Delegation Situation

First of all, here is a little background information...

The hospital I work at is part of a large health sytem and is undergoing major changes. Many specialty areas, such as cardiology and neurology, are moving to other hospitals within the system. Our oncology program is set to move to another hospital sometime next summer. Many of my co-workers in the outpatient department have left which has resulted in one secretary, one PCA, and no transporter.

The current and only PCA fomerly worked steady night shift and has a bit of an attitude problem, but she does have a decent work ethic. Our patients are scheduled for certain times throughout the day for infusions and outpatient procedures and enter our department through a short registration process. During this time, we have the patient sign treatment, insurance, and billing consents and obtain vital signs. The procedural patients are prepared and then sent off to their procedure. Traditionally, we had a dedicated transporter that did this. After he left, our former PCA's would do the transporting.

We typically have 5 to 6 patients at any given time--some receiving infusions such as chemotherapy or blood products and others having outpatient invasive procedures. Our manager decided that our sole PCA would do the registration process while the RN's transport patients all over God's creation in the hospital. However, this presents a problem when you have to constantly report off to another nurse and when multiple patients are being sent off to other departments. For example, last week I was off the floor for nearly 45 minutes transporting 3 different patients to radiology, GI lab, and pre-op holding. Each time I had to report off to someone different because other RN's had to transport.

I am perfectly fine with transporting patients, in fact I used to work as a nurse tech on a busy cardiac unit so that was a norm. However, I feel that as an RN in this type of setting and with some of the patients we have, it is unsafe practice for us to be constantly running off the floor. If the patient has chemotherapy or blood prodcuts infusing, then we most certainly have to go with them. Several other co-workers have also complained about the same thing. It is bad enough that we have to play secretary on most days too.

It is also important to know that our current PCA likes to complain--A LOT!!! We think this is why she is doing registration, and registration only, instead of transporting.

Personally, I feel that transporting (in this situation) is a PCA duty. In our fully-staffed past, if we had a PCA call-off we would register our own patients as they came in or when not busy. We can also obtain their medication and health history during this process which helps out the other RN's if they patient wasn't our own. This would be my proposed solution to this problem.

Does anyone have thoughts on this issue? Is there anyone in administration that has any suggestions on how I could approach our manager and try to resolve this issue?