Would you take this assignment?

  1. Could you give me your opinion on this scenario?

    This afternoon,the charge nurse came up to me and asked if I'd "be comfortable taking a pt with a Ventricular Access Device". She said,and I quote, "he's from IMCU and his nurse will walk you through it" - that's it. I said,"uh,no,I'm not -and nor should anyone else here be -we have no experience". Prior to coming to PACU 4 yrs ago,I worked CVICU for 10 yrs but never had a VAD -they're mostly in CCU keeping the pt alive until he/she receives a cardiac transplant. She found someone else -turned out to be a new PACU nurse,I worked with her in CVICU and she'd worked with once with one of the older models-same principal though,I'd guess). No one else in our unit has looked after one,nor has anyone had an inservice of any kind.

    Later on I saw that the RN from IMCU was still with the pt!! and I told the charge that if I'd known the IMCU nurse was remaining to look after the VAD, I'd not have refused the assignment! She knew the nurse stayed with the pt all through the operation -my guess is so anesthesia would have someone to troubleshoot (this was a non cardiac surgery) -and sort of apologized for not passing that along. Though later when I said there'd been miscommunication all along about this pt -she balked at that!

    The part that I am steamed about is that based on the fact that the pt "has had it for a month", "didn't need to even be in IMCU", and "was going home with it" - she felt fine about accepting the pt the day before when the OR called her to give her a 'heads up' and ask who would be looking after the pt postop.

    I thought she was very caviler about the whole thing (she has never worked cardiac) -I got the distinct impression that if the IMCU nurse was only coming long enough to give the basic info to the bedside nurse,that would be fine and dandy -as the pt himself was not critically ill. I actually heard her say that the VAD was "irrelevant".

    Our nurse manager is on holiday but I plan to send her an email -though I know right now,she'll favour the charge's decision. I'm going to ask her to specifically comment on the unit policy for accepting pts who have critical devices that we have not been inserviced about.

    What would you have done? or said?
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    About All4Seasons

    Joined: Nov '04; Posts: 158; Likes: 94
    Staff Nurse; from CA
    Specialty: 31 year(s) of experience in PACU,Trauma ICU,CVICU,Med-Surg,EENT