Patients on different floors ????

[JamesLPN]

Hello everyone !!! This is my first thread, I've been an LPN for close to three years now and have worked at the same facility since graduation. They started to do something that I find rather questionable. Is it legal to have a set of patients on two different floors? They recenty started this trend on their overnight shift. I find it rather unsafe. I usually work mornings, but sometimes float to nights. I cant imagine how this can be safe in any way. The nurse from the night shift looks constantly worn out and tired after going up and down the stairs all night. Just so I can paint a clear picture for everyone, down stairs is our rehab, upstairs is LTC, each floor has one nurse assigned to a set of patients, and the remaining third nurse has patients on both floors. I personally refuse to do it. I have had my license for almost three years, and plan to keep it that way. What if something happens while the nurse is on the other floor? Has anyone experienced this before?

[vanburbian]

For CNA's I know a facility that does this, but for nursing, not so much unless they assure me and had a written policy indicating that while you were gone from your assigned patients on one floor, that other nurse was solely responsible for anything that may happen and for monitoring them.

I'm sure that is impractical, and IMO, so is this sort of assignment.

[JamesLPN]

I wont do it. I never imagined that we would risk someone's well being to save a few $$$

[vanburbian]

I did have another thought just now....in ED, we have nurses who float all over, and they simply do interventions prn, or cover lunches, help out as needed.

Maybe if this 3rd nurse did not have a patient assignment, but instead had a specific set of tasks like a med pass, or vitals, or wound care assigned by the other non floating nurses, this could work??

[kool-aide, RN]

One of the hospitals I work at does something similar to the CNAs. This hospital has two med/surg units, on it general m/s and the other is ortho/neuro and they're on the same floor and share a nurses' station. Imagine an "H" with the nurses' station being the crosslink in the middle and the left being ortho and the right being m/s.

Not long ago they ruled that if there was one CNA for each unit on night shift, that the CNA on the unit with less pts would pick up the difference on the other unit to make CNA assignments as equal as possible. Well, it's awful. Even though the units are on the same physical level, the rooms aren't THAT close together and it's easy to get caught up on one side and neglect the other-- Especially because the specialty on the ortho unit is hip and knee replacements! Those pts are super time consuming. It's not safe and very hard on staff! The RNs do something similar to this...

[dscrn]

This sounds like a really BAD idea...I would never accept assignment on 2 floors for the same time period...

[Mom2boysRN]

I work in a snf and if they have someone call off on nights they will commonly pull the nurse from the dementia unit to work on one of the other floors and a nurse from another unit is supposed to cover the dementia unit for the night (basically leaving that unit without a nurse) .

[xtxrn, ASN, RN]

While it's not ideal, it's not illegal- the floors both have nurses on them. It's not any different than a spread out facility having one hall that has coverage from another wing, but a CNA there at all times to alert the nurse if something goes on before he/she comes down for scheduled meds or whatever.

[xtxrn, ASN, RN]

I wont do it. I never imagined that we would risk someone's well being to save a few $$$

This is the medical and nursing profession. Money is the bottom line. They do have people who look at the risk of policies. While it may be inconvenient, the patients have the other nurse around :) Nobody's well-being is risked when there is another licensed staff on the floor- unless you have staff working who would refuse to help in an emergency until you got there- then THAT is a problem with that nurse- not the practice.

You can have staffing like this, or give up CNAs. That will be the answer. It is about money (and that stinks). But this is very doable- especially on nights.

It will work out- and you'll get a routine down if you decide to stay :)

[~Mi Vida Loca~RN, ASN, RN]

I wouldn't do it, doesn't seem safe at all. Now if it's the same hall on same floor but technically 2 different units, then sure. But to be having to go to different floors for your patients while they are all your patients. Not like spending first half of shift with x patients, then second half you go to another floor with Y patients. Then that another deal. But for first deal,that's just absurd IMO.

[Rodoon, BSN, MSN, RN]

Wait, Up and down two floors? How can there be responsiblity for licensed people? If another license is responsible for that patient, I wouldn't go in the room normally, even if we shared the same floor unless asked, or to do something the other couldn't. I can see the staff disagreements growing in this place...

[MrWarmHearted]

when I worked at an assisted living facility, I chose to walk up/down 4 flights (rather than walking down the long hallways to use the elevator).

Look at it from the bright side - you have a job and you get to workout at the same time!