Is it legal?

[CardiTeleRN, BSN]

Hi,

I work as a "floater" in a speciality outpatient clinic meaning I float to the speciality clinics, (I.e pulmonary, cardiology, etc). Recently, I was floated to work outpatient surgery. I wasn't trained or shown what to do initially, I just had to do it. I had to prepare the surgical materials (had no idea what I was doing so I mostly spent time asking other people where things were) and prepare consents and get the patients ready (gowned up). Then a few days later, someone decided to finally give me proper orientation to the unit and I got 1 hour of orientation and expected to function effectively from then on until they hire someone permanently for that outpatient department. I was told the work is easy and its simply preparing the tray, witnessing consent, and printing after visit papers since its outpatient. 

Only been a nurse about 2 years. Is this legal? I've never worked in this area, I've gotten 1h of orientation. It seems like its simple on paper but I'm not 100% sure. We have a union but they're not that helpful. I feel I would need solid case before approaching them. 

 

Sigh..So tired of nursing.

 

 

 

[klone, MSN, RN]

Legal? Yes. Safe? No.

Check your CBA to see if it addresses cross-training, floating, orientation, etc.

[CardiTeleRN, BSN]

2 minutes ago, klone said:

Legal? Yes. Safe? No.

Check your CBA to see if it addresses cross-training, floating, orientation, etc.

Whats the CBA? 

Should I address the safety aspect? I just feel uncomfortable. Mostly because I don't want to miss preparing a surgical instrument or forget to do a step and cause a delay mid-surgery or worse, cause a lawsuit. 

[klone, MSN, RN]

Collective Bargaining Agreement - your union contract aka the Bible. Your union works for you - it's totally worth it to give your steward a ring and just run it by him/her. Have you had a conversation with the supervisor/manager at the OPS center regarding your feelings of lack of safety secondary to not having enough orientation?

[CardiTeleRN, BSN]

3 minutes ago, klone said:

Collective Bargaining Agreement - your union contract aka the Bible. Your union works for you - it's totally worth it to give your steward a ring and just run it by him/her. Have you had a conversation with the supervisor/manager at the OPS center regarding your feelings of lack of safety secondary to not having enough orientation?

LOL I've been trying to get a copy of my union contract since I was hired coming up on half a year now. No one wants to provide it for some reason. I have had the convo with management and they're the ones who told me its easy work and I should be fine. 

[klone, MSN, RN]

Call HR and request a copy of the union contract. There is no reason why they can't give it to you then and there. Legally there has to be a bulletin board at every union facility that has union notices (at the very least, a notice of Weingarten rights), and it should also list your union contacts. It's often found in the break room.

Also, I'm sorry. As a manager, that makes me really angry that they responded to your request for additional orientation in that manner.

[dream'n, BSN, RN]

It’s definitely legal. Most employers consider a nurse is a nurse is a nurse.  When I worked Oncology I was floated to Cardiology, ER, and L&D. Talk about being way out of my league. I always wondered how a Cardiologist would have handled floating to deliver a baby. Way unsafe

[Closed Account 12345]

Ask yourself this:

Would a reasonably prudent RN with no training accept the liability of opening a surgical field for an operative patient without orientation or an understanding of what she is doing?  

My answer would be no.  You as the licensed nurse are aware of your personal scope of practice and competencies, neither of which is established simply by your degree or license.  Briefly learning about sterile fields in nursing school does not make one a competent perioperative nurse.

The assignment is likely legal, but that doesn't mean you aren't setting yourself up for legal/licensure problems by accepting it.  Any time you aren't acting as a reasonably prudent nurse, you're at risk.

Legally, "a nurse is a nurse is a nurse" simply does not stand.  We are not interchangeable, and you'd be hard pressed to find any evidence-based, peer-reviewed sources saying otherwise. If a long term care nurse floated to L&D, accepted a laboring patient, and the baby died because the nurse had never been taught to read the strip and respond accordingly, would that nurse be liable? Of course. The nurse shouldn't have accepted that assignment. If a public health nurse floated to ICU, accepted an intubated patient, had no understanding of vents and ICU drips, and the patient died a preventable death, would the nurse be liable? Of course. The nurse shouldn't have accepted the assignment. 

If you've been a nurse for two years, you are 100% capable of asking a patient to put on a gown, witnessing consent forms, and printing discharge paperwork. Those are tasks all RNs could safely perform without additional clinical orientation. 

Properly setting up a sterile field for an operative procedure is a learned competency that requires teaching.  It's a skill you can probably learn relatively quickly, but you are endangering the operative patient if you just go in blindly and make your best guesses. Contaminating surgical supplies or mislabeling medications/liquids on the sterile field are the concerns that come to mind.  Ask for a 1 day orientation with an experienced nurse in the unit before accepting this assignment again.

[Been there,done that, ASN, RN]

We can't tell you what's legal. Not in the TOS. 

 I have been a floater too. No way would I accept an assignment this far out of my experience.