Covering tele for a non-tele nurse

[grouchy]

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.

[pickledpepperRN]

If a patient has an order for continuous cardiac monitoring that patient needs a nurse who is educated and experienced in the recognition and treatment of an abnormal rhythm.

I work ICU, telemetry, and med-surg.

I would, and have, agreed to float but NOT to accept assignment of responsibility for patients.

Since we have the ratio law if I float to mother-baby I can help a lot but cannot be counted in the ratio. Management has to admit the ratio was not met. And I am there working so clearly didn't refuse to "help out".

The California Board of registered Nurse has an advisory on floating. It includes that the competency standards to which the Board holds the RN accountable are specified in the Nursing practice Act.

The Nursing Practice Act and the Standards of Competent Performance apply in all settings where RNs practice nursing.

If the RN accepts an assignment for patient care and is not clinically competent, the RN license can be disciplined.

Nursing administrators, supervisors, and managers have a crucial responsibility to assure appropriate and competent nursing care to patients. The BRN requires nursing administrators, supervisors, and managers to only assign patient care to RNs who are clinically competent.

Nursing administrators, supervisors and managers may have their licenses subject to discipline if they do not ensure assignment of clinically competent RN staff.

Floating advisory: http://www.rn.ca.gov/practice/pdf/npr-b-21.pdf

Standards of Competent Performance: http://www.rn.ca.gov/practice/pdf/npr-i-20.pdf

[karenesn]

My Nursing Process IV Instructor, who was also a former Telemetry Charge Nurse, informed our class that you must inform your supervisor of your lack of experiance and request to be given orientation to the unit first, or be cross-trained. Find out what your hospitals Floating Policy is, before accepting the job. If you are still sent, write a memorandum in detail, as a written protest. Keep a copy in your own personal file, then send a copy to the Nurse Administrator. This will show that the nurse was attempting to act reasonably. It shifts some responsibility to the institution in case something goes wrong.

[heartbeat2]

I was a labor and delivery nurse that due to a broken knee could no longer work in my area. My hospital now lets me work as a monitor tech where I watch many patients on several floors: up to 48 patients at a time.

I have asked in the past what other hospitals do, and what their policies are. I know I look at things a bit differently because I am a nurse and have the liability so engrained in my mind, to do what's best for the patient and then myself.

I teach BLS, am ACLS certified even when I was working labor and delivery.

Also, does anyone have any suggestions on where/how to become certified in telemetry?

Thanks:redbeathe

[mama_d, BSN, RN]

We have med-surg nurses get pulled to our tele floor sometimes, and it makes me cringe. They just are not used to the ebb and flow of our floor in comparison, and are more likely to miss subtle signs of cardiac complications than we are, since we deal with it every shift. Not trying to dis med-surg nurses here, I hate getting pulled to their floor since it's out of my comfort zone and I'm afraid that I'm going to miss some subtle clue on one of their patients, since it's not my specialty.

Usually, all the nurses are aware of the situation, which patients are assigned to the med-surg nurse, and try to keep an eye on the monitor. Charge nurse is the one who is ultimately responsible, and who runs the strips for the chart.