can my DON force me to work the floor?

[glm777]

I need some advice. I have been an MDS coordinator for the past 21 years. Due to some restructuring in management, it looks like I might be put on the "on call" rotation. For my building, the on call person usually has to go in and work at least one shift per weekend on call.

Now, I have not worked the floor in 21 years. I am not up to date on the current meds, equipment, etc. As it is, I do my MDSes with a drug book nearby since nearly every med is now in generic form. I haven't done trach care, IV meds, tube feesdings, etc in 21 years. I am truly afraid that I might hurt someone...or worse! I'm also not familiar with much of the paperwork that needs to be completed such as incident reports, SBAR, Interact to name a few.

I am so against this I can't even tell you. I have at least another 40 years to work and I truly feel that I would be risking my livelihood and my residents' lives by trying to give meds, tube feedings, treatments, etc after not working the floor for so long.

When this first came up we were told that "we are all NURSES" so we can all work the floor. I disagree. Yes I am a nurse and my license is the same as every other nurse, but I certainly wouldn't want my mother to get dialysis from a nurse who's area of expertise was not dialysis! But hey, we're both nurses, right, so why not????!!

I'm really just wondering what my legal obligation is to my company. Can they legally force me to do something that I am so uncomfortable with and that I truly feel puts my residents at risk? Can they fire me for not agreeing? I thought the nursing standards of practice made it MY responsibilty to NOT do something that I do not feel qualified to do. I would rather lose my job than make a mistake that hurts or kills someone.

I'd be interested in hearing what others think or about any experiences like this. Thanks so much!

[AZMOMO2]

Yes they sure can force you to do anything that is within their scope. I would suggest that you request an orientation to the floor and a few days on the floor prior to being thrown in on an on-call basis. Not much has changed over the years, you are still working with the same paperwork. Unless they have gone all electronic and you have not accessed a MAR or a Chart in 21 years, which I doubt, I have seen many an MDS coordinator come and take MARs and Charts from our unit.

Generally there is a list of meds, that can not be crushed etc, on the cart, as well as every cart has a med book in it. Tube feedings are still the same, check-placement, head elevated, flush, fill, primp, start. Paperwork is pretty much the hardest part, but people are usually there to help with that and you know enough to ask the questions you need to about which paperwork you need help with during an orientation period. (4 weeks is pretty excessive in LTC and I doubt they would even give it)

Of course I don't blame you for just not wanting to go onto the floor, but hey nursing is all about learning.

[46oldnewrn]

At my job, we are frequently getting calls off, and we need the help to cover nursing positions. We went to computers last year, and since then, not a single office nurse has helped us on the floor. I think you should do the orientation, and get used to it. Also what if there were an emergency and they immediately needed an extra floor nurse. You have had a good long ride of the MDS job, so it will only be maybe two days a month, that is even IF you are called in.

[elkpark]

I certainly sympathize with how you feel, but every nursing job description I've ever seen, over many years in many different settings and roles, has always ended with the "magic" statement something along the lines of "... and other duties as assigned by your supervisor." That's where they've "got" you.

[Nascar nurse, ASN, RN]

I was an MDS coordinator for over 10 years and always had to be part of the on-call schedule. It really isn't fair that any one nurse in the building should get exempt from anything but their own duties - that's just not the reality of this business. That is not to say that you should be taken advantage of either. I probably ended up working 3-4 shifts a year while on call. The most ironic part of it all was although I dreaded it when I knew I had to go in, and I was very slow/rusty...I always ended up enjoying my day on the floor. It is easy to forget why we became a nurse in the first place and working the floor was always a great reminder of that for me. Heck I'd go back to it in a heartbeat if I could only make the same $.

[imintrouble, BSN, RN]

I wonder if they would expect the surgeon who has only seen pts in the office for 21 years, to perform major surgery once a month?

[Nascar nurse, ASN, RN]

I wonder if they would expect the surgeon who has only seen pts in the office for 21 years, to perform major surgery once a month?

I would expect the surgeon, who is being paid by the surgery department, to keep his/her skills up to date as a condition of employment. As new procedures or equipment becomes available I am sure there has been education provided at the time that services are implemented.

You know, I'm not really speaking out of turn here. I actually was an MDS coordinator for more then 10 years. I did find times that I felt I was falling out of the loop. It was my responsibility to get up out of my chair and go seek information. After all, if I was writing most of the plan of care I ought to really know what care was involved. This is simply good nursing practice.

And, I just bet that surgeon was part of an on-call rotation too!

[sunny4you]

Totally agree with your last statement....

[ibtootie]

Does Safe Harbor apply to SNF's?

[glm777, BSN, RN]

If you had read further you would have seen that I clarified my earlier post to say that I said that refering to the fact that it seems like I will never retire due to a recent divorce. I didn't think it would be taken so literally and that folks would be counting. And it actually has no bearing on my original question.

[morte, LPN, LVN]

If you had read further you would have seen that I clarified my earlier post to say that I said that refering to the fact that it seems like I will never retire due to a recent divorce. I didn't think it would be taken so literally and that folks would be counting. And it actually has no bearing on my original question.

OP, has it goin'?

[gcupid]

Either ask for orientation or move on....

[TheCommuter, BSN, RN]

Does Safe Harbor apply to SNF's?

No, it does not. . .and Safe Harbor can only be invoked in Texas. Safe Harbor does not exist in any other state in the union.