Can clinical nurses review routine labs?

[Mithi26]

Im at an administrative position at a new department in the hospital. I previously worked at a Peds Heme/Onc Dept where as a staff nurse we reviewed all labs for patients seen the same day of appointment and we escalated/notified physician as necessary to physicians. Here at the new department which is an in Infectious Disease Outpatient Dept, all patients get labs once every 3 months, ideally before their scheduled appointment so that it is ready to be reviewed with patient when they are in clinic. What was happening is the clinic nurses would get preliminary labs sent by labcorp and drop it off on the ID Fellows desk, this was disoraganized, as Labcorp would send several preliminary results for the same patient before the final report finally gets faxed to us. These preliminary results would pile up and most of the time, wouldnt be seen until the final report for that same patient would be sent in.

We devised an action plan where we wanted the staff clinic nurses would review the preliminary labs and see if there is any critical values (a list of critical results was made by our Attending, to make sure nurses knew what the doctors considered critical), and if they met the critical value list then that preliminary report would be given to the ID fellow who would review and make a plan of action as needed. If the lab results on preliminary report dont meet the criteria for critical value as per the Attending, then it would be kept by the nurse until the entier final report arrives, which is usually 1-3 days after labs were drawn.

Now for the question, the staff nurses dont want to review the labs and have also complained to administration about this. They do not want to be responsible for looking at the preliminary labs and screening for critical values, before the final report comes out.

In my opinion, looking at labs and interpreting them is a critical thinking skill all nurses are supposed to have, and we learned this in school. The NJ Board of Nursing, doesnt have any specifics about this.

Any opinions or comments about this will be appreciated.

[classicdame, MSN, EdD]

geez Louise, all they have to do is determine if the lab values are elevated or depressed, related to normal values. They do not have to diagnose, just screen. Hospital nurses do this routinely. I think the nurses ought to justify their license. Just doing what the DR. says does not require a license.

[CrunchRN, ADN, RN]

As an office nurse I always did this and alerted the doc if needed.