Urgent advice needed!

[paris2]

I am a clinical nurse specialist work with specific group of patients in all settings, OPD, Wards, Theatre.

Historically one consultant's patients are admitted to the ward at 12.30 the day before surgery. Ward round is done at 1pm and then the consultant will start start his clinic at 1.30pm. But ward manager (acting lead nurse) wants to change this. She says that if this consultant wants his patients to came at 12.30 then the patient should wait in OPD area and be seen there first and then admit to the ward at 2pm.

Rest of the consultants patients are admitted at 2pm. The differance here is that no other consultants do the ward round anyway. Their patients are seen by SpR's at 4pm onwards.

She is going to have meeting with me on Friday to clarify this though i know she will have her way anyway. The consultant involved is not aware of this yet.

Please advice me what i should do.

[XB9S, BSN, MSN, EdD, RN, APN]

I would personally talk to my consultant ASAP to see what he feels about this, at the end of the day they are his patients. What is the ward sisters rationale for changing this.

[paris2]

I would personally talk to my consultant ASAP to see what he feels about this, at the end of the day they are his patients. What is the ward sisters rationale for changing this.

Ward sister feels why she should make exception for this consultant when all other consultant's patients are admited at 2pm. Also 1.30pm is handover time so it can get busy to attend to admisison too.

[cariad]

the ward sister has got a point, admissions at handover time are not good, but she is not dealing with it in a very professional manner.

[paris2]

the ward sister has got a point, admissions at handover time are not good, but she is not dealing with it in a very professional manner.

thanks so how would you deal with this differently? and also do you think she should go directly to consultant rather disscusing with me? at the end of the she want change her mind and she will make it look as it is me that is chnaging. also i am sure when consultant will ask her she will say that i have okay it.

[Silverdragon102, BSN]

Thanks so how would you deal with this differently? and also do you think she should go directly to consultant rather disscusing with me? at the end of the she want change her mind and she will make it look as it is me that is chnaging. Also i am sure when consultant will ask her she will say that i have okay it.

I would suggest a meeting involving all concerned and then take it from there

[XB9S, BSN, MSN, EdD, RN, APN]

I think that you should at least let the consultant know what is happening and if he wants to either attend or have input into the change then he has the option to. Obviously the ward sister has her reasons for wanting this change but it is basic managment to make sure that all interested parties are involved otherwise it is not going to work.

[paris2]

Thanks to all of you for your helpful comments. Will let you know the outcome of the meeting which is on this Friday.

[XB9S, BSN, MSN, EdD, RN, APN]

how did it go Paris??

[paris2]

Hi

Our meeting was cancelled by the manager as she was busy. Next week she is on holidays but she said that she will discuss it with me when she returns.

In a mean time i have mentioned this to the consultant and he is not happy.

But he is going to wait and see what will come out our meeting.

At the moment he does the ward round at 1pm - 2pm with all his drs. He then goes and does his clinic, SHO (shared by other consultant) also goes to do the other consultant's clinic, SpR goes and dose acute clinic based in emergeny dept.

If the change would go head then the ward round will be done at the end of the day which mean consultant will have to make some changes to his workload and so will his junior drs. All clinic workload will have to be reduced in order for them to return back to the ward for ward round (mangement wont like that). Junior drs will not stay after 5pm.

However if the consultant decide that it would not be possible to do ward round at the end of the clinic then it would be done in a morning just before patient goes to theatre. In this case there will more op cancellation will occur (management wont like this either).

So will have to wait and see what will happen.

[paris2]

Hi XB9S

Just to let you know nothing has been done yet about above issue, the manager has not mentioned again to me, she has either forgotten, or she is too busy!

But will let you know the outcome when it happends.

[XB9S, BSN, MSN, EdD, RN, APN]

I was wondering how you were getting on, is it possible your consultant has had a word, maybe got her to back down a little I know thats what my docs would do if they didnt approve.