camilleRN68

Does anyone have a policy on RN assessments of patients to be done at least every 24 hours. Meaning, if you have RN and LVN staff how often do you require the RN to make an assessment. Or do you require that? Does your charge nurses have to coordinate who has been seen by an RN? Can any of your patients be an inpatient and only see an RN on admit and not again until discharge? If not, how do you accomplish that?

I totally agree. I just don't know what else to do at this point. The techs have been brought in and signed papers if they do something else not on their list of duties it will be grounds for immediate termination. What I feel like is that it should be addressed more from the charge nurse or staff nurse point. Which makes it hard because I have no control over that realm. I am in charge of the NT program. Granted the techs should say no. But we can't seem to get the RN's to understand their delegation rules, which amazes me. The techs have a pathway which has the duties that they have been checked off on and the nurses should ask for it, which they don't. The techs have been instructed that if when they come to work and don't have that pathway of their check offs they will be sent home.

You are right Mike. IV's are medications. They are NOT supposed to be doing that but the nurses continue to ask them to do it. I have done everything to let the NT know what they can and cannot do, yet, it is hard for them when seasoned respected nurses continue to ask them to do things which are not to be delegated. Camille:D

I work in a 267 bed hospital in a rural area. We stopped using agency about 3-4 years ago, and it has worked great. We expanded our prn pool and give bonuses to fulltime staff that work extra hours. It is wonderful. And it has helped with retention as well.

I am having problems with the nursing staff in area of delegation. I know the rules of the NPA and They should know them as well, but we continually have issues with improper delegation. Mostly in the respect of our Nurse Techs or Externs (employees that are currently enrolled in a nursing, RN, program. We allow these employees to do skills that they have been checked off on at their school (with the exception of medication, they never do that) and of course we evaluate them for competency as well, i.e, foley catheter, NG tube, etc. But the nurses are asking them to things that they should not be doing, for example, calling the physician and taking verbal orders, hanging IV bags, etc. I have tried to address this from the NT point telling them not to do these things, but it seems to me it needs to be addressed from the nursing end in that they shouldn't be asking them to do it. Does anyone else have this problem and what have you done about it?