Should a Risk manager who is a nurse also perform direct patient care

[christyPI71]

Hello everyone. I have read several post over the last few years and just decided to join and post. I do have a question to bounce off of all of you. I have done QI in home health for 10 years and now in the hospital setting for 1 year. I am the nurse at our hospital that does QI and there is another nurse who does risk management. I do not perform patient care, however she does. Is it appropriate for the risk manager to perform direct patient care? Anyone who answers I will appreciate it.

[Jolie, BSN]

I don't see any conflict of interest as long as she reports to a supervisor who would address any issues related to the quality of her care, should they arise.

I can see where it might be of benefit to her in her RM role to gain clinical experience that might help her to anticipate problems in clinical care, understand the nurse's position in terms of staffing, P&P, patient management, collaboration with other disicplines, etc.

[psalm, RN]

I can't speak from a management viewpoint, but I think it is awesome when I see nurses in management positions who work 1 or 2 shifts a month as a staff nurse, usually on a weekend, 1st or 2nd shift. The educators see firsthand what the bedside nurse is up against aka as our reality. The nursing managers are reminded why grids aren't always "sufficient" (ie, acuity vs. numbers). Nothing like being "in the trenches" now and then to appreciate why your staff is crying for better staffing and working conditions, working equipment and why Press Gainey comes after real patient care.

Even a couple four-hour shift of bedside nursing would be an eye opener...esp. when being slammed with admissions.

[christyPI71]

Thanks Jolie. I appreciate it. She's actually rather familiar with all of that as she has worked her for several years. She was given that RM position just about 6 months ago because as I've been told "she didn't have enough to do". The reason I had asked is there was possible occurence in the ED and it was her patient and she didn't want to write it up. I guess the way I looked at it was if you are doing patient care and something happens you won't want to critique yourself.

[christyPI71]

I can't speak from a management viewpoint, but I think it is awesome when I see nurses in management positions who work 1 or 2 shifts a month as a staff nurse, usually on a weekend, 1st or 2nd shift. The educators see firsthand what the bedside nurse is up against aka as our reality. The nursing managers are reminded why grids aren't always "sufficient" (ie, acuity vs. numbers). Nothing like being "in the trenches" now and then to appreciate why your staff is crying for better staffing and working conditions, working equipment and why Press Gainey comes after real patient care.

Even a couple four-hour shift of bedside nursing would be an eye opener...esp. when being slammed with admissions.

Thanks Psalm. Actually our Direcotr of Nurses does get out there and perform patient care, and yes, sometimes on weekends too!

[Jolie, BSN]

The reason I had asked is there was possible occurence in the ED and it was her patient and she didn't want to write it up. I guess the way I looked at it was if you are doing patient care and something happens you won't want to critique yourself.

When I answered your original post, I wondered if that was the issue.

When she works as a staff nurse, I assume she is under the "supervision", although probably not directly, of the ER nurse manager, charge nurse, nurse educator or CNS. I would expect one or more of those people to address her on any issue of quality of care or nursing judgement. It seems odd that an experienced Risk Manager would shy away from an incident report, since she should be well-versed on the concept that they are intended for identifying problems, learning, and protecting the interests of the institution, and not for disciplinary purposes.

It makes me wonder just how far out of the norm her "incident" was, and whether she has the skills and experience necessary to work independently in the ER.

[zahryia, LPN]

I don't like it for the reason that was posted here. While I think it's great for a Risk Manager to continue to do floor work, I think it should be at another hospital.

It just doesn't sit well with me.

[Tongo2008]

Please help me. How do I deal with my manager who is visibly unfair. Do I pack my bags?