sure I have every angle covered to the best of my ability.
My school gave--I mean, sold--each of us a copy of the Nurse Practice Act for our state. I would imagine most states have them available--you might check the campus bookstore at the nearest school of nursing. If that doesn't answer your questions, a consultation with an attorney might not be terribly expensive. Many lawyers around here will see you for an initial consult for $50 or so--a small price to pay, to protect your license and peace of mind.
One thing I always do whenever I float to another unit, is that during report, I tell the nurse that I am floating, and is there anything I need to know to do or check for for that patient that I might not know to do, because that isn't my usual floor. I ask this question about all the patient he / she reports to me about. Also, in the State of Texas, we can declare " safe harbor " in which we still float to another unit, however it is under official notification that we don't feel believe we have been adequately trained to work on that unit. It seems to me that if you don't know their rules / procedures, that maybe you could declare this. At our hospital, then the house supervisor on nights or head nurse of hospital on days, would be notified, and would come talk to us, and then let us know if we were the only person or not that could fulfill the hospital's needs at that time, and if so, then a form would be filled out and kept with the hospital. The idea is that if a lawsuit were to be filed on you at a later date concerning something that occurred that day, that that would be in the record, and would be beneficial to you -- that you didn't feel adequately prepared or trained to work on that floor, and that the head nurse of the hospital who was in charge at that time, had been notified.
PANurseRN1
1,288 Posts
Is this the same unit as the one with the "gross out co-worker"?