Working Alone

[Whitesranch, BSN, RN]

We work alone on sat. Sun. Our policy and procedure says we follow aspan guidelines. Our second nurse is the " or scrub" but they leave after the surgery is over of course. The other nurses in my unit say that " well if you think your pts in trouble, you could always ask someone to stay with you" meaning anesthesia md. But my feeling is that anything could happen to anyone at anytime and why should pts on the weekend be given a lesser standard of care?

[twozer0, NP]

I think ASPAN standards is two nurses of which only one needs to be ACLS/PALS certified. We always have two nurses on call here, never a nurse alone (although I wouldnt mind it). It is best for the patient to have an extra set of hands ready if things go south. Kinda hard to bag and call someone at the same time!

[Whitesranch, BSN, RN]

exactly, 2 rns, And Yes Who Knows When Someone Could Take A Turn For The Worse. I am shocked that our hospital has been doing it this way for over 30years. What should I do?

[Double-Helix, BSN, RN]

ASPAN guidelines say that two licensed caregivers must be "present in the environment in which the patient is receiving care." This applies to phase I or phase II of recovery. While this is open to interpretation, it is generally taken to mean the same unit where the patient is. One nurse in the recovery area and one nurse in the OR, involved in patient care, would not be acceptable.

I would get a copy of the ASPAN guidelines and well as your facility policy that states these guidelines are to be followed. Then escalate this to your manager. If nothing is done, escalate to the manager of the facility, who may well be horrified to know of the massive amount of liability associated with this situation.

[Whitesranch, BSN, RN]

Yes, this is exactly what I am doing. ..I will keep you guys posted as to what happens.

[azhiker96, BSN, RN]

I'd avoid any debate about how it's always worked in the past or whether a particular pt is okay with only one RN.

The main point is there is a national organization that has published minimum standards. These are the standards by which

we'll be judged if there is an event.

[Whitesranch, BSN, RN]

OK so...my manager is having a meeting with the director next wednrsday...I am glad she is acting upon my concerns. ..the other nurses on my unit are gonna hate me...because when I brought up my concerns with them, they didn't seem to care, as long as they could only be on call every 9th Sunday and every 5th sat they do not want to take on more call..only one other nurse seems to be on my side...the newest pacu nurse from icu.

[Whitesranch, BSN, RN]

Ok everybody, we had a meeting this past Tues....our manager of course wants two nurses on call, perfect, exactly what I wanted. The problem is that the nurses who have been there for 30 years (which is about everyone) is super p.o. They do not want to do this. They are taking it out on me, since I questioned our call in the first place. No one is talking to me, I am like the plague.. They actually move when I come and sit down. It is terrible, I can't believe grown women would act like this. I am on the verge of tears at work. My only salvation is that I know I am right and doing what is right for every pt.

[twozer0, NP]

If it pains them that much its time to move on. When I started in PACU we did every 11th weekend on call, its now every 4-5th weekend. We do two staff at a time. I liked the 11th weekend setup and the every 5th works too, its still better than every other or every 3rd. Sounds like the old ladies know they had it good and change is upon them. Its a national standard so its way overdue to jump on board. I'm glad you got the two staff on. Hang in there, they will get over it or retire!

[Whitesranch, BSN, RN]

You are so right...the charge rn is now punishing me by having me do 3 to 4x the amt of call then anyone else...I am documenting everyday I work and what goes on in specifics and also bringing the schedule to my managers attention...they are trying to push me out...but not without me excersizing my rights first. This is a classic tale of harassment and bullying..I thought I was done with that in 6th grade!! Unbelievable. I will post what happens next.

[Cathy C.]

ASPAN does state two (RN's) nurses, one who is competent in Phase 1 recovery and the other in the same room or unit where the patient is receiving Phase 1 care. Your hospital is not following the standards. The intent of the standard is that a nurse providing care to a Phase 1 patient is not left alone with the patient. Look up Laidlaw et al v.Lions Gate Hospital. It is a landmark case.

[Whitesranch, BSN, RN]

Ok..I will look it up!!