On the unit where I work, it's the charge nurses job to note all orders. This includes making sure orders are in the computer and on the Kardes. THIS DOES NOT INCLUDE checking the MAR. The primary nurse is responsible for getting MAR changes done, but does not have to sign the order. Same plan goes with the 24hr chart checks, the charge does the computer and Kardex, the nurse does the MAR.
I say this goes against the Nurse Practice Act (Tx). If you sign off an order, you are responsible for the computer orders, kardex, AND MAR. Whose to say the primary nurse saw the medication order, or to despite you, or due to laziness, just didn't follow through. I say whoever signed off the order is responsible.
My nurse manager disagrees with this, saying that if everybody checks the MAR at the begging of thier shift with the Kardex, we won't have a problem. Problem is nobody checks the MAR with the Kardex.
I would like to hear thoughts and comments on this. Am I too anal retentive and compulsive?