D.R.A.

The good news is this meeting has come and gone. I think we are on the road to bring everyone at my facility out of the dark ages.

They are very afraid of change, very timid, very submissive. I'm trying really hard to be positive here. =) Perhaps you can imagine where I'm coming from. Small hospital politics.

I'm really not talking about staffing by acuity. That's something different all together. I'm having a really hard time accepting that staffing assignments are clerical. Perhaps I'm completely wrong. Or perhaps I'm just progressive in my thinking, but if patient care doesn't begin when the patient hits the unit, I don't know when it does. Comparing answering a phone to patient care is not really a fair comparison to me. Comparing answering phones to having a UAC assign patients to a professional nurse isn't either.

LTC typically pays more than hospital in my experience. In my area, new grads hire at $19/hr. I'm in the south. Cost of living in way low. For LTC they hire around $21/hr. Pay scale goes up for PRN and float pool. Find some of your classmates who know the going rate. I requested the going rate for my required pay scale. Employers here don't use the terminology 'lowest wage' very often. I think its tacky anyway.

We really don't have a policy that spells this out. But, if the BON can't spell it out, then I wouldn't expect the hospital to. I am a charge. I do not delegate the task. The HUC has been assigning patients for 15 years. Yes, the other charges are aware that I have a problem. They agree that patient assignment is to be based on acuity. We all agree that a UAP cannot make that determination, however, this falls under a gray area for most of them. They don't want to upset the basket.

The true meaning of up with assist x 1

Up with assist x 1. (;

I'm glad you brought this up. Great advice here on a topic that everyone should pay attention to even if they aren't having leg pain....yet. I'm 33, and I have spider veins. My legs have always taken a tendency to be splotchy and blanched. So, I think its safe to say that compression stockings need to be on my legs at all times.

ASN 31 BSN- to be announced MSN-to be announced

What I have found from my BON: 1.) Generalized opinion regarding delegation which includes questions to answer before you delegate. 2.)Decision making tree for delegation to the UAP. Utilizing those two things, the first criteria that must be met prior to ANY delegation is an RN assessment of the client's nursing care needs must be completed. I think we can all agree that an RN must first be aware of a patient to even make an assessment of nursing care needs. So, while the BON does not directly "prohibit" the UAP from making patient assignment, utilizing the delegation tree I cannot in good conscience delegate that task. In my state, even the LPN works under the supervision of an RN. I don't make the rules. I just follow them. The responsibility falls back on the RN. How I feel about it is, when the responsibility falls back on my license, I need to be the one who made the decision that I am to taking responsibility for. The UAP's assessment of nursing care needs for a patient cannot replace the RN's assessment. While the UAP may be very experienced and knowledgeable, and good at guessing how the patient needs to be assigned, he or she does not posses the critical thinking and assessment skills of a professional nurse, and, therefore, the assignment is made based on a guess. Delegating patient assignment to a UAP is not permissible in my state based on my assessment of the law. It would be much easier, however, if that was spelled out. And I think that is why I choose this forum to post my question in. If the professional nurse continues to give away her responsibilities to the UAP, I feel patient care will suffer firstly, and secondly, she will soon find her role not needed. Patient care begins and ends with the professional nurse.

Market forces aren't calling for BSN in my area. Anyone who managed to practice nursing for 30 years on an ADN, and is still able to do so to date, probably isn't going to face unemployment at this stage in the game, and is probably thinking about retirement. Hospitals in my area are loyal to their employees.

I'm all over the nursing side. I've got stacks of information on that. It is a cut and dry issue from that side, and in my perspective. I am just grasping at straws to find mention of UAP's in the capacity of handling written orders, etc., and the role that is essentially theirs, which is not necessarily one that is 'delegated,' in a well intentioned effort to validate the individual. Entering orders is not a task that we delegate, it is a task that falls under the job description. Answering the phone is not a task that we delegate. Basically, I have to go in and say, "While I appreciate your 15 years of experience, and I realize that you do possess a lot of knowledge regarding doctors, nurses, and patients, and while you have been allowed, wrongfully so, for many years, in the past to do so, the BON prohibits me from allowing you to make patient assignments." Period.The.End.

