Duties not related to nursing.

nursesteph · May 4, 2002

I agree. They kill us with paperwork & we need to be with patients. I'm sorry, I don't think there is a good answer to this dilemma, or a change anytime soon. Keep the faith, we are needed and valued, somewhere....:)

micro, RN · May 4, 2002

and i must say, we never took seriously the clause that so prudently and blatentlySTATED THAT WE MUST...............

BUT THEN I AM ELDERLY.....AND repeat myself.......the younger generation can keep this thread up...........

cause we are nothing but for our kids anyway.................:kiss :roll :)

2ndCareerRN · May 4, 2002

Such as check the extra oxygen tanks to be sure they are full (daily),

I personally check the O2 bottles on my main 4 gurneys (2 trauma beds, 2 cardiac beds) at the beginning of every shift I work. I make sure my ER tech checks all of the other ones. I would hate to need the O2 and have it run out, or not be there.

check the crash cart for outdates (monthly)

Who restocks the cart if it is used? I would bet the pahrmacy does. But, if your facility is like the small one I used to work at, there are more than drugs in the cart that expire. It seems to make sense that a nurse from the unit check the cart to ensure all of the fluids, etc are still good. Once again, I would hate to need something right now and have to wait because the material in/on the cart is outdated. I also feel the pharmacy should be responsible for ensuring drug correctness and not being outdated in the med drawer.

We also have a fall risk paper we are suppose to fill out on each person who is admitted. Some of the questions on there are about gait and changes in gait that are more geared for a PT person to determine than a nurse.

Every pt I ever admitted to the floor, or into the unit at my last job I did a fall risk assessment on. It comes with doing an initial assessment to the floor. What ever I can't answer, I don't. One thing you do not want to have happen is have a pt take a tumble on the way to the potty or wherever and not have the fall assessment finished to the part you can say the pt is not at risk for falls.

on admission if anyone shows S/S of infection we are suppose to fill out a paper for the IC nurse

Why not have the infection assessment as small part (yes/no) of the admisson assessment and leave a voice mail for the IC nurse to assess the pt furthur? Just a random thought.

Most of the things here I can see as something the unit manager or assistant could and should be doing. There is no reason why the cart check, if only done monthly, cannot be done by one of them. The shredding of paper can be done by the unit secretary, if you have one, just keep a box of shred to be done daily.

So, as you can see, because I work the ER I feel that some of the things you protest are actually my responsibility. It is obvious that a small med/surg floor will have different priorites. If you have CNA's or unit secretaries, use them. As a nurse you should be able to delegate the jobs that you feel can be farmed out.

Now, I will tell you why I feel the crash cart should be checked by a nurse. Last week I went to a code on the med/surg floor @ ~ 0300. This pt had a full knee replacement earlier the previous day, so he was less than 18 hours post-op. The code was called because he was unresponsive. He was a LARGE man, on his back, had been receiving MSO4 all day, IVP and PCA, and most likely sleep apnea. Upon arriving in the room less tha 2 min after the code was called, the crash cart was already there. It did not have an Ambubag on it, the scope blade the Dr. was going to use to intubate with did not have a bulb in it, and the med drawer only had a 0.4mg ampule of Narcan in it, instead of the two 2mg amps that should have been there. So we now have a man in resp distress who we can not bag, nor enough Narcan to see if that would help. So, RT runs to get a bag, the floor nurse runs to get me a handful of 0.4mg ampules of Narcan (only Narcan that was on the floor, the 2mg amps are in the cart) and did I mention, there were no pads for the defib...glad we did not need that. Luckily the first .8 of Narcan helped a little so we did not have to tube him. It took another 1.6 mg to arouse him enough to talk to us..and then more as it wore off. The policy on this floor is to check the cart daily, but had not been done for over a week.

I hold the unit manager responsible for this, we could have been in deep doo-doo very easily with this situation. So, not only should a nurse who knows what should be on there check it, but also held accountable if it isn't done. If that means assigning the task, than so be it.

I have now put on my Nomex BVD's, so flame away if the urge strikes.

As always, the opinions expressed here does not represent the opinion of the site administrator, the moderators, or your local broadcast station, but are the opinions of the author.

bob

micro, RN · May 4, 2002

bob as you can already tell by the hour of the day or morning, etc............

i am probably not functioning at my best capacity......but am at at home and have my WOW WHAT A BONUS.......US NURSES GET EVERY OTHER WEEKEND OFF.................

so for you lay people out there..............we only get to chill for two days straight .....q o wk.................and you wonder why we get so stressed and so out of whack...........

but love youall..........., cause probably most of you have gone this way before i..........something like a a star trek voyage............................

**canoehead, BSN, RN** · May 4, 2002

I also like nurses to check the cart, but pharmacy outdates, and housekeeping they can keep for someone else.

Micro, are you sure you are on the right thread, you are making less sense than usual.

NicuGal, MSN, RN · May 4, 2002

We do a lot of extra paperwork too. We check O2 tanks, make sure the crash boxes are locked, check med areas, check all 12 fridges and freezers, check transport equipment, and have about 15 pieces of paper on admission. For the misc. stuff we assign those duties to one person per shift and they are responsible for doing the checks.

Home Health Columnist / Guide · May 4, 2002

Agree with Bob 100%...code cart is RN's responsibility.

