Covering tele for a non-tele nurse

mysticalwaters1 · Apr 21, 2006

What is my legal liability for covering tele for a non-tele nurse? I work on a short-staffed unit, where this is happening more and more often. I don't have time to assess and intervene on behalf of that nurse's pt, as my workload is maxed out. We are told all we have to do is "watch the monitor, and put a strip in the chart". I'm convinced that if something awful happened, and the case went to trial, a good prosecutor would have a field day telling the jury how I should have done more - alot more. Anyway, does anyone know the actual law -or any anecdotes-regarding this? It would be helpful in standing up to this dangerous practice.

I don't know but I would like to know the answer too. Our heart monitored floor was recently short and kept having non tele med surg nurses up. They were told the same thing another tele nurse would be responsible for the monitors. One med surg nurse floated there said nobody put the strip in the chart. So who's liable. I think the entire situation stinks! Should never be allowed but it does.

Toby's mum · Apr 21, 2006

I'm not sure about liability, but when non-tele nurses are pulled to the tele floor, they are told they do NOT have responsibility to pull the strip,& id rhythm--a tele nurse does this for them. They also would not be assigned to any one on major cardiac drips.

BKRN · Apr 21, 2006

What is my legal liability for covering tele for a non-tele nurse? I work on a short-staffed unit, where this is happening more and more often. I don't have time to assess and intervene on behalf of that nurse's pt, as my workload is maxed out. We are told all we have to do is "watch the monitor, and put a strip in the chart". I'm convinced that if something awful happened, and the case went to trial, a good prosecutor would have a field day telling the jury how I should have done more - alot more. Anyway, does anyone know the actual law -or any anecdotes-regarding this? It would be helpful in standing up to this dangerous practice.

I am a MED/SURG (non-tele) nurse-I have refused to be pulled to a tele floor. It is not fair to me or to the tele nurse that has to monitor my pts-I look at it as out of my scope of practice. Obviously these pts need to be on a tele unit for a reason! I do believe that the nurse "just responisible for watching the monitor and putting the strip in the chart" would be held liable if something were to happen.

TazziRN, RN · Apr 21, 2006

Non-tele nurses should not be caring for a tele pt unless they being paired with a tele nurse like an assistant.....in other words, the tele nurse should share the same load with the non-tele nurse, not have a load of her own and be expected to back up the non-tele nurse as well.

Freshman RN · Jul 18, 2007

Isn't this fraud of some sort? we just had this dicussion, if we are charging for this service shouldn't we provide it?

pagandeva2000, LPN · Jul 18, 2007

This is good to know; I am wondering myself. I am an LPN who just finished taking a basic EKG as well as the 12 lead interpetation courses. At my hospital, LPNs watch the monitors on the tele units. I am noticing that there is a sharp difference between how the readings look in the textbook verses strips from real patients. I work in a clinic at this time and wish to work overtime on the floors; however, I am leery about working tele as a monitor since I believe I need a bit more practice in interpeting the real deal.

I did hear that they have alarms and the strips turn red when there is a dangerous rhythm, but I have to see for myself before I actually take on that responsibility.

WOLFE, BSN, RN · Jul 18, 2007

Are there monitor techs watching the monitors?

meandragonbrett · Jul 18, 2007

Isn't this fraud of some sort? we just had this dicussion, if we are charging for this service shouldn't we provide it?

How would this be fraud?

Sisukas · Jul 18, 2007

If the alternative is no nurse at all, tele nurses need to work with the non-tele nurse. As a med/surg nurse who floats to tele, I can tell you that at first I was given some attitude because my teles needed to be charted by the tele nurse, but enough times of pointing out that if not for my help they would each have one more patient to assess, medicate, chart on, etc stopped that nonsense. Now I work float team and have my ACLS and so can do more, but I still remember the stress from 6 years ago.

Obviously, assigning appropriate patients is key; usually there are some medical patients on tele floors due to lack of medical beds; some tele patients have DNR orders and those a good ones for his/her assignment; tele patients in a stable rhythm who haven't changed in the past 24 hours or so are appropriate; and a good clinical coordinator or charge nurse will know where her float nurses are and make herself as available for back up as possible.

Freshman RN · Jul 19, 2007

fraud?

because if you are charging for a tele bed and not providing that service by competent staff wouldn't that be fraudulant???

We can't charge patients for meds or procedures that we don't do and we can't charge patients for services provided by housekeeping if they fall under medicine.

What if medicare audited,found one incident and looked further and found out this was the practice?

loriann, BSN, RN · Jul 29, 2007

If the alternative is no nurse at all, tele nurses need to work with the non-tele nurse. As a med/surg nurse who floats to tele, I can tell you that at first I was given some attitude because my teles needed to be charted by the tele nurse, but enough times of pointing out that if not for my help they would each have one more patient to assess, medicate, chart on, etc stopped that nonsense. Now I work float team and have my ACLS and so can do more, but I still remember the stress from 6 years ago.
Obviously, assigning appropriate patients is key; usually there are some medical patients on tele floors due to lack of medical beds; some tele patients have DNR orders and those a good ones for his/her assignment; tele patients in a stable rhythm who haven't changed in the past 24 hours or so are appropriate; and a good clinical coordinator or charge nurse will know where her float nurses are and make herself as available for back up as possible.

I think that pretty much sums it up. I work on a tele floor and we had a non-tele float down a few times and they were given the med/surg type patients who were stable in their rhythms. I think all the beds in my hospital have tele capabilties, its just that not all the nurses are trained to understand the rhythms, how to treat, etc.