Please share your tales, most especially those about WA state. I have newly joined a very lovely ALF that had no RN, just 2 LN's, 99 beds with a dementia floor. We have a Med Assist program for our assist only folks, nurses pass meds to 15-20 dementia residents, plus treatments for rest of house, including a handful of diabetics. One of the LN's is the Mgr-which I was happy to have since she gets 24 hr call, does the assessments and the worst of the paperwork. Eventually, I will manage QA. We also have a mgr of the aides who was a CNA herself. I am part of mgmt team, but out of the loop over some things that I am seeing would fall back on me as the RN. We are going to start training for Nurse Delegation, which the Director feels is our magic bullet, but someone else is doing the training and setting up the documents, obviously I am going to be going through the other 2 mgrs to hear about issues-they sign off incident reports, etc, I only see those that happend when I am working. Meanwhile, I work 3-12 hr shifts at a dead run most days-covering the house, when is there time for oversight? Now I do not want more responsibility-this job is not my life, my family is more important now and came back to direct care to work shorter weeks-but feel my license is the one that will be most in the line of fire here.
So I am answering my own questions here-much as I am really happy with a great group of sharp people, I keep feeling myself pulled more and more at risk. I also have an intense director who manages every bit of minutia-some of which I am a bit amazed she cannot trust her staff for, which I am also finding means she is too busy to talk about this big stuff. I am too busy to even talk about them during my shifts, and too exhausted or catching up days off to go talk about them.
Any suggestions for how you have seen Nurse Delegation work, I guess?
Jan 7, '08
I beleive that your licence is carrying the risk. Check with your state board, regarding delegation. I have to be the one to delegate if I am overseeing the client. I would be concerned. Kathi