grace08

I am trying to ask a support question regrading my field that I am currently working as an occupational & employee health RN. One of my duties is to evaluate employees upon return to work after a serious or long term illness to ensure that they can perform their job description. My Human Resources Dept (HR) is stating that HR does not need to forward or give me a copy of the employees doctor excuse to return to work before I assess the employee. HR states that I am supposed to trust the HR department when they tell me that they have the doctor excuse from the employee. Does this sound normal? My idea is that I should not trust anyone on their word or email that they have a doctor's excuse unless I see the excuse. I feel that I need to see to verify. Am I correct? Also, does this put my license at risk if I assess an employee's job capabilities, based on HR's word, to perform their job description post illness/injury and if they are injured after returning to work due to miscommunication from HR that the employee had restrictions and I did not know?

Must an employee health nurse or an occupational health nurse physically have or view the release from an employee's doctor before assessing the employee to return to work or can they just take the word of human resources that human resources has received the release to return to work?

Is it common practice to back chart? And is it appropriate to do this? By this, I mean if you forget to chart something on your shift and then you remember and chart it the next day or at a later date.

Distal end is in stomach. The tube feeding are not the cause of VS deteriorating. SBP in 80's, DBP in 40's, map vacillating 60-64. heart rate 50's. patient is septic, pulmonary edema, and third spacing, trach on vent, concerns for having to start levophed. These vitals have changed from previously stable VS. My concern is if the patient codes and we proceed with chest compressions then doesn't the tube feeding place patient at a higher risk of aspiration during compressions? So, shouldn't the feeding be turned off temporarily until stability is maintained?

Do you think that it is appropriate critical thinking to turn off tube feeding on a patient that is at risk of immediate coding because of deteriorating vital sign changes? Patient would be at risk for aspiration if chest compressions were performed and should you have to get a doctors order to turn off tube feedings?