what do you think of this policy?

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our don told floor nurses today that when there are change of condition of resident and there are possibility of sending patient out to the hospital she said " our policy is to call me first because if you call doctor first then you have to act on it" what do you think about this?

we have a similar policy due to our recent ij involving not notifying md's of change of condition. Ours is to call the md first then the DON, but also if there is a change we are to let the DON know the entire details of the events leading up to the change if we are aware, etc. In our facility our big problem is communication. We have state due back in for follow up from ij anyday and seems like noone is too concerned but me, the ADON and DON. (we have a new one YEAH!!) anyway we also got hit on pain- so I did a whole hall of pain

evals and left a few with all the residents names for the night crew and evening crew to do. They did not do a single one!!!!! I swear I am sick of being the only nurse that listens to the DON. I believe they feel that doing fall risks assessments braden scales, aims forms or any type of assessment other than the initial one is not there responsiblity. so aggravating. I dont know if I should spend my only day off today going in doing the rest of the pain assessments or just let us get in trouble again. We just had a web bases training on pain all direct care staff was to attend some did not even show up and I hope the DON sticks to his guns that the ones that did not come dont have a job.We have had 2 brand new nurses come in wanting jobs I am all for an overhall of a couple of people that caused this whole situation in the first place.

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Specializes in geriatric/long term care.

Ms RN. I think yiour DON is seriously cracked!!! I wonder what the physicians think about that little policy? Or the State Board? It sounds like your DON is more into CYA than what is best for the residents that she is allowin g into the building. How to tolerate these kind of people? God give you strength:cry:

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Specializes in LTC.

We have this exact same policy where I work....initiated by our DON....I have yet to follow it because I work 2nd shift and she is NOT an MD. I am the nurse for so and so.....they depend on me and MY judgement...when I know something is wrong....I call the MD and do what HE says...if he says send them to the ER...thats what I do...I notify my DON AFTER I get them sent out. After all, shes at home at 10pm....what use is she to me when I have a resident who has a BP of 200/100, c/o chest pains, sob and a dropped sat? NONE. I think its purely stupid to rely on a DON to tell me or another nurse who is actually on site with a patient whether to take action or not if there is no doubt action needs to be taken. If a lawsuit is ever brought about, its your license on the line not theirs. Do what your nursing judgement tells you to do because ultimately you are the one liable and responsible. In my case, we dont have an RN or an actual charge nurse on my shift...we are in charge of whatever unit we work on. And I agree that its ultimately to save a dollar.

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