mycotton

If a physician writes an order on a patient's chart, i.e., "Aspiration Precautions", and the hospital does not have a policy for this, what is the nurses obligation for following such precautions? What is the hospital's requirement for having policies in place for all physician orders? I'd appreciate your input.

Would this hospital put a transferring nurse on any floor without a proper orientation? NO! Therefore, you should not be expected to take the role of a nurse who had a full orientation. If you are being placed in the position of working in an area where you are not comfortable or not 100% qualified, you must first tell the supervisor that is telling you that you must go there. You may have a chain of command, and utilize this system of communication. If they continue to insist, you must chart the fact that this supervisor was notified that you do not feel properly oriented or qualified to work in this specialty area. Let her know you are doing so. This usually stops it cold! Now, they are responsible for their unsafe assignment. Call your State Nursing Board, and double check, they will concur with this. Ask where you need to chart this. If you do not follow this Standard, you are then held liable for the care of this patient. Your administrator knows this, and is betting that you do not. If anything goes wrong, I'll almost assure you that she says that you failed to inform her that you were not comfortable in this situation. Your word against hers. Call the Nursing Board before putting yourself in this situation again. Good Luck.

No I've never been sued. I am, however, a Legal Nurse Consultant. You have no idea what kind of responsibilities you hold on those shoulders. We are with the patient 24/7, and if something goes wrong, they're coming after you. If you don't feel a situation is safe or if you don't feel comfortable taking care of a patient due to lack of experience, tell the supervisor, and chart it if nothing is done. Good Luck. I am lucky to be in a hospital where documentation is a religion, and there is a policy for almost everything you can think of . I appreciate this, and value that in my institution. Nurses are legally liable to conform to "Standards of Care", whether or not an institution enforces such Standards. The trick is "finding" the "Standards of Care". hmmmm.

:uhoh21: How are things out there on Gilligan's Island? :uhoh21:

I wasn't ever referrring to a profession that would be labelled as "easy". We couldn't even come close. Other than being a physician, try to find a profession with a fragment of the responsibilities we face daily: (#1 or #2 factor affecting the life of a human being, legal issues that we must be held accountable for every minute of every work day, based on "Standards of Care", that exist in a secret vault somewhere, ( I call us the "KRYPTONIGHTINGALES" ). What profession, anywhere, is expected to follow professional "legally" recognized standards of care, for every single move they make, without ever seeing exactly what those "legal" standards are?! Nurses spend the entire shift with the patient, and are the #1 target for Malpractice cases. Reason: Deviation from "Standards of Care" are broad, general, and we don't know what they are, "specifically speaking". Go and ask what the Standards of Care are for (pick a topic). Utilize your crystal balls, nurses, because, many if not most policies are only based on them. If your place of employment does not even have a policy based on a Standard, you are to be held to the Standard, that you cannot find, and are liable for practicing under the Standard. Think you are making enough money yet? I believe a "Standards of Care Course", "Legal Course", and a "CYA" Course should be a "Standard" of Nursing Education, or Nurses should be allowed to sue the Nursing School that spit them out. Also, yes, Doctors are sued due to malpractice situations, but remember this, Doctors actually have a "say" into their practice, unlike nurses. If a Doctor feels he or she needs help, they get help. Do you think they would do a procedure without every bit of needed help? Would they put up with anything less than the utmost of respect and acknowledgment of their expertise when expressing concern for patient safety? Forget hours worked, we work them! Christmas, New Years, Weekends, etc... What other profession runs all day, non-stop, and dares stop for a break only to pay back with being behind on charting and staying late? Our overwhelming responsibilities, stress, lack of input, ignorance to our needs, and liabilites could be a Saturday Night Live Skit if it weren't true. Easy pay? or Easy prey??? Speak up today!!!!!!!! :rotfl:

Thanks for your well-stated and informed observations and opinion. I happen to agree with you. To everyone who is hanging the artist because they can't find the picture, allow me to clarify. My point was that Nursing is not a career that a person should choose for the money aspect...ONLY. If any of you think that this should be the reason, you are selling yourselves short. I am not saying that the money and benefits are not important, quite the contrary. They are extremely important. We have to live also. But, if I wanted to pick a career purely based on making money, and not on something I felt I would love, I would tell a person to look into their heart before they made that leap, because it's very difficult, mentally, physically, and emotionally. It is also very rewarding, in its own way. That innate gift that many, not all, nurses possess, is unique and sets us apart. Look at other professionals...lawyers, PT's, PA's, Teachers, Accountants, etc. We're just different. Maybe in a self-sacrificing way - we tend to be!! That may be the issue. Personally, I don't think we make enough! For all the lives that we must account for, the liability and responsiblity on our shoulders, just one little error,or God Forbid,a huge one...it only takes a second of fatigue, or a missed order, or just being human, (we're not supposed to be), and we are done with our careers! Work too long, short-staffed, ill, without a break, etc, don't dare screw up. You have to love what you do, to expose yourself to this, hence "heart 101" prerequisite, or potential failure, or maybe, yes, you could venture into other aspects of nursing without direct patient care. You could become Managment and make the rules for the floor nurses, having 0 knowledge of what floor nurses actually deal with on a daily basis!! Yes, you may start with the wallet, but that heart should be in it somewhere! You can't be a "people phobe" and decide that nursing will pay the bills! I respect Nurses more than I can say, that was my point. This is not easy money: Nurses must: take all the heat, Think on their feet, restore a heartbeat, and deal with defeat. That is just in 5 minutes... Stop fighting yourselves! It's HUMAN to want the money, for godsakes, but you can make that with your brain in other places. You're special. Appreciate that about yourself.

I think that anyone who becomes a nurse for the money will be sorely disappointed in their decision. This is a career choice that comes from the heart, not the wallet. They would never cut it. You have to love this job, you have to love people, and you have to be strong and devoted to the profession to remain a nurse. They wouldn't last past their first pair of messed up new shoes!