maryx

This message is intended only to inform anyone else asking the same question originally posted in this thread...and not to provoke Daytonite...Just wanted to post some information, and help...... After some research I became aware of the following information relative to the Texas State Board of Nurse Examiners....The full document including the Nurse Practicing Act Rules and Position Statements can be viewed in full at the Texas BNE's website..... ALL LICENSED NURSES PRACTICING IN TEXAS ARE REQUIRED TO "KNOW AND COMPLY" WITH THE NURSING PRACTICE ACT (NPA) AND BOARD RULES. RULE 217.11(1)(T) REQUIRES THE NURSE TO "MAINTAIN A SAFE ENVIRONMENT FOR CLIENTS AND OTHERS." THIS STANDARD ESTABLISHES THE NURSE'S DUTY TO THE PATIENT/CLIENT, WHICH SUPERSEDES ANY PHYSICIAN ORDER OR ANY FACILITY POLICY. THIS "DUTY" TO THE PATIENT REQUIRES THE NURSE TO USE GOOD PROFESSIONAL JUDGMENT WHEN CHOOSING TO ASSIST OR ENGAGE IN A GIVEN PROCEDURE. [sEE POSITON STATEMENT 15.14 DUTY OF A NURSE IN ANY PRACTICE SETTING]. LUNDSFORD V. BOARD OF NURSE EXAMINERS, 648 S.W. 2D 391 (TEX. APP.--AUSTIN, 1983) A NURSE HAS A DUTY TO THE PATIENT WHICH CANNOT BE SUPERSEDED BY HOSPITAL POLICY OR PHYSICIAN'S ORDER..... NPA SUBSECTION 217.11(1)(B) THE NURSE'S "DUTY" REQUIRES THE NURSE TO INTERVENE APPROPRIATELY TO PROTECT AND PROMOTE THE HEALTH AND WELL BEING OF THE CLIENT OR OTHERS FOR WHOM THE NURSE IS RESPONSIBLE...... NPA SUBSECTION 217.11(1)(T) ....REQUIRE THAT EACH NURSE PRACTICE WITHIN THE LEVEL OF HIS/HER EDUCATIONAL PREPARATION, EXPERIENCE, KNOWLEDGE, AND PHYSICAL AND EMOTIONAL ABILITY. There's much more information on this including the fact that by refusing an assignment.......... it is absolutely forbidden for a facility or person to retaliate by placing a nurse on suspension for refusing, or terminating them as well......Read the complete document at the home website for Tex BNE...... You do not have to be bullied into these assignments with threats, etc......

Daytonite.....The supervisor's informed...he's the one floating us....and the suggestions I was looking for was not from the supervisor's perspective in order to empathize with him or her...so I don't know how you thought you could be of any help. It's unfortunate that you perceive others voicing their opinion as arguing, or as being deceptive just because it doesn't agree with your thinking. It sounds as though my opinion has fed your anger, as is evident by your allegations, and insults. You would benefit from your own advice to be willing to listen, and change....but your game plan is just to get in a pissing contest, and try to attention seek with how clever you believe you are. In regard to the supervisor you mentioned who likes to "punish nursing staff" by spitefully floating them, and then attempts to provoke them in to getting angry and quitting....I would never feed in to that type of childish behavior. I've delt with many bipolar, labile, borderline patients for quite some years...also those like yourself who are grandiose and intrusive as well. You're welcome to reply to this message, and say whatever you need to in order to feel better about yourself, it's of no effect to me. I worked my field long enough to know you that you can't reason with the irrational, and those with a perception that is not reality based. See you on Geri Psych.!!!! Now prove me right, and respond back!!!!!!!!!

