Liability risk?

[DnCali]

I could write a book about my dilema but I will keep it to the nuts and bolts. I responded to a job advertisement seeking a RN capable of sub acute care for a new group home catering to clients with profound disabilities (trach's, gtubes, etc.). Currently the clients are housed at a state run hospital and many have lived 40+ years there. New legislation requires that these out dated intuitional hospital close and place the clients in their communities. These clients will be placed in this new, state of the art group home. Sounds nice....BUT the institution that houses these clients are fighting the process every step of the way (they will lose their jobs with the closure). They give no guidelines on what we need to do in order to bring the clients home from this place. This is not under JACHO or the department of health but rather a regional services center for disabled individuals. They have given very vague information on what needs to be done to be up and running. The prior nurse had one client home for one week when they inspected and guess what she had no policy or procedures in place and there had been very little training that was documented of the staff . Now for me that is crazy to work in a place with no P&P, no competency tests for staff....NOTHING. What the employer really wants is for me to write a complete P&P manual and develop a staff education department from nothing. No guidelines or anything. I think this is well beyond the scope of practice for a bedside nurse and carries a real risk of liability. In addition, the group home will be staffed with all new graduate LVN's and unlicensed assistive personel. Let's say that the new grad LVN is working and the patients trach comes out, she panics and he is injured as a result of not knowing clearly what to do. The incident is reported and they ask to see P&P as well as training related to the topic....well if it can't be provided the RN over this mess is responsible. I know this post is confusing because the entire mess is confusing. They had a nurse and one patient came there for a week and were returned after they found no P&P, training, etc. in the home. The administrator of the home SHOULD have ensured this was done and should have hired someone who is proficient in writing these documents--especially for a new group home accepting these clients that would be a PILOT model....the first of its kind here.....not a bedside nurse. The prior nurse was reported to the board of nursing. The administrator just wants it done to get things going....a mickey mouse job done by an unqualified person is a liability risk in my opinion. As a bedside nurse I do not feel qualified to write such a manual and develop an entire education department. In order to write this policy and procedure a clear outline of what can be done in the home is necessary. The Regional center's nurse over it all says she has the information in her mind and says oh you can do this but the next day says no I changed my mind...not like JAHCO, where you know exactly what must be done. Opinions please.

[Bruce_Wayne, ASN, RN]

Yea they need somebody in the role of a chief nursing officer and/or a risk manager and they need it like a while ago.

[classicdame, MSN, EdD]

I write policies based on our states' nurse practice act and guidelines from various associations. For instance, I am revising one now on central lines and am using the NPA plus the Infusion Nurse Society standards as my guide, plus various articles to make it evidenced based. I will say that your task is probably not for ONE person. I might have been better prepared as I have a Master's in Nursing with an emphasis on education. But without that background my job would be more difficult. I think you need help. Good luck!