Tami707

Thank you everyone for your replies. We, all the Charge Nurses, have requested a meeting with our Manager, the DON, and CNE to discuss this. The consensus among us, is that this is an unsafe, as well as a license jeopardizing practice.

Wondering if anyone else has run into this and what you have done. I work in ICU and am frequently assigned as a Charge Nurse. In addition to unit resource, Charge nurses are a member of the RRT/Code team. But they are also responsible to break other nurses when there is not a break nurse. Previously, when there has not break nurse, we have called the house supervisor and let them know that we will have a patient assignment and will not be able to attend the Code or RRT until the other nurse has returned. This past week, both the DON and CNE have stated that it is their expectation that Charge nurses leave and attend the code regardless of breaking another nurse. They stated that Title 22 (California) allows for this in emergencies. There is a section in Title 22 that reads: "The hospital shall plan for routine fluctuations in patient census. If a healthcare emergency causes a change in the number of patients on a unit, the hospital must demonstrate that prompt efforts were made to maintain required staffing levels. A healthcare emergency is defined for this purpose as an unpredictable or unavoidable occurrence at unscheduled or unpredictable intervals relating to healthcare delivery requiring immediate medical interventions and care." The BRN however, does not have any such allowance. If one has accepted that assignment, then severed that assignment without first giving "reasonable notice to the appropriate person (eg. supervisor) so that arrangements can be made for continuation of nursing care by others" that is patient abandonment. Neither ICU staff or our manager is comfortable with his new expectation, but our manager feels their hands are tied, and we must follow the directive. I disagree. I believe the argument can be made that RRT & Codes are not unpredictable or unavoidable in a hospital setting. We are not willing to put our license in jeopardy; I know I will flat out refuse to leave patients under my care, but know others won't. Has anyone run into this problem before? How did you handle it? Thanks in advance.

Do you have any type of Professional Performance Committee or Staffing Committee that nurses sit on? At my hospital, the Charge is a, mostly, rotated assignment. Some senior nurses won't do it, and new grads are not allowed. The Charge does not have an assignment, but we are the Code team, Stroke team, Sepsis team, etc. Not only do we resource and manage bed control in the unit, but we also resource the other units in the hospital. Except ED, occasionally, we may get called to a code there, but it depends on their staffing. We do not take an assignment for those reasons. And are to call our manager if the House Supervisor wants us in the count. Sounds like it's time to start a petition among nursing staff about the Charge position not being utilized in an appropriate manner, or start a PPC or Staffing Committee to change this to a more resourceful position.