What are the boundaries to help a pt that is not assigned to you?

RheatherN, ASN, RN, EMT-P · Jun 4, 2009

i guess i dont understand, why wouldnt you help someone, meaning the pt or the co-worker if they need it. Just because you are not the pt's primary RN, why would you not help if needed? that is why you are a nurse right?

or am i completely understanding this wrong?

-H-RN

rnmi2004 · Jun 4, 2009

If you have good teamwork, there are lots of instances where you'll help a patient that isn't specifically assigned to you.

When I'm charge, I usually take care of whatever the patient needs if I answer the call light. If another nurse is very busy, I'll pass meds or prn pain, nausea meds, etc.

In an emergency situation, if you're not helping with the unstable patient, you're covering the patients assigned to the staff that is involved in the emergency.

We have pretty good ratios where I work, which means even when I have my own assignment it won't put me behind to help out patients that aren't assigned to me.

Basically any time that it will take more than a few minutes for the patient's assigned nurse or aide to get to them, I'll take care of it myself.

classicdame, MSN, EdD · Jun 4, 2009

depends on how you define help. I frequently pop into rooms to silence alarms or respond to patient's personal requests. Taking a patient while the nurse is off the floor or otherwise engaged is fine if an appropriate report was given. But interfering with another nurse's plan of care is bad teamwork and may be a violation of the patient's privacy.

Medic09, BSN, RN, EMT-P · Jun 4, 2009

So far, you've all missed the point of the question.

The poster said she was reading on 'legal issues'. So the question was relating to 'duty to act', not to 'being a good team player.'

Academically, it's an interesting question. As posted, the patient isn't assigned to you; so one might think there is no duty to act. OTOH, the environment itself and simply being on shift and present might create a duty to act where the patient might otherwise come to harm (as distinguished from they needed help changing the TV channel). I'm interested to hear from someone who really knows the legal issues on this one.

nanacarol · Jun 4, 2009

Assignments are not stone walls. Patients and families are our customers, if a patient has a need an employee should respond to that need within that individual's code of practice. If you can meet the need I as an employer would expect you to handle it and then do a hand off to the individual to whom the patient is assigned. When we become so territorial that we feel comfortable walking away from a patient request because it is someone else's patient we have missed the mark. And to say we may intrude on another nurse's treatment plan says that we are not communicating care needs of our patients. Let's suppose that nurse dropped dead, would noone pick up those assigned to her for fear of not completing "his/her" treatment plan? Please, lets get over ourselves and see the patient as the driver of the plan of care, begin to collaborate and communicate. Nanacarl

FLArn · Jun 4, 2009

I would not give meds without checking with the primary nurse because we all know that sometimes meds don't get charted promptly (I work in a system that does not have computer med pass) so I would be afraid of duplicating meds. I also ask before getting another's patient out of bed as I am not sure of their ability to transfer/ ambulate etc. Anything that doesn't put the patient at risk I just do -- otherwise I ask first.

nanacarol · Jun 4, 2009

I hear what you are saying, but I am of the opinion that every nurse would ensure that the issues related to medications and intrusive treatments would be investigated as would any care need before the nurse or other intervening party implemented the intervention. A professional sees the needs of the customer as priority and intervenes well within the scope of practice and standards of care for those intervening. Nanacarol

cardiacRN2006, ADN, RN · Jun 4, 2009

Charge nurses have the legal duty to all pts, to make adequate assignments, and to even ensure the environment (lighting, clean unit) is safe.

I would think that all staff nurses have a duty to act, once made aware of a pt need.

If a staff nurse noticed a pt getting out of bed who shouldn't, then they have a duty to act to protect the pt from falling. If the same pt was s/p cath and had a hematoma because the primary nurse didn't check the site, then I don't believe the other staff nurses are responsible. Although, if the assignment was bad, and the nurse couldn't reasonably assess her pts frequently enough, then the charge nurse could be held responsible.

I bet your hospital has some kind of policy on it.

Medic09, BSN, RN, EMT-P · Jun 4, 2009

nanacarol, I agree with everything you've said. When I work, we are all regularly stepping in and getting it done for the patients.

That isn't the original poster's question at all. Please read the original question. It is about the legal realm of duty to act, and how it applies with patients not assigned to that particular nurse.

All the talk about the professional and moral thing to do obfuscates an attempt to arrive at understanding a question of law.

Oh, and if that nurse drops dead, as you posit; then she becomes the priority patient while everyone works the code, eh?

RNperdiem, RN · Jun 4, 2009

My unit had to address that issue when dealing with alarms from the central monitor.

We had fallen into the complacent habit of not being responsive enough to alarms on the other patients.

Now, we are expected to be more responsive to alarms and IV's and communicate more with the nurses when assisting their patients.

GrumpyRN63, ADN, RN · Jun 5, 2009

Oh, and if that nurse drops dead, as you posit; then she becomes the priority patient while everyone works the code, eh?

I actually worked a shift and the oncoming nurse dropped dead.. right in the conference/report room. We did all code her, for a very long time..she did become the priority patient. The (other) patients kept coming out of their rooms about the commotion. We basically shut the doors and pretty much ignored them during the whole time.... they all survived. It was pretty horrible.The next day pretty much all the pts got discharged or transferred and we closed the unit for a couple of days. No one could face unit and what happened. Hard to get past someone you worked with everynight now dead with an ET tube sticking out and a sheet over her. We were a small unit, close bunch, our manager and administration was especially sympathetic. There was no swat or rapid response back then. I don't even remember a code "team", yes anesthesia, med resident, no Icu nurses, we had to run the code cart. I would hope-- if that ever happened again, my fellow nurse/coworker would be the priority patient.