No More Fingersticks for Techs!! - page 8
Is this happening where you all are? I live/work in New York City and work in a city hospital, and in the past few months, the BON sent a mandate stating that techs, CNAs, PCAs, etc...can no longer... Read More
May 28, '09Joined: Jun '06; Posts: 7,129; Likes: 7,794Quote from kidsbut that is not what THIS thread is about.....I am not at all opposed to delegating information gathering tasks to trained NACs. But I expect all of my numbers be reported promptly not just the abns. I also have the sense to recheck abn values before acting on them regardless of who obtained the value.
I can honestly say that in 20 years of nursing I've encountered far more nurses who falsified documentation or lied about giving a med than I have a CNA lying about VS.
Are you ready to start doing all your own lab draws too? The phlebotomy class offered by my local community college is 8 hours on a Saturday. My kid took it 6 months ago and was hired by the largest hospital in town 2 weeks later.
MAs are not governed by the BoN so any ruling has no effect. MAs are governed by the Board of Medicine.
Jun 3, '09Occupation: RN-working on BSN Specialty: Renal/Cardiac ; Joined: Jan '07; Posts: 201; Likes: 86At my hospital in Florida techs not only do accu checks but they also do insertion of foley caths--I as a nurse do not exactly feel comfortable with the foley insertion so I usually do them myself
Jun 3, '09Joined: Jul '08; Posts: 67; Likes: 50I work in Ohio for one of the largest hospitals and do the fingersticks all the time. Unlike other PCNA's I write them down so that the RN's have the exact figure. We have no ability to "chart" the numbers in the patients chart. I'm surprised to hear this. Any way for me to find this on the internet to show my nurse manager?
I wanted to add that we too use an "accu check" whereby it too downloads it into a main database whereby the RN's can review. Any issues and we can validate numbers, times, dates, etc through this database.Last edit by creativemom on Jun 3, '09
Jun 3, '09Occupation: CVICU RN Specialty: 4 year(s) of experience in CVICU ; From: US ; Joined: May '08; Posts: 72; Likes: 60I work in SC where techs/NAs do finger sticks all the time. With our system, the tech scans a barcode on the patient's identification band and then proceeds with the FS. The results are then downloaded into the patient's computerized chart. Before I ever administer insulin (or D5 in the event of hypoglycemia), I verify the blood sugar level in the system. It takes no extra time/work to do so since both the med administration software and the computerized charting software are both on my med cart. For me, it is no different than checking potassium levels before I hang IV fluids with potassium. It does, however, save me time when I have a heavy case load to have the FS done by someone else. As with anything we delegate, we, as RNs, are ultimately responsible for every aspect of our patients' care.
Jun 3, '09Joined: Jul '07; Posts: 42; Likes: 44Every hospital I ever worked in always had the CNA's do them. Once it is done, we chart it. If it is out of the "normal" range, we personally notify the RN after charting so the nurse can assess the situation.
Jun 3, '09Occupation: Clinical Supervisor, Wound Care Certified RN, Preceptor, Telehealth Nurse Specialty: 35 year(s) of experience in Neuro-Surgery, Med-Surg, Home Health ; From: US ; Joined: Mar '08; Posts: 256; Likes: 411>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>
Phlebotomists used to do the FSBG checks in our hospital here in San Francisco...Then about 10 years ago, they said something about accountability, so the RNs and LVNs were the only ones doing FSBG checks...Then the hospital removed all the LVNs from all the inpatient units and we now have only all-RN staffing.
Serum glucose are both done by RNs and phlebotomists but if the order is STAT, then the RN has to draw the blood unless a kind phlebotomist happens to be on the floor and agrees to draw the blood saving valuable time for the RN. The RN will then take the tube from the phlebotomist, prints the lab slip and calls for stat pick up.
That's just one of the ways you survive in a busy acute care hospital.
Jun 3, '09Joined: Apr '07; Posts: 2; Likes: 2In regards to the fingers sticks, I am an RN that has always done my own. I work on a primary nursing care floor. We do not have additional ancillary staff, so I am just accustomed to doing every task possible for my patients. It is all just a part of my daily routine of care. Most of the other floors in my hospital have nursing assistants who are responsible for the vitals signs, fingers sticks, and other tasks. I actually love working on my floor. I feel as if I'm closer to my patients and can really care for them on a 1 on 1 basis.
