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June 16, 2008

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joan e

I am coming to believe that the ability to look at more than the policy( or law, or rule) when judgements are made is common practice. And not just in nursing issues.

Yes, she disobeyed a resident. No argument.

I worked for 7 yrs in a CVICU at a major university med center.

The first thing I thought was who would choose to electively intubate an alert pt on a med/surg unit??

HELLO!?!?

there is an ICU bed waiting, with monitors, experienced staff, and also staff ratios to handle it.

To intubate on a general floor, with an alert pt, there would need to give conscious sedation, and staff to restain the pt, not just cardiac monitoring but staff to know how to read it, just to mention a few basic requirements ...

then the need to get an xray for placement before moving, the risks of moving an intubated pt who is no longer capable to breath independantly thanks to sedation, staff that knows how to secure an ett, and knows basic ventilator info, not to mention in many older facilities the inability to use a vent in rooms used for general non acute pts.

Then there is the staffing issue, and again this cracker jack residents choice to intubate on the floor.
It is ok and not of concern to place the other pts on the inut in danger because that pts nurse is unable to even think of her other pts, and the other staff needed to help her are also forced to put their pts on the back burner???

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