...Actually no, the Rehab nurses are never floated to Psych. and have verbally expressed their absolute repulsion for Psych. stating that they would not like dealing with those type of patients or the families. In addition, the Rehab. nurses would have to have SAMA training which would train them on techniques to process with the Psych. patients...first using verbal skills, then at last resort physical, so as not to harm themselves, or a patient that requires a "follow down"....who is an imminent threat to himself or others...but not only that....they would also have to have the right attitude, emotional stability themselves..etc,...etc...to deal with those type of patients....It's not easy...many people can't do it....they don't have the stomach for it, much less the appropriate temperament....perhaps I did not mention....that as an LVN...which I am...I am not even required to do patient assessments on my unit...but yet they want me to do assessments on Rehab....My comment on informing the patient of being a Psych. float is not intended to stress the patient any more than them READING MY I.D. BADGE which clearly states the same information is.......If I appear to fumble around, and seem lost, it actually helps the patient to know that I don't work that unit....instead of them stressing about my competency...For the higher ups to acknowledge that nurses are specialized would disallow them to continue to "pimp out" nurses to other floors with the same disregard they are allowed to now. They wouldn't dare do that. They will continue to place themselves in a position to assume all the profit, while we hapless souls go off as sheep to the slaughter and assume all the risk....

addendum to previous message for "Daytonite" Your insider info. about the dumber nurses being floated to Rehab is really insulting and rude. I think you owe all Rehab nurses an apology.

Understood, but the expectation when floated to this unit is for us to perform as medical nurses, and carry a patient load where the patients are split up. There is no consideration for us by giving us the "easiest patients", in fact the rehab unit is not allowed any transferring equipment like hoyer lifts or even trapeze bars or it disqualifies these patients as "rehab" since they're suppose to be able to "participate" in their recovery. So if there is (and was) a 300 lb. CVA patient, with one sided paralysis guess who gets assigned these patients? I haven't seen an "easy patient" yet on this unit. I'd like to know what you think an easy patient is. Of course it doesn't take a brainiac to toilet someone, dress them, take vital signs, and answer a call light, etc. I'm not worried about parting someones hair crooked and getting myself in trouble. I'm concerned about significant assessments and observations that could be missed because of the lack of perceptiveness to recognize these events which are impaired by lack of practice, not intelligence.... But on this occassion there is nothing gereralized about the assessments we are asked to do. The patients we have are CVA, MRSA, VRE, dialysis, and post surgical with ORIFs etc. It's a fact....... You lose the skills you don't use when working one field of nursing. That being the case, how can you assess a patient, and document on them if you don't know "what to look for?" To have an oversight of this information would be considered neglect. If that's not considered dangerous then why not float Psych nurses to ICU then? This same hospital had to call the "Ready Response Team" When a patient's blood pressure fell to a panic level. The Psych. tech. assigned to this one to one patient didn't even know that this patient was in any distress while she was shaving his face. Her perception was that he was breathing, and as long as he was breathing, he was okay! My father was injured once by a nurse who lacked the competencies to take care of him. She perforated his intestine. When it went to personal injury court, guess who won? Not the nurse, and not the agency. He was awarded an astronomical amount, as this was before the cap was placed on these type cases. God forbid any harm comes to any patient on this rehab unit, but I can guarantee you that if the patient and there family were given the informed choice of care for themselves or their loved one they would much rather have a medical nurse tending to their medical patient than have a Psych. nurse with rusty med. skills.

That's my point! Psych. and Rehab. are not interchangeable

I agree, but the bottom line is all about money. The supervisor that is forcing the Psych. staff to float to Rehab is the Nurse Manager for both units. The Psych. staff was never asked to float to the Rehab unit until this supervisor became Nurse Mgr. of both units.....also, I chose Psych. as my field of nursing because that's what I want to do. I'm not interested in practicing any other field of nursing, and don't feel as though I should be forced to...just to accommodate patient nurse ratios on a unit that's short staffed. He, my Nurse Mgr. refuses to adequately staff both units so he can run both with minimal payroll....... meanwhile it puts us at risk, not to mention the patients...perhaps I should add that information when introducing myself to the patients and their family when floated to that unit....that I'm a Psych. nurse that's been floated to that unit for that shift to help out...maybe if the protest of this practice coming from informed patients and their family might make thr mgrs. pay attention.

Anyone out there experience problems with supervisors forcing you to work on medical floors without meeting their unit competencies? This practice is being done where I'm at. A supervisor is using Psych. nurses to help staff a medical floor (Rehab)....If you have any suggestions as to how to help....it would be appreciated. I feel like my license is in jeopardy everytime I'm forced to float over to Rehab, and the complaint is falling on deaf ears.....I really question the legality of this practice....