Opinions please re: Phase I

[sharann]

Ok, what do you all think about the common practice (more like Mal-practice) of one RN being in PACU with a patient. This of course is usually on a weekend or at night when resources are at the most minimal.

How do you justify this in court when it comes up which we all hope it never does. Doesn't anyone worry about their patients or their OWN safety. We recently had an RN alone with a patient who was assaulted. She didn't even write an incident report. Dumb yes. We are discouraged by peer pressure to not make an issue of working alone with critical and noncritical phase I patients. Kind of a "don't call me if I am 2nd call unless you have a dang good reason".

Any opinions/thoughts/advice?

Thank you

[canoehead, BSN, RN]

I used to work on my own in labor and delivery, and I am currently on my own at night in the ER. It's not ideal, but the beancounters aren't going to budge. The trick is to have all your equipment ready and waiting for anything you can think of, and not be afraid to use the code button to get help on the double.

[Babs0512]

Sharann, I have the same problem. Our nurse manager gets around the 'two" nurse rule by saying that the OR nurse can help you if you need her. That's only true if certain OR nurses are working, some will tell you outright "NO' if you ask for help. Most of the time, the OR is gone within 15-20 min, while I still have the PACU patient. Then what??? My boss always has an excuse. Like you, we too are EXTREMELY discouraged to call our second call in. Of note, our second call DOES NOT do FIRST CALL - so if we are sick or in an MVA on the way to the hospital, there is no one to recover the patient.

I don't know what the answer is. I've talked to the the nurse manager and HER manager, but I've gotten no where except on the bad side of my boss. Administration is home warm and safe while we are on call working all kinds of ungodly hours - nothing is going to change.

If the PACU nurses would stick together, maybe something would get done, but they won't *T is too busy kissing mangerial butt, *V - is a two faced (female dog) who cares of no one but herself, *K is just too sweet and trying to be everyone's friend. *P doesn't care, as he will be leaving within a year, going to nurse anesthestest school, *N likes to stay on everyone's good side and she's up for *P's day position. *Me, I'm willing to raise cain, but no one willing to stand up with me. So, we're going no where fast.

Good luck to you, I feel your pain

[ativanni]

I believe ASPAN standards have changed and there is to be 2 RN's in PACU. WE had had to change our staffing model over the past year because WE always had one RN also!

[Babs0512]

You are correct, we are suppose to have 2 RN's "available" to PACU according to ASPAN, how my boss gets around this is she says "Ask the circulating nurse to help if you need it." Well, I just got back from recovering a C-section. It's 0020 my time. My circulating nurse dropped of the patient, gave me a report and said, "night". Then left.

We've told our that we cannot always depend on the circulating nurse to be there. So far, it's gotten us nowhere.

Well, I have to try to sleep, gotta be back to work by 0700, hope I don't get called in again for anything.

Night

[nellie_nurse812]

according to ASPAN standards, 2 RN's, one being competent in PHASE I care must be in attendence. Believe me if a case would go to court, this would be the standard applied.......