Only RN and they want me to do care fore patients and blood transfusions.

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Specializes in Ambulatory Infusion Center.

I work on a outpatient ambulatory Infusion center. We do outpatients antibiotics, blood transfusions, wound care, PICC lines, small surgeries, bone marrow biopsies and post op surgicals. sometimes pre-ops on the weekend. Due to management not being upfront with us we recently lost 3 nurses leaving me alone many nights. We get anywhere from 8 to 18 patients on nights. Since we have lost the nurses I have been refusing to do the blood transfusions or post ops on the nights I work alone. We are fairly isolated from the main part of the hospital so if something goes wrong I am a long way from getting help. Also of course I can never leave to get the blood, much less silly things like breaks. We have recently been told we don't need 2 nurses to do transfusions, next will be the surgicals I am sure. Granted it only takes one nurse to do the transfusion, but how can it be safe to be the only nurse or staff member on the floor? I have been a nurse for 36 + years, worked in most departments, have my ACLS and am very experienced. I think because of my years of experience I know how rapidly things can go south and want to know if there are any standards of care out there that can protect me from this situation. They run the entire hospital on skeletal staffing these days but I have only 4 more years to go and really don't want to run the risk of getting fired or losing my license at this late date.

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What??? Only one nurse for a transfusion? That is so unsafe. I thought it was common practice for two RNs to check that the blood is safe for the patient to receive. Then you're doing VS q 15 min. God forbid the pt has a reaction. That leaves your other pts neglected for who knows how long. No way. Get out of there. That's too big of a risk.

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Specializes in Ambulatory Care-Family Medicine.

That doesn't sound safe. In my state the two nurse verification can be done with a LVN and RN but the RN is the one who hangs the blood and is ultimately responsible for the patient. It sounds like they are giving you unrealistic expectations and it's not safe. If a pt were to crash on you and you are the only RN, you will be running the code, but what if two people crash at the same time? Do you have any LVN/LPN working with you at least or is it just you and unlicensed personnel? This really doesn't sound safe.

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Specializes in Ambulatory Infusion Center.

Nope, I am the only staff member. No cna's or anything. They want me to call NS to come check the blood for me and have the house CNA go get the blood. I talked to them about it again yesterday and they just said, well any of your patients could go bad, not just the blood patients, and I said exactly, which is why I should never have to be working alone, ever. The entire hospital is short of course, aren't they all and they don't want to have to send the patients to the floors but I feel at least the floors have more then one nurse and it is only for one more week until our new nurse starts, until another one quits. I was hoping for some sort of regulation stating a floor must be staffed with more then one personal at all time, even a outpatient walk in clinic like ours. I know they will be trying to send me the surgical next. In all my years I really have never seen this disregard for patient safety before.

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Specializes in Ambulatory Care-Family Medicine.

What state are you in. There may be something in your nurse practice act, especially regarding the blood. Also look up your facility's official policy regarding the blood process. If you find rule/policy about it, Print and keep a copy for yourself as a cya and also send a copy in writing to the managers.

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Specializes in Ambulatory Infusion Center.

We have been asking for the official policies on our floor for years, still have not received. tonight I had 2 patients getting blood, they wanted to send me 3 surgicals. I had a total of 15 patients tonight. They said since my patients walk in they are not bad enough for me not to take the surgicals. Then for some reason they didn't send them but we are having a meeting tomorrow. I have a feeling it will be bad. I just wish I had a standards of care or some sort of safe practice guidelines to show them. I am a hard working nurse, not trying to refuse work, just trying to do it as safe as possible in increasing difficult situations.

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Specializes in Dialysis.
What??? Only one nurse for a transfusion? That is so unsafe. I thought it was common practice for two RNs to check that the blood is safe for the patient to receive. Then you're doing VS q 15 min. God forbid the pt has a reaction. That leaves your other pts neglected for who knows how long. No way. Get out of there. That's too big of a risk.

Exactly!

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Specializes in POST PARTUM/NURSERY/L&D/WOMENS SERVICES.

I think I would be letting them know that my services would be appreciated more at a competing facility....you can only be walked on if you let them walk on you...

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Specializes in ICU + Infection Prevention.

"Can you please provide me a written copy of the policy and the state practice act that show it is permissible for me to do these things?"

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Hello everyone

I took the ANCC certification exam for Ambulatory Care Nursing Certification known as RN-BC twice and did not pass. I read AAACN Core Curriculum from first page to the last page many times. I also read their study guides. I know we are not allowed to share or distribute exam items. All and any advice is greatly appreciated.

Thank you

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You should create a new post for this. Buy the questions rom AAACN and practice them. Review the topics and info that you get wrong.

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Specializes in UR/PA, Hematology/Oncology, Med Surg, Psych.

I would love to get an update from your meeting.

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