Hospitalists and how they interact with nurses

[alicern1950]

is it OK for hospitalists to sign off a patient to a nurse ? My friends who work in a hospital that has added hospitalists to the medical staff are alarmed that these hospitalists have been told to sign off to the nursing staff after they order their medication and do their H and P.

My nursing instructor always said that an RN signs off to an RN and an MD to an MD of the same specialty . My friends are worried that if they complain to their supervisors they will be "let go" or charged with malpractice if the patient has a bad outcome.

Has anybody else had this experience- I always thought hospitalists were a good idea but this changes my opinion.

[applewhitern, BSN, RN]

That doesn't even make sense. Surely there is a doctor assigned to each patient; the patient has to be admitted to somebody.

[SionainnRN]

So you're saying there's no doc assigned to the pt? If the start crumping no ones on their case? I find this very hard to believe. What did the hospitalist say when they left?

[toomuchbaloney]

I wonder if you are confused.

The hospitalist cannot "sign off" to an RN as the RN cannot manage the medical care of the patient. The patient in the acute care setting MUST have a prescribing and managing medical provider assigned to the case.

[jadelpn, LPN, EMT-B]

The hospitalist may sign off to the patient's PCP? Or the admitting MD? And advise the nurse of same? I would be the first to make sure that you say to the hospitalist "so any new orders or changes in condition are to be called to (PCP)?"

Usually the hospitalist is a convenience that works with a PCP to be able to round on patients, write some orders, follow up that type of thing. There are other facilities that have a mix of MD's, PA's and NP's who work from the hospital. I am sure that they can (???) sign off to each other.

It is not within the scope of any RN (who is not an NP) to be a primary clinician for a patient. I would address this directly.

[klone, MSN, RN]

You need to define what you mean by "sign off"

[nurseprnRN, BSN, RN]

klone said:

You need to define what you mean by "sign off"

I have worked c hospitalists and would greatly appreciate it when they would go to the effort of finding me before they left the floor to report off to me. That's not the same as delegating physician level of care to me, though.