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In order to cut costs, we were told that one nurse would be responsible for covering call for two departments. Couldn't this compromise patients' safety?

Wednesday June 20, 2012
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Dear Nancy,

I am an RN in a Special Procedures unit. Our hospital and CNO want the Cardiac Cath lab and Special Procedures to be combined into one unit. There is 24-hour RN call coverage needed for each department. In order to cut costs, we were told that one nurse would be responsible for covering call for both departments simultaneously. I feel this could be a potential danger to patient care. If we are called out for an emergent case in Special Procedures and a Code Stemi is called for a STAT angiogram at the same time, wouldn't that be unsafe nursing practice? Based on the ANA code of Ethics (and other applicable nursing ethics codes) wouldn't this not only compromise the patient’s safety, but our nursing license as well?


Nancy Brent replies:

Dear Rose,

Although not all of the details of this proposed arrangement are included in your question, it does sound like a precarious situation — both in terms of the safety of the patients and the nurse's potential liability if a patient injury or death occurred (professionial negligence) — and his or her potential liability under the state nurse practice act and rules. The hospital may face potential liability as well.

Staffing of any unit, but certainly special units like yours, requires a careful analysis of the patients on the units, the skill and expertise of the nurses staffing the units and how emergencies will be handled. Your description does not sound as though much thought has been put into the staffing of these two combined units and clearly not with your role when covering call.

It might be helpful for you to do some research about what your state nurse practice act says about a nurse's responsibility in taking on a role that compromises patient safety. Also, it would be helpful to know what your state regulations are concerning staffing in each of these departments and when they are combined. This may be difficult to research on your own, but an attorney or a nurse attorney could help you find this information. Your risk manager also might be a valuable resource in helping you locate this information.

In addition, your professional nursing associations, including the ANA (nursingworld.org), can be helpful in providing you with documented research and peer-reviewed articles that speak to what the numbers should look like when nurses take call in these specialty units.


Nancy J. Brent, RN, MS, JD, is an attorney in private practice in Wilmette, Ill. This information is for educational purposes only and is not intended as legal or any other advice. The reader is encouraged to seek the advice of an attorney or other professional when an opinion is needed.