all PACU RNs Wrote up!

[jrgrad1912]

This is crazy! I work in a 150 bed hospital and we have 4 PACU RNs. We were all called to HR and given a written verbal warning for discharging Pts with out an order. We have been discharging PTs by our policy, which uses the Aldette scale . We were informed we violated the Nurse practice Act and worked outside our scope of practice, by not following a standard that requires the anesthesia provider to write an order to discharge. We still have not seen this "standard". We have a new Anesthesiologist and we are sure he is behind it. To fight this would be job suicide and we all have ties in the Community.

[sm9796]

We have a criteria that the patients should meet and then we discharge them when we feel it's safe/appropriate etc. No note from the anaesthetist. Seems a bit like it's more of a legal issue.

[azhiker96, BSN, RN]

Our anesthesia records have a preprinted order, "May discharge when meets PACU criteria." This serves as the order from anesthesia for legal/billing purposes. Our criteria includes stable VS, tolerating PO fluids, and Aldrete >8. Most surgeons will also write an order for discharge. Some go into great detail even including discharge instructions and some only write "D/C".

If a patient is not stable, has pain or N/V issues we page anesthesia for additional orders.

[HeartsOpenWide, RN]

maybe you should write up the anesthesiologist for not writing discharge orders.