nmred

Don't know where the PACU Forum is... but I'm both CPAN and CAPA and I used The Core Curriculum for Perianesthesia Nursing Practice by Litwack. The ASPAN/ABPANC site has a full list of references. Also there are practice test on the website, they are really helpful. Best of Luck

I keep my wrappers as well. The scrub should be keeping all sleeves and sterile wrappers. I NEVER toss/remove the trash from the room until the case is completed. Just in case you have to go digging for items.

The hospital is saying the individual does not work under my license, no matter how many pages from AORN, DOL, ASPAN, Federal Code are placed in front of them. I have already thought about having to return and be around all of these individuals. Not a nice thing.

My supervisor objected to the incident report, and I'm being punished for it. S/He was angry about the write up, not about the situation. It was clear S/He was angry that the report was seen by her/his supervisors not about the hostility. Alos, it's clear I'm not wanted in the unit.

I'm glad some one gets it. I still can't return to work (my time off is on my dime), and this guy is still working. He's making money. What about my financial obligations? What about his abuse? Apparently it's being condoned. Abuse is never acceptable.... PS: BTW... Writing the incident report is what got me in trouble....

I'm not a "Newbie". S/He didn't have anyone in to relieve her/him. The hospital is only saying they had permission to leave to CYA. As a matter of fact the surgeon told s/he to stay and the individual continued to walk out. Let's see, that's insubordination, pt abandonment, failure to complete duties, creating a hostile work environment. All of which are unacceptable. PS: This individual has hit me in the face with instrumentation in the past... Why are they still employed?

Met with HR, everyone/everything backs my statement except the individual getting permission to leave the room. HR and my supervisor are mandating I receive counciling for calling this disruptive individual a perjorative. In the mean time, s/he is STILL working. They (upper management) state "One Tech may tell another Tech to break scrub and leave the room". According to State and National standards the Surgeon is the immediate supervisor. The point is...this individual in question is not being held accountable.

Not a union hospital. Apparently, everything/everyone has confirmed my statement. I'm being punished and s/he's been let off the hook. National Standards: S/He is directly responsible to the surgeon. MD said stay, s/he walked.

S/He threw an object at me. I called him a perjorative. Questionable: the pt at risk. I am not accountable for her/his behavior. Abuse, verbal or physical, is never acceptable.

I recently had an altercation with a CST in which s/he provoked, and admitted provoking, a response from me (the circulator). The surgeon reprimanded her/him for the behavior. S/He broke scrub and exited the room without mine or the surgeons permission. The hospital is saying that s/he had permission to leave the OR from another ST who was in the room as an assistant, not to relieve her/him. The hospital has placed me on administrative leave saying I provoked the incident. They are investigating me. The CST is still working. Apparently no one is collaborating my statement. Any thoughts?

Start with the DOL in your area. I live in NM and on our DOL webpage there is a statement of forcing personnel to work over 16 hours straight- not allowed. Which means the hospital must have some policy in place with step by step instructions, who to call, when to call, how much time to give them to find a replacement, etc. The problem is enforcing the policy. There is always ONE nurse who will choose not to follow it and that will set the whole unit up for failure. ASPAN's standards for 2008-10 (?), it's the latest ones, has a call/exhausted check sheet for PACU nurses. You go down the list and check off the boxes. If you feel you are unsafe it guides you through the proper steps and channels. Maybe presenting this to your Superiors will help clear a path for safer patient care. Remember: The Superiors are at home sleeping... you're the last thing on their minds.

My hospital recently hired a JCAHO consultant to "walk" through the hospital and advise the department managers of "potential" problems with the units and how to "beef up" the areas for the next Joint Commission inspection. One of the "requirements" for PACU is for Anesthesia to list the order in which pain medications are to be given (if there is more than 1 option). The consultant stated Joint Commission is watching for this now. So our anesthesia providers have to mark next to the medications what order the meds are to be given and the nurses MAY NOT deviate from the list. The nurse MUST give ALL of med #1 prior to advancing to med#2 and so on. It makes no since to me. Where is the critical care aspect of nursing? Especially in the PACU. Has anyone else come across this issue? Until now, I've never heard of such a thing. Is it a true Joint Commission reg?

I'm sloowwly learning Norwegian. The problem is I have no one to practice with. Have you worked there? If yes, what was it like?

Thanks for your responses. Just an update: We just had an incident where an ICU nurse was instructed to move a patient to another unit and receive a patient from PACU. The patient had been here 11 hours waiting for a room, had a craniotomy. The ICU nurse refused to move the original patient until 9 PM. When the charged Nurse tried to resolve the situation she was threatened with "you had better stop your behavior (solving the problem) or you will be in a lot of trouble". She asked the manager "Are you threatening me?" "NO I'm not threatening you, I'm just saying..." The manager now denies the conversation. She has reported the treat to Joint Commission and CMS. We shall see the out come.

I was on the internet the other day, just checking my professional websites, and stumbled onto an article on the ASPAN website about Bullying in the workplace. Anyone else seen this? It's an article about how JAHCO will be mandating a violence in the workplace protocol. The organization must have a policy in place that ID's proper conduct and what steps will be taken to modify inappropriate behavior. All employees must sign the form. It's about time! In the last three years I gone through three jobs because of hostile work environments. And I've been in the field 2o+ years. The problem I have with this is you can't put it into practice. Some hospitals aren't JAHCO certified, so they don't follow policies and standards anyway. There are others who don't follow any standards when they are JAHCO certified. So what's the point? It is estimated 48% of the medical field would be unemployed! Any thoughts?