Jun 3, '09Occupation: LPN Specialty: 10 year(s) of experience ; From: US ; Joined: Mar '09; Posts: 6; Likes: 6In one of our local hospitals, the CNA's do fingersticks but in 3 others the nurses do it, but get this: Nursing students, such as myself, are not allowed! Luckily we got our "sticks" in before the rule changed.
I'm uncomfortable with this, and perplexed. I am not allowed to gather the information I need to give insulin, but I am allowed to administer a dangerous drug. Go figure!
Jun 3, '09Occupation: Mommy,Nursing Student,CNA Specialty: Med/Surg/Ortho/Uro/Rehab CNA ; From: US ; Joined: Aug '07; Posts: 54; Likes: 25yep, i worked in a hospital in colorado and as of a year ago we let cnas/pcts do fingersticks.
i had to take training to be able to do it and always wrote down the numbers for the blood sugar just incase something screwy happend to the docking electronics (which occasionally did:smackingf). i really loved doing fingersticks (no really!), call me crazy (and i'll probably get sick of them later), but it feels kinda "nursey" (compared to regular cna tasks i suppose) and it just felt really good to have that extra knowledge and be that much more useful.
can anyone tell me why at a huge hospital that is connected to a level ii trauma center and a brand new childrens hospital right next door would only let cnas on rpcu do fingersticks?
((since then i've moved to a more affordable small town w/ a great nursing program and only a one semester waitlist (i guess not a whole lot of people want to live/ go to school by the colorado/nebraska/kansas border- about 2hours from denver, lol. i can stick it out for a few years til i move to phoenix :vlin:.)) i now work at a nursing home where cnas arent even allowed to take vs unless the nurse is busy and can't do it herself and we can't fill o2 tanks, basically we are there just there to toilet, dress and feed. even a whisper of a cna doing a fingerstick would be a stupidly hideous suggestion. they don't even let the cnas sit at the nurses station there which also baffles me.
Jun 3, '09Specialty: 31 year(s) of experience ; From: US ; Joined: Jan '09; Posts: 20; Likes: 46I would love it if they made the nurses do them but they have not where I am. RNs have given too much away. If I am going to give insulin I want to make sure the fingerstick was correct.
Jun 3, '09Specialty: 31 year(s) of experience ; From: US ; Joined: Jan '09; Posts: 20; Likes: 46Quote from pagandeva2000I am not sure that is ethical... at least in my eyes. Why would you subject the patient to a second stick? If you can't trus the first one, do it yourself all the time. I say the nurse giving the insulin should do the stickIf I administer insulin, I am doing it based on the reading reported by the UAP. Now, I see that I have to be more careful, do a secondary stick myself to be sure and make sure that I report it to the physician or the RN I am working with so that we are all on the same page.
Jun 3, '09Occupation: RN & Critter Mama From: US ; Joined: Feb '04; Posts: 4,977; Likes: 20,733Quote from rainyannDo you run your own labs before you give potassium? Why are accucheks and insulin so different? Do you do ALL of your own vital signs? What if that tech that's too incompetent to draw a drop of blood did a bad blood pressure reading? Or held the thermometer in the wrong place and didn't catch a 39.8 fever? If you don't do EVERYTHING yourself, bad things could happen. Of course, while you're doing EVERYTHING yourself, you could be failing to save because you're busy doing something that a tech could do instead of doing an extra assessment that only you as the nurse could do.I would love it if they made the nurses do them but they have not where I am. RNs have given too much away. If I am going to give insulin I want to make sure the fingerstick was correct.
Jun 3, '09Occupation: Licensed Practical Nurse Specialty: Community Health, Med-Surg, Home Health ; From: US ; Joined: Sep '05; Posts: 9,297; Likes: 8,221Quote from rainyannI work per diem on med surg floors and each unit has different rules, so to speak. Some require the CNAs to go directly to the medication nurse to inform them of the fingersticks immediately, no matter what it is, others don't come at all. Some do it even if it was requested that the nurse do it. I'd rather do a second stick under confusing circumstances if I had to administer insulin. Now, it is a mute issue since they are not allowed in my hospital any longer.I am not sure that is ethical... at least in my eyes. Why would you subject the patient to a second stick? If you can't trus the first one, do it yourself all the time. I say the nurse giving the insulin should do the stick