refusing to prep a pt for surgery?

Esme12, ASN, BSN, RN · Mar 28, 2012

Tough one. Is the doctor performing this procedure board certified? Has he performed this procedure before? Is your facility certified/approved to perform this surgery? Like not every facility is approved to perform open heart.....so just because a MD WANTS to and the administration says it's OK.....it isn't.

If you make waves and "everyone is on board' be prepared to lose your job. You can file a complaint with The Joint Commission about quality of care. You are within your right to refuse to care for a patient you do not feel safe about but there are no laws protecting you from retaliation from your employer for not being a "team player".

In an emergent situation I could see crossing the usual and customary lines....scheduled? Not so much. You are in a catch 22 situation. This may be one time I'd become suddenly very ill and somehow an anonymous complaint would get filed from someone .

Chicken, I agree....but in this current employment market the path of being righteous is a lonely and probably unemployed one. :smokin:

jenzau · Mar 28, 2012

Are you a member of a Nurse's union? If so seek their help! Where I come from it is permisable to distanced yourself from a situation that threaten's your registration. We as Nurse's are the patient's advocate and must fight for their safety!

GHGoonette, BSN, RN · Mar 29, 2012

Op, it's already the 29th where I live, so any further discussion is probably moot at this point. You don't say what kind of surgery is planned. As the pre-op nurse, you don't have much say as to whether the surgery is performed or not, other than fulfilling your pre-operative duty and ensuring the patient signs informed consent.

You can inform the theater UM that you will be doing this, so as to ensure that the PATIENT is on board with the "plan", and that the Dr, Hospital Manager and NSM have all done their duty and informed the patient of the potential safety hazards,!20which are ultimately their responsibility. If the hospital is indeed performing a procedure on a patient for which it is not equipped, both doctor and patient need to sign documents indemnifying the hospital if things go South.

nursecass · Mar 31, 2012

I just wanted to follow up and thank you for all of your responses. Unfortunately the surgery went as scheduled, and instead of being able to distance myself from the situation I was in fact the primary nurse for both before and after surgery (until I handed off to the ICU nurse) because I was the only one in the recovery area competent/capable/comfortable with the invasive monitoring that the pt came out of the OR with. The next day I told the manager that I would no longer be working in that unit because of the safety problems that I had identified and then witnessed and experienced (including being left completely alone with the pt in the PACU). No more PACU for me. Thank you all for the advice though-it was very appreciated! :)

Esme12, ASN, BSN, RN · Mar 31, 2012

I'm glad it all ended up being OK. Talk about a great ethical dilemma paper subject.

nursedejuan · Apr 1, 2012

Being left ALONE in PACU unfortunately is very common.... We have the surgery nurse to call if we need help (yeah right).. If though I do think ASPAN standards do state 2 licensed nurses in unit at all times, again HA.... If they bring me a patient and I'm not comfortable with their status, neither that circulator nor the anesthesia provider get to leave... I ususally prefer the CRNA to stay over circulator, most of the time they aren't comfortable either... When we are on call, its just one of us.. The ciruculator always tries to leave and go home when they are done, and so does anesthesia... But sorry I'm not being left in a locked down unit alone