Margaret51

I don't envy you having your assignments made by the previous charge nurse. If you have to live with the assigment and your staff, you should be making the decisions. I like to assign my nurses geographically. You can't answer call lights and be there for the little things if your are off in another part of the unit. If too many high acuity patients are in one area, they might need to be moved to improve assignments. Also, as possible, they should be dispersed around the floor as they are admitted. I realize this can be difficult, but all things are possible. Assigning admissions and postops is a problem on those days when you start with a low census and end up with double the patients you started with. Everyone has to realize that the charge nurse is trying to be fair and give the patient the best care possible. If you have a charge nurse who is not being fair with assignments, it needs to be brought up to the manager. If the manager can't see that part of her team in undermining unit morale, you might want to find another unit.:)

Another reason to flush the line first is to clean it out a bit. You don't want the blood you draw (even after drawing the discard blood) to have an undue concentration of anything you have been giving the patient. If you have the patient on a heparin gtt and don't flush and discard properly, your PTT will come back artificially high. This can cause you to miscalculate the gtt rate if you are using a heparin protocol.