Reasonable and Prudent

[ohbet]

what should a reasonable and prudent nurse do when he/she is so busy that its impossible to follow the accepted standards of care,which would be following our facilities Policy and Procedures.

Do I report the situation to the DON,if the DON is not supportive then what? I have a suspicion other nurses take short cuts. What should a reasonable and prudent nurse do in this situation?

I also have another question. Some of our Policies and Procedures are appalingly out of date or non existent. We have new equipment but no P/P for the equipment and and some of the P/P is not reasonable to follow in light of the patient acuity. How does one get the P/P updated or changed?

[BrandyBSN]

First, yes, try to contact the DON.

Secondly, how about submitting a proposal to your intitution's review board? I have found that many committees are more receptive to updates and changes if you come to them with a plan written out. Its hard to support a complaint if you have nothing to offer as a replacement to the protocols that are already in place.

If there is not a committee to oversee updates and improvements, try recruiting members to begin one. Good changes rarely happen when there is no one to initiate them :)

Good Luck!

BrandyBSN

[Genista, BSN, RN]

I agree w/ Brandy's suggestions. My thoughts: If you come to work & feel that your assignment isn't safe, notify whomever is the next up on your chain of command (ie charge nurse, nursing supervisor, etc). If they do not provide timely help or relief, I would tell them I am filing an assignment under protest (AUP).

;-0 Yep, that's right. Maybe people are "taking shortcuts" because the floor isn't staffed to acuity? There's nothing wrong with speaking up and letting it be known that you can't safely provide care. Taking shortcuts is risky & dangerous. The prudent thing is to inform your supervisor of the potential danger of the situation, so that it can be remedied.

Be sure & document whomever you notified & the time. Write down the pertinent info for that date (ie census, acuities,your assignment & the staffing matrix). If you submit a AUP to your supervisor along w/ a QA, keep a copy for your records. Long term- Talk with your DON about updating your P&Ps and concerns about staffing issues. As Brandy suggested, participation is key. Suggest a unit meeting to discuss the problem & solutions. If they don't address the problem immediately & with all seriousness, I would start looking for another job & give my notice. It's not worth it. There are a million jobs out there, and some facilities just don't give a darn.

Good luck!