Say 'no' to UAP charting requests (Page 63)

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By Mathew Keller RN JD, Regulatory and Policy Nursing Specialist

In a cost-saving move, when certain units at a Minnesota hospital are short staffed, managers are asking nurses to allow Unlicensed Assistive Personnel (UAP) to chart under the RN’s license.  This allows UAPs to care for patients autonomously without supervision and oversight from RNs.

Needless to say, this practice is incredibly dangerous for many reasons, three of which we will highlight here.

  1. UAPs simply do not have the training or expertise to independently care for patients without proper RN supervision (and chart accordingly).
  2. Charts are legal documents, and when others chart using your name and login, it is legally the same as if you completed that charting and said that you did the work being documented.
  3. All electronic medical records track patient lookups and history; therefore, if the UAP utilizing your chart is looking at other patients, there is a strong possibility of HIPAA violations.

Far from a cost-saving practice, allowing UAPs to chart under someone else’s license is dangerous for the UAP, for the patient, for the nurse, and for the facility.

It cannot be emphasized enough how incredibly dangerous this practice is.  In fact, we have seen nurses in other facilities be disciplined for failing to log off their medical record properly, therefore resulting in someone else charting (inadvertently) using the nurse’s login.

Have you been asked to allow another to chart under your license?  We need to know.  Please contact your steward, your labor rep, and me — at Mathew.keller@mnnurses.org.

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In: Nurse licensure, Uncategorized

Mat Keller headshot

By Mathew Keller RN JD, Regulatory and Policy Nursing Specialist

In a cost-saving move, when certain units at a Minnesota hospital are short staffed, managers are asking nurses to allow Unlicensed Assistive Personnel (UAP) to chart under the RN’s license.  This allows UAPs to care for patients autonomously without supervision and oversight from RNs.

Needless to say, this practice is incredibly dangerous for many reasons, three of which we will highlight here.

  1. UAPs simply do not have the training or expertise to independently care for patients without proper RN supervision (and chart accordingly).

    2. … Read more about: Say ‘no’ to UAP charting requests  »

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In: Hospitals, Minnesota Nurses Association

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By Mathew Keller RN JD, Regulatory and Policy Nursing Specialist

In yet another sign that Minnesota Hospitals are using the myth of a Minnesota “nursing shortage” in order to avoid appropriate nurse staffing, the Star Tribune recently reported that our 10 largest hospital systems “saw operating income jump by 38 percent in fiscal 2014 compared with the previous year.”

These healthcare systems reported sparking income growth by “putting the brakes on hiring.”

In particular, North Memorial Medical Center saw its highest net profit margin since 2006 (and yet is currently laying off RNs); the Mayo system reported a 1 percent decline in salary and benefit costs while experiencing a 36 percent increase in revenue (complaining of a nursing shortage and cutting pensions the whole time); Sanford reported eliminating positions through attrition (while also reportedly purposefully staffing 10 percent under grid in order to cut costs); and HCMC, a 472-bed facility, added the equivalent of only 38 full-time positions.
… Read more about: Minnesota hospitals’ income soars  »

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In: Home, Issues, Minnesota Nurses Association, Nursing, Patient Safety

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By Mathew Keller RN JD, Regulatory and Policy Nursing Specialist

 

“If you don’t stay and work extra, who will take the admission that’s coming?  There’s no one else.”

Sound familiar?

If you’ve been told by your nurse manager that you must work “mandatory” overtime, don’t buy it!  Under Minnesota state law, nurses cannot be disciplined for refusing overtime if, in the nurse’s judgment, it would