goflyslow2

Thank you! Excellent sage advise! You brought up concerns and approaches that we/I had not even thought about. Thanks again. Chaz.....

I am an R.N., working in PACU (recovery room). We have just implimented a new program that encourages same day surgical patients and families to call our "Nurse Liason" any time, 24/7, post operativley, with questions that they may have. Our previous and current practice, is to provide discharge instructions to the Patient and family member, related to their surgical procedure, including a Micro Medex print out of discharge instructions, and print out of medications Rx'd at that time. We also have told them to call their physician in the case of various untoward problems, preprinted on out forms (Temp, increased pain, nausea, swelling, S/S of infection, etc, etc) My concern, is that no parameters nor guidances have been set for this new "telephone Triage". The intent of the "Call a Nurse" program, is to improve customer relations / satisfaction. The nursing personel assigned, will be taken from a pool of PACU nurses on a rotating basis, with that nurse to carry a beeper / cell phone for a 24 hour basis, 3-4 day rotation. We are paid an "on-call" rate of $6 per hour to do this. It is voluntary, yet highly "encouraged" that we participate....or it will be assigned as an on-call duty. (we already have required on-call/standby for emergency surgeries at this 250 bed acute care hospital. Again, no guidlines for informational output have been established. And, the nurses within our PACU department vary considerably in their knowledge and communications skills. What should we nurses be investigating and be concerned with regarding the above "Call Our Nurse" program? What are our liabilities? How should administration be approached? These "new and wonderful" programs seem to come from administration....without much forthought. Thanks, C. Scrivner RN

I am an R.N., working in PACU (recovery room). We have just implimented a new program that encourages same day surgical patients and families to call our "Nurse Liason" any time post operativley, with questions that they may have. Our previous and current practice, is to provide discharge instructions related to their surgical procedure, including a Micro Medex print out of discharge instructions, and print out of medications Rx'd at that time. We also have told them to call their physician in the case of various untoward problems (Temp, increased pain, nausea, swelling, S/S of infection, etc, etc) My concern, is that no parameters nor guidances have been set for this new "telephone Triage". The intent of the "Call a Nurse" program, is to improve customer relations / satisfaction. The nursing personel assigned, will be taken from a pool of PACU nurses on a rotating basis, with that nurse to carry a beeper / cell phone for a 24 hour basis, 3-4 day rotation. We are paid an "on-call" rate of $6 per hour to do this. It is voluntary, yet highly "encouraged" that we participate....or it will be assigned as an on-call duty. (we already have required on-call/standby for emergency surgerys at this 250 bed hospital. Again, no guidlines for informational output have been established. And, the nurses within our PACU department vary considerably in their knowledge and communications skills. What should we nurses be investigating and be concerned with regarding the above "Call Our Nurse" program? What are our liabilities? How should administration be approached? These "new and wonderful" programs seem to come from administration....without much forthought. Thanks, C. Scrivner RN

Re; Voice Care reporting. "Voice Care" is a telephone recording procedure that has recently been instituted in our 300 bed facility. An initial patient history is recorded by the admitting nurse (ER or Floor) The recording is inputted to the room/bed#. Updated shift reports and procedural reports are inputed to this patients original history until discharge. Sounds good Huh? This system has proved very cumbersome and time consuming as opposed to traditional verbal reports. In todays fast moving patient population, a typical patient may be transfered 3-4 times and have 2-3 procedures in the course of 2 days. Each transfer is a separate action required.......and not integrated into the actual transfer process that is already in place. It is an added transfer process. (Read - just one mpore little thing) From the recovery room where I work, it may require that I "key" as many as 80 trelephone number combinations in an effort to locate the Patient, transfer the patient into my area...give a post procedural report...transfer that report to the bed assignement...call the nurse on the floor to DISCHARGE the patient that is blocking the new bed assignment for the NEW patient, begin the transfer process again when I think that enough time has elapsed.........find that it hasn't been done yet..............finally transfer the recording, call the nurse back and tell them to listen to "Voice Care'.....arrive with the patient......nurse hasn't had time to listen....end up giving verbal report anyway. This thing sucks. It was intended for long term facilities. It has the ability for family to access for a family specific report (we have yet to utilize....and probably never will) It can't keep up with the patient that presents in the ER with Chest pain, goes to cath lab in 1 hour, goes to Recovery room for 2 hours, goes to CCU for 12 hours, PCU for 10 hours, Tele for 8 hours, then home. Even though everyone complains, it is still being used after 6 months. $50,000 of Volunteer donation monet spent on this by a director that didn't get input first from staff that would actually use it. Typical...... Chuck RN. 33 years CCU/ER/PACU