[FreshHeart]

I have a question about Scope of Practice. I have been working in a Cardiothoracic ICU for well over a year. I am no stranger to critical care.

A few days ago my father had a subtotal gastrectomy to remove a malignancy that was in his stomach. He had surgery in the hospital where I am employed. While visiting him in the recovery room around 9:30 or 10:00 PM, my father asked me what this thing was resting on his arm. I lifted up the blanket to see what was bothering him. It was a JP drain that was full. I explained to him what it was and what function it performed. He then asked me to empty it for him. Because there were no nurses nearby I did just that.

When a nurse finally did come to the bedside I informed her that I emptied the JP and what the output was so that the I/O would be accurate. This nurse threw a fit that I had done this and has complained to nursing administration and accused me of practicing outside my scope by emptying my father's JP to make him more comfortable.

I am a registered nurse just like her. I am as experienced in caring for a patients with a JP's as she is. I think we all learned that in nursing school. Is it me, or is this nurse crazy? How can that be out of my scope of practice?

Please give me some feedback....CTU_RN

[Anonymous]

I think I can understand her. She is the one who needed to chart the amount, color, clots etc. I would have found a nurse. But that's just what I would have done.


WR,,, three commas for Becca

[cassioo]

I would not have been upset with you had I known you were a nurse and capable of the JP and as long as you gave me the information I needed I'd be fine.
I had a mother of a labor patient pull out the internal pressure cath a few weeks ago because it was in the way when she wanted to help put the pt on the bedpan. I have no problem with helping get on the bedpan I do have a problem with pulling out things you don't know what they are.

[1mg.epi]

The down to earth legal issue is that you were not on the clock. Thus the hospital is not responsible for any thing to happen (what? i don't know). It is for this reason or the one wanderingRN or cassioo said. OR this person is so anal retentive or full of her self that she cant say thank you for doing that. Some people, every now and then some nurse is so crazy you need a danger sign, "Do not help, may explode."

[Anonymous]

Some nurses are protective of their patients and rightfully so. Also, would this poster have emptied the JP on another patient? I have had family members in the hospital and it took all my will power not to "help" but at the time it wasn't my duty to. Of course if they were falling out of bed or something like that yes.

Sorry to say but I just think the poster has to accept the facts..IMHO


WR,,, three commas for Becca

[cassioo]

I think for my family member I would do that..I did adjust the monitor on my daughter when she was in labor...why else monitor if you aren't picking up baby. But I would not have done so on someone else. It's called common sense. I would not adjust an IV drip on my family but call who was taking care of them if the pump was beeping (ok maybe I'd hit silence before I called) but I wouldn't spike another bag.

[Anonymous]

That's my point exactly Cass there has to be a cut off .. Might as well make it "I won't do anything invasive".. Emptying a JP IMHO is invasive. Did she wear gloves. Did she wash her hands before and after. Many questions unanswered here.

WR,,, three commas for Becca

Actually, I'd want a nurse who protected my family member that much.

Yes I know she's an ICU nurse but we all know the old
ass u me theory. Never do it. When you do you're liable to get bitten in the arse..

[cassioo]

I think we're both right here I'd just rather have an ICU nurse who is empting their families JP drain then someone who's not a nurse try and do it and mess it up. Like I said I did adjust the fetal monitor on my daughter but wouldn't have had it been an internal monitor (but then it had better have been picking up if it was internal). Haven't you all had the helpful family member who pushes the pause or silence on the IV because they've seen the nurse do it then they don't call or they help adjust the IV because it didn't look like it was dripping. Just depends on the circumstances.
Would the liscense be in any question if the family member is off duty or works at a different hospital? Another how far do you want to push it question. Call me a rebel living on the edge.

[Anonymous]

Yes we did have people silencing pumps and we lost IV's. So we started locking our pumps out..


WR,,, three commas for Becca

I actually had quite a discussion with a "nurse" who thought the IV wasn't working properly because I didn't have the sensor on the drip chamber. I couldn't convince her that the pump monitored the flow internally. She called in the charge nurse. So my contention is that not every nurse is up to date to take care of my patients. And shouldn't.

[1mg.epi]

Although my reply above seems kind of flippant, I do agree with the two of you. I do not explode at the family members if they touch things, I would ask them just ask me to empty it. If they were a nurse, which I had similar thing happen, I would tell them, "You know better than that. Just ask me, I'm the nurse and you are a visitor. I do attempt to re-enforce the rolls we are in. But, I would still thank them for the help.

What did piss me off is when family would tough monitors and equipment when I worked CVICU. We had vents that were touch screen to make changes. You know there are some family members who are so stupid they start playing with the settings and don't have a clue (I am sure I am the only nurse that has happened to0. Our space lab monitors you could place tape on the edge of the monitor and it would lock out the touch screen. I would go in the room and find my displays changed and the family would not say a word about they did it.

OK as I am talking about this I think I need my sign, "danger may explode." No, I never get mad, and always treat the family with respect no matter how many functioning neurons or tattoo/teeth ratio they have.