imagineme

I would do the research and write the guidelines myself if I knew how!

You said it... Thanks again for your input!

First, I want to thank you for being here to help other nurses...I don't know who you are, or what your qualifications are, but it's very nice of you to take this time to help other nurses. Many nurses seem so cutthroat...an odd characteristic considering the profession. I have been on this case for 1 1/2 weeks. I only work part time. The full time nurse has informed me that she has tried to convince the mom to give the medicine to the baby, but to no avail. I must say, that I just went along with this other nurse (but not the part about leaving the MAR blank) because I was new on the case. By the way, there is an index of abbreviations (outdated, no less) and one is "F" for family. That is what I have been writing down in the box. Also, there are no times given for the meds...just once a day, twice a day...no hours. I feel that by writing that, I am saying the ball is in the familys' court. They are assuming the responsibility for the task. I am not charting that they are giving it or not. I will do a better job at writing in my flow sheets that the parents refuse to allow the nurse to adm the medication and that I didn't witness the p0arents adm it. I agree that the doctor has to be informed, so she can chart this in her records as well. I also want to know in more detail why the mom feels the way she does about the medication (the dad doesn't express an opinion.) Maybe she is just misinformed or had a bad experience with medication before...ect. At any rate, I would still like to have a set of guidelines in front of me. I have gone to a HomeCare Educator/Clinical Nurse for a local hospital who suggested I contact look into the NJ State Licensure standards, CMS guidelines, and Nurse practice Act but she thought everything was based around guidelines to general hospital care. It's just that this situation (and many others) would not surface in a hospital... Anyway, I have contacted these agencies plus CHAP, JHCO, and NJ state Nurses Association, and am waiting for responses.

I am having difficulties finding written guidelines in Homehealth nursing, specifically. Generally, most education/ training is given for a hospital position. I am working in pediatrics and have had 2 cases in a row that due to the parent's refusal to call a doctor when the nurses deemed it neccessary or withheld medication (or allow the nurses to administer,) that a doctor has prescribed for the child, there is an increase in risk for injury or danger to these children not to mention liability to the nurse. The medication is not even available for the nurses to give. I have an immediate supervisor who said I should go over the parent's head and call the doctor myself, and another supervisor who said I can't go over the parent's head, that the parent has the right to refuse medication and or treatment. The nurses on the case have been told by one supervisor to LEAVE THE MAR BLANK... (if you can believe that,) not to write on the mar that the parents refuse the medication administration by the nurse. (I'm thinking that would put the parents in a possible AMA situation where their nursing services may be jeopardized, thus a lost case for the agency?) How do the nurses protect themselves? Where are our guidelines? When your agency doesn't seem to support it's nurses...