Is your surgery dept. anything like this?

[RNMommy2]

This is my first time to post but I would love to hear the response of other surgical nurses to find out if this is typical. Frequently I am the only nurse scheduled for preop and recovery. Recently a tech was hired who has a lot of knowledge but has not finished school. Yesterday we had 5 surgeries. When the first one comes out of surgery with a general anesthetic I am busy in preop pushing 3 preop meds for the next scheduled pt. I also have a pt to work up in the next bay including all history, consents, orders and starting his IV. The tech can't push the meds and is not supposed to work up the next pt or recover. I went to my supervisor who had just walked in the door and she said she would sign the tech on in her name so she could recover. This child is screaming and trying to get out of the bed. Later on that morning we brought an add on to the holding area. The patient told everyone she was npo but in fact she was not. Again, the tech had been working her up because I was recovering 2 pts. I hate to even think what would have happened had she aspirated and a nurse was not even preoping her but it was logged in as though one was. Is this typical?

[Marie_LPN, RN, LPN, RN]

Noooo that's not typical. That's insane! That is a dangerous situation that HAS to be illegal.

[Jolie, BSN]

Recently a tech was hired who has a lot of knowledge but has not finished school... I went to my supervisor who had just walked in the door and she said she would sign the tech on in her name so she could recover... I hate to even think what would have happened had she aspirated and a nurse was not even preoping her but it was logged in as though one was. Is this typical?

The supervisor logged in so the tech could provide care while creating the appearance that the care had been given by an RN?????

This IS illegal AND reportable. Fraud and practicing nursing without a license are nothing to be tolerated.

The supervisor should be reported to the BON. The tech risks losing her opportunity to ever practice as an RN by engaging in this conduct.

Run from this place!

[RNMommy2]

That is exactly what I told the tech over lunch! I am considering going back into my previous field of nursing (home health). I never had to worry about things like that there!

[tddowney]

If I were you, I would get out of there pronto.......without 2 weeks notice.

The sort of dishonesty shown by your supervisor will sink all of you sooner or later. You can bet that isn't the only lie.

[Jolie, BSN]

The stupidity of some people with "RN" after their names never ceases to amaze me!

We can all understand being busy, and in the real world, corners are cut sometimes. But this is soooo over the top in terms of irresponsibility, lack of professionalism, fraud, indifference to safety, etc.

I suppose it is just out of the question for the supervisor to actually come to the bedside and DO PATIENT CARE! That she would log onto the computer to enable the tech to do RN work doesn't really surprise me, I guess. But how shortsighted of her! What if that child had aspirated? How would she defend herself to the plaintiff's attorney or the BON? "Oops. That wasn't really me caring for the child who aspirated and suffered brain damage. It was an unlicensed tech working without direct supervision while I was in my office 2 floors away. So please don't blame me."

At first I felt a measure of sympathy for the tech. She is probably young, naive, in desperate need of a job, and so afraid to speak up even when she knows that things aren't being handled properly. But if you have spoken to her about the risk of losing her (yet to be earned) nursing license, and she continues to do this, then shame on her.

The only person in your hospital who MAY give a hoot about all of this is the risk manager/hospital attorney. S/he is the one person who ought to have a clear understanding of the legal implications of this practice. (Potential criminal charges, potential civil litigation, possible loss of 3rd party payor funding, possible loss of accreditation, etc.) If you think you can make a case with the risk manager, please try to do so.

If not, then please get yourself out of this setting ASAP. Please make clear notes regarding dates, times, and other personnel involved in this practice and report them to the BON, as well as the State Department of Health (or agency that licenses hospitals.) This is truly a public health and safety issue.

[shodobe]

RUN AWAY! RUN VERY QUICKLY AND FAR! People can be very stupid especially those with a license. The tech should lose their cert because they are practicing out of thier scope. The supervisor should be fired because they are a liability to the hospital. Find something you feel safer in. Good luck!

[elcue]

run away. far. today.

you are in an illegal, unethical, unbelievable situation.

and after you get far away, call the board of nursing. and jhaco.

[StikTie]

Dear Mommy...Your OR situation is where the rest of us are headed...The operating room has some strikes against those who "live" in there. Operating room personnel are 'hidden' from the rest of the hospital. Bad things go on in there that no one 'outside' has any clue about. The only ones that do know, are us...all of us who brave the abuse (although some days/moments, not so bravely), everyday we don 'the scrubs'. God, I could say so much more. But, on some level...anyone who works in this environment could write their own book. I for one am thinking seriously about it. Actually, I even thought about opening the doors of our OR's to the public in a very exposing way via newspaper forum...I realize of course in doing so my career would quickly dissolve faster than any quick absorption suture we know about. I would not want to ruin anyone's credibility or reputation however, I would like to think that it would shake up some hospital administrators and stock holders...What do you guys think...? Would we dare?...

From what I have seen...I doubt there would be many to step up to the plate...OR nurses are some of the toughest around...iron spine and a steel mind...who all happen to have bills to pay...administrators know this and also know that when it comes to taking care of our families...we are vulnerable....some of the toughest minded nurses have turned to jelly when their job was threatened...and I can't blame them. They have families to feed. So did I but...I left them (administrators) shaking...it can be done...

[nickola]

This is not safe & definitely not typical of anyplace I've ever worked!! There are STANDARDS, check out ASPAN.org -- there are specific nurse-to-patient ratios for recovering patients in various stages, based on acuity, age, anesthesia, etc. A TECH STUDENT recovering patients??? Every PACU I've worked requires all RNs to have ACLS & PALS to work in PACU. At least one RN needs to be in PACU w/any patient in stage I recovery- and 1 RN & another LICENSED person w/a pediatric in stage I. I would not be putting my license on the line or my name on those charts if not directly taking care of those patients!! I'd be looking for another job b/c this sounds like a disaster waiting to happen!!

[redraccoon, BSN, RN]

Not typical.

Not legal.

NOT SAFE.

Run, Forrest, RUN....

No way would I have my liscense anywhere NEAR that kind of situation.

Further, I wouldn't feel the least bit bad about reporting it!!

[StikTie]

This is not safe & definitely not typical of anyplace I've ever worked!! There are STANDARDS, check out ASPAN.org -- there are specific nurse-to-patient ratios for recovering patients in various stages, based on acuity, age, anesthesia, etc. A TECH STUDENT recovering patients??? Every PACU I've worked requires all RNs to have ACLS & PALS to work in PACU. At least one RN needs to be in PACU w/any patient in stage I recovery- and 1 RN & another LICENSED person w/a pediatric in stage I. I would not be putting my license on the line or my name on those charts if not directly taking care of those patients!! I'd be looking for another job b/c this sounds like a disaster waiting to happen!!

Amen to that