Individuals, like myself, did do what we needed to do, which was attend and complete and approved nursing program, and all other terms deemed necessary by our respective states to sit for boards. The point that anyone needed to do what they needed to do, meaning get a BSN, is moot. That simply was not the case at the time, or it would have been required. There is a huge difference between a requirement, and an option. We have seen this before, have we not? With nurses trained in a hospital setting, or diploma nursing. I do agree with tuition reimbursement being equally available, but should the facility make new mandates that are not state required, then I think the training should be paid for by the facility for currently employed RN's. Should the state mandate something, then I do not feel it will be at the expense of long standing, current professionals, at least not to the tune of $30,000 to obtain a 'degree' in a field in which you already practice competently. My initial goal was to obtain my BSN. However, I often ask myself now, "What purpose would it serve?" I have to ask myself that question when preparing to invest many thousands of dollars. I know many of you will tote that one should want to better one's self professionally. That it is a mere sign of personal integrity. However, after viewing first hand many of the online BSN programs, and having peers who have recently completed said programs, I am second guessing my integrity should I jump into, and spend a lot of money on, a bunch of bologna. Particularly when pay scale in my area does not reflect the many thousand dollar deficit incurred. There are plenty of opportunities for education within the nursing field. The idea that currently licensed professional nurses can't self direct their education is sad. Bottom line for me, boards don't reflect the need for BSN preparation. If it becomes a standard, it should be reflected in the boards. Otherwise, we can all find better things to do with $30k should we so choose.

I have spent a great deal of time sifting through the ANA, as well as my state association and BON, looking for something that addresses the role of the HUC/UNIT SECRATARY. I am preparing to address some issues within my unit regarding the role of the HUC. Yet, I can't determine definitively that they are even addressed. They do play a vital role. Are we lumping them in with UAP?? It would appear that way. Everything I have read ignores addressing directly the role that the HUC plays in patient care. Someone point me in the right direction? If this needs to be moved, I apologize. I really didn't find a forum that I felt this would fit into.

I wouldn't beat myself up. The ED probably just flushed the line and sent the patient back. Things happen.

I hate our call policy. If you are called off, you are on call all day. SO you belong to the hospital, but don't get paid...unless you count the $2/hr you get....yeah that's right....$2/hr

I teach nursing students everything I can when they spend the day on our unit. I make it a priority.

Nursing school is a huge rip off because its geared at making money for the college and those who sell NCLEX geared curriculum. Honestly, I found NCLEX to be rather ridiculous. Nursing school was all about books. Fundamentals are great, but you learn everything after you graduate. My hospital had me in orientation for over 3 months to train me. They place all new grads that way. I learned more in those 3 months than I did the entire time I was in school.

And our policy book....well it might as well be empty. There's nothing in it! Wanna know what the facility policy is on something, just make one up and go with it! Yes, this is a true story. This is happening.

Oh, and we have a HUC who plays charge nurse. Gives orders to clinical staff, and tries to make pt assignments, and police nursing care. Yeah, its quite a huge disaster.

Don't let the sound fool you. What I failed to add was that half the staff usually calls in. So we over staff in hopes that we will end up with what we need. And of the staff that shows, they are lazy, don't do their work, or take an entire day for 3 aides to give am care. And don't have time to toilet the patients and answer calls because they are 'too swamped.' They are too busy to turn the patients properly, and take frequent, lengthy breaks. Oh, and they are insubordinate most of the time. Still sound like a cake walk?

I have proposed this plan as well. I love that idea.

Thanks for all your responses. I really appreciate them. Sometimes, we are made to feel like we are crazy, that our requests are unwarranted. I plan to address my concerns with a superior. It probably won't do me any good, but at least I can say I gave it my best shot. If I don't see a change, then I know I have done all the good I can do at my current facility, and it will be time to move on to bigger and better things.

Yes, it really has happened. The nurse manager is Laissez-Faire....and busy playing Candy Crush. People constantly complain, and nothing ever really gets done. Its every man for himself out on the unit. Survival of the fittest. Apparently, the other CN let this go on...then I showed up, and I was astounded. I've been employed for about 1.5 years. Initially, I didn't charge that much, now I charge quite a lot. I don't tolerate this, but it still happens. Its like pulling teeth to get these fools to understand that its unacceptable. The secratary has been employed by the facility for 16 years. Apparently, that makes her a nurse in her eyes. Absurd!

Geographic location- KY Pay rate- $20.08/hr base pay In which area / specialty do you work? med-surg What type of license do you have (RN or LPN)?RN What type of degree and/or certification do you have? ADN How many years of experience do you have? 2 Are you full-time, part-time, or casual / per diem / PRN status? FT What shift do you work? Days Do you receive any shift differential? YES Are you a manager or supervisor? Charge when senior staff on shift, which pays .50 more