HATED when I needed to use cart, ambu missing or scope blade not replaced after last code. The more frequently you check the cart, more familiar you are where items located for use during a code. It should take you ~ 5 min to check supplies. Pharmacy should be responsible to check med expiration.

Combine other assessments: infection control, falls, need for Social Work/Discharge planning as part of admission forms.

Paper shredding goes to unit secretary or nursing assistant; if no positions then enironmental services; if hospital small, then shred while on hold with docs.

I come form the "good old days" pre computer when nurses + aides were the only ones in the hospitals off-shift, everything was hand written, and we had ONE orderly for entire 250 bed hospital---only on middle shift. WE made it by banding together for the good of each other and our patients.

Current central intake position in homecare agency has no shreeder in our office. We use our hands to rip up info. "Good wrist exercise, different muscles used than typing" stated boss. Shredder located in back storage closet other office area and used only on monthly basis to destroy copies of forms by Medical Records.

HOWEVER, as new HIPAA Privacy officer, I will be recommending shredder's in our office AND relocation of main shredder to Medical records back room with clerks doing the shredding. Not immune to shredding while waiting in line for copier...it's how a team get's work done.

kaycee · May 4, 2002

Our crash carts our locked so we don't check the contents. I work ER so we use them enough that nothing ever expires. When we use it, we send the whole cart to the pharmacy they send us one back, loaded and locked. Our ER techs check our critical care areas for supplies and as the charge nurse I check with them so I know everything we need is there. Our techs are good though I trust them to do thorough checks.

Our triage assessments are now 3 pages long with what JCAHO wants. We do pain assessments on anybody with pain above a 4. We do nutritional assessments, risks to fall and decubiti assessment . It's really quite ridculous the amt of paper work we all have to do because of JCAHO. That's a whole other topic.

Our secretaries shred paper and the techs clean the fridge(nurses help if we aren't busy). Everyone is responsible for cleaning up after themselves. Anyway my point is, you are not alone. I don't think nurses should be assigned cleaning duties. Nothing wrong with helping when you're not busy but no cleaning assignments. As far as the paper work, we all got it and we all hate it. Nothin gonna change there! As nurses I'm sure we've all felt frustrated because we are frequently a secretary, an aid, a phlebotomist,a housekeeper, sometimes the doctor, when is there time to be the nurse.

I understand your frustration. Wish there were answers. Anyway do the best you can and be a nurse first the rest of it can always wait!!

deespoohbear · May 4, 2002

We do "code team" nurse who does check the crash cart for ambu bags and stuff like that, but nursing is responsible for checking for outdates every month. I feel that this should handled by the pharmacy. Our crash cart doesn't get used very much, so things will outdate before they are used. I think pharmacy should be responsible at the end of each month to come to the floor and check the cart for outdates. When I orient a new nurse one of the things I tell them is to make sure where the crash cart is kept. I also tell them to take the time and open the thing and look and see where all the drugs are located. The crash carts throughout the hospital are all suppose to be stocked in the exact same way.

I guess I just feel that if everyone else was doing there job, not so much would be dumped on nursing. Our hospital philosophy basically is to pass it on to nursing if you don't want to do it.

About leaving the fall assessment thing blank in spots, that comes back to haunt us. We will get the chart back from Medical records with a little a note on it saying that we didn't do it. DUH! So, I might as well just fill it out the first time and not have to mess with it 2 months later.

My biggest complaint with all this paperwork is that no one ever asks the floor nurses about how to make it more streamlined. The bigwigs just sit in their office and make these decisions without asking us and how it will effect our workload. I know some of this stuff comes down because of lovely JCAHO regs. But some of this stuff is just passed on from other departments and managers who think nursing is responsible for the whole hospital. Shoot, we have an administrator is get upset with the nursing staff if the census is low. He actually thinks it is our fault when there aren't enough patients. I haven't ran into a staff nurse yet who has admission priviledges at our hospital. And that is what I tell the administrator. Not much he can say that one.

**canoehead, BSN, RN** · May 4, 2002

Nurses are always being asked to do just one more thing for other depts, and all those things "only take a minute" but we keep being unable to say no so are stuck with about an extra hour of other dept's work each shift.

And now that we are doing it they will say it is not cost effective to hire someone else to do it- after all nursing is the only profession that CAN do it all without extra training.

Fgr8Out · May 5, 2002

Our admission assessment form is now ONE PAGE!!!! Just a few simple questions regarding health history, etc.... We chart on computers, and changes were recently made that actually eliminate the aforementioned form if we answer similar questions during our computer assessment. If something does come up (fall risk, social service needs, etc...) it triggers to the appropriate Department.

Our Crash Carts are locked. Outside the cart is a label placed when Pharmacy puts in the medications, that lets us know the earliest expiration date of any of the drugs. We have the cart sent back to Central Processing if a cart has a label about to expire. Nursing does do a daily check of the Cart, making sure the suction/defib work and we have a quick check list to make sure all relevant parts are there. Time total to check is maybe 3 minutes.

I agree Nursing is put in the position of playing "clean up" for the Hosptial "team" because Nursing is right there whenever something might need attention. But it would certainly be nice if Houskeeping, etc, were more readily available so Nursing would not have to feel the need to perform these duties.

Peace:)