Recovery of OR patients in CCU

[gooser]

Hi, I have a question for this group. I am a CCU nurse in a rural hospital and found out today that we are to begin recovering the surgery patients after hours to avoid overtime for the PACU nurses. This is something that has not been done for about three years in this facility and now they want to start it all up again. PACU nurses are making a fuss about all the OT they are putting in.

I am wondering what is the standard of care. I personally feel that this is not the same standard of care because if you are having surgery between 0700 - 1530 you will be recovered in the PACU. seems like each person deserves that same standard . They did say that if we are busy we can call in the PACU nurses, otherwise we will do the recovery. Don't these patients sometimes need 1:1 care while waking up?

Who is responsible for this patient if something happens to them on the way to CCU, the OR is two floors down, so they have to go up on an elevator and down a very long hallway to get to the CCU. They will have portable suction and O2 of course. I am thinking about the possibility of some immediate complications of general anesthesia. Are we heading for trouble or is this a common practice in small towns? I would appreciate any feedback you all can offer.

T

[zrmorgan]

spoken like a true icu nurse advocate mommy...thank you

[ckalston]

I have no problem when I see ICU nurse sitting outside patient's rooms doing whatever. My problem only occurs when I (as the house supervisor and on call recovery nurse) ask the 3 nurses sitting behind the nurses station playing games on the computer, reading bridal magazines, talking on the phone, if one of them would be able to take a recovery patient coming out. The ICU census is down, the patients in ICU are mostly boarders (rest of hospital is full) and the patients they have are walkie talkies. I don't like being told, we can't we are to busy, when I know better. If you tell me your busy, be busy. Otherwise, I think we need to stop this we are better than anyone else in the hospital and regardless if the patient is walkie, talkie, we won't do any more, when the nurses on the floors are taking care of 6 patients a piece and most of them sicker than the ones being boarded.

[mommyof2grls]

"I have no problem when I see ICU nurse sitting outside patient's rooms doing whatever. My problem only occurs when I (as the house supervisor and on call recovery nurse) ask the 3 nurses sitting behind the nurses station playing games on the computer, reading bridal magazines, talking on the phone, if one of them would be able to take a recovery patient coming out. The ICU census is down, the patients in ICU are mostly boarders (rest of hospital is full) and the patients they have are walkie talkies. I don't like being told, we can't we are to busy"

I have dealt with this as well, those are the ones who need a swift kick. (I am sneaky those are the ones I give the harder assignements to, that way I know they are busy and I can rely on others to help them out.)

For the most part we all make the same pay, your here for 12 hours or whatever. If your work is done what harm is it to help others. None, what else is there to do. we had a thing in the unit I used to work in that m ost everyone would go around asking if anyone needed anyting before taking a break etc. A very good crew, but there was always that one nurse who would say yeah, empty my urine do this do that , (you all know the nurse every unit has one) and she had the lightest assignemnt. Those people are left to hang in the wind.

There are those who think they are being taken advantage of, and sometimes that may be, maybe they time manage better, maybe they are better I don't know, but they get the job done, therefore seem to get the big assignments. Those are always the ones I got out first if census dropped and no floats were needed, gave a light assignment to when I could etc. Because I knew....when I needed 110% they would get it. It is all a balancing act. Team work is a priority, but not just within the unit.

I have read and nodded my head at several referrals to nurses in other posts about nurses cutting one another down , not liking to see a co worker advance, always looking to make sure they feel their assignments are fair. Life is not fair, assignments can't always be fair, live with it. I am there to give the best pt care possible, checking out what everyone else is doing is not my job, unless I am in charge.

I know I am going to get dinged for saying this...but I have never run into that with my male co-workers, NEVER!! A few lazies...sure, but never the kind of backstabbing, stuff we women are known to do.

Got a little off the subject sorry.

:)

[zrmorgan]

Any supervisor that has spent quality time in an icu would be glad to see the icu nurses hanging out relaxing for once instead of flailing in feces, melena, bile, sputum, urine, mrsa, vre, hiv, hepc, hepb, thirty different numeric variables, vasoactive medications, malignant arrhythmias, psychosis, grieving angry suit-prone family members....and oh yeah....by the way now pacu's patients, in addition to floating one staff to cath lab, and another to the step down floor.....hey were short tomorrow, can someone float us someone? capital N capital O no .

keep your hands off my nurses, and quit dumping stuff on our unit that you CAN handle....

anyway I am done with this thread...thank you everyone for the insight...sorry if I am a little vocal and random in here