New Task Risking RN license?

[TallBlondie]

I work in an operating room that has just begun a major cost-cutting initiative that is driving us nuts. At first it started with management asking us to clock in and out within a certain range (as not to accidentally accrue overtime pay) and then progressed to staff not being allowed to drink cokes or orange juice. They stopped our pre-op nurses from using post-it notes and other cheap behavior. This is after asking staff to donate some of their pay for our hospital's new 'Surgery Center'. These tactics were more of an annoyance at first but now they are asking RNs to run the Cell Saver instead of the auto transfusion company we had been using. I have concerns over using this since they have to potential to kill patients! Am I not being a team-player by rejecting the use of this equipment or should our staff stick up for ourselves and our licenses by not using this? Our 'training' consisted of the representative talking to us about use of this product for 45 minutes and a couple of staff trying to read the confusing manuals. There are several settings that the outside company uses to tailor the consistency of the blood product to each specific patient and none of us learned how to do any of that! Also, the manual says not to use blood from patients with malignancies and the main cases that we are using these with are prostate cancer surgeries! :trout:

[crackerjack]

Personally, I wouldn't run the cell saver. I'll set it up until perfusion can get there but that's it, after that I'm not going to run it. It's one thing ot try and save money but expecting someone to run equipment when not adequately trained is just plain not smart. A 45 min session and a manual does not sufficiently train someone to run the cell saver.

Ya, our facility is doing the same thing with the clocking in/out during a snug range. However, my annual review found me getting point deductions for 'clocking out late unauthorized.' I had a nice lil discussion with the super who was doing that review and told her I have absolutely no deisre to hang around this joint after I'm off work. If I clock off 'late' it's because I was not relieved on time. If I'm scheduled to be off at 3 and am not relieved until 3 or later, I cannot possibly clock out by that magical 305. It ain't happening, I have to give them report, get changed into my street clothes and invariably someone needs something from me along the way. I was told 'oh you need to tell me when that happens because that shouldn't be happening, you should be able to expect to get off and leave at your scheduled time.' Ya, right...w/e. The very next day I was reporting to her...'today I was scheduled off at 3...it's 330 and I'm just now being relieved...example of the usual.'

[ewattsjt]

our facility is doing the clock in and out thing too. money savings is all it boils down to. we are doing other crazy things like that too.

we are not however substituting staff in a manner that could be dangerous to our patients. be very careful about operating outside what could be considered your scope of training. this is a matter that should be followed up on!!!

[Chianastar]

I agree you should not be using the cell saver if there is no adequate training.

In our hospital (in uk) we do not have perfusionists, and are required to set these up ourselves, however we have to have a study day and an exam and a period of time where we work with a trainer (usually about 3 to 4 times) to say we are competent.Then update yearly.

You cannot use them with malignancy as the machines do NOT wash or filter the malignant cells.

Is there anyway you could clarify this with both the company that supplies your cell savers and your surgeons? as this is a potential risk to your patients.

[rn/writer, RN]

From outside the OR looking in, it seems like your management folks are being penny-wise and pound-foolish. One bad outcome, one lawsuit, one plaintiff victory and all these pesky and annoying "savings" wil be wiped out tenfold. I wonder if the hospital's risk management people are aware of this latest economy measure, especially in relation to using the cell-savers on malignancy cases. Is it possible that someone forgot to mention it to them?

[passionate]

We use a timeclock too--the hospital has found that when we didn't they probably paid us less because we didn't charge for and all of the missed lunches.

Don't perform any task that you have not been certified on and done a return demonstration for competencies, Staff needs to stick together on this, especially if it takes away from your circulating duties.