When does ready mean “READY?”

By Carrie Mortrud, RN

Carrie Mortrud, RN

Carrie Mortrud, RN

Registered Nurses are constantly assessing patients for their “readiness.” Is my patient ready for surgery? Is she ready for teaching on lifestyle changes? Is he ready to learn how to bathe his baby, and is he ready for discharge teaching? With this much emphasis of a nurses’ responsibility being on assessing whether or not others are ‘ready,’ shouldn’t we be asked if we are ready? Ready to take on charge responsibilities, ready to train and indoctrinate new staff, ready to consider cross-training and the biggest one, ready to come off orientation?

Too often I see reports of MNA’s Concern For Safe Staffing forms that indicate nurses were “pulled off orientation to take a patient assignment.” This means the new nurse and the nurse manager during the hiring process talked about the new nurse’s needs and determined a set amount of time that the nurse would be on orientation—assigned with another nurse. Not taking an assignment independently until the orientation time was completed. Now, there are exceptions to this: the new nurse, the trainer nurse (called the “preceptor”), and the manager decide the new nurse is progressing faster than anticipated. If they all feel the new nurse is ready to take patients independently, they may all choose to shorten orientation. In other words, have the new nurse skip the last few shifts assigned with a preceptor and “let the new nurse go” and take care of a patient all on her own.

 

There are usually set orientation periods for nurses who are new grads, nurses who are just new to the hospitals but come with experience, and nurses who are simply new to a department at the same hospital. When does this get disturbing? When that critical discussion hasn’t taken place yet but supervisors and managers are so desperate on a shift or weekend that they prematurely pull a nurse off orientation, take them away from being assigned with another nurse, and give them an assignment independently because staffing is so short!

Patient Story

arlene townsend staffing award

Unsafe staffing costs a Florida facility $1 billion

From Trial Magazine, March 2014 issue: Trial Magazine, 3/11/14 VERDICTS & SETTLEMENTS Arlene Townsend, 63 suffered a stroke and required 24-hour care. She was admitted to Auburndale Oaks Healthcare Center, a nursing home owned by Trans Healthcare, Inc. In the three years leading up to her death, Townsend suffered numerous fall resulting in broken bones and lacerations, infections, significant weight loss, chronic constipation, skin breakdowns, dehydration, and other problems. She is survived by her adult son. Townsend’s estate sued Trans Healthcare, alleging that it had understaffed the nursing home to increase profits and failed to provide adequate care, including protecting Townsend from falls, ensuring a safe environment, and documenting changes to her condition. The court entered a judgment of liability against the defendant, and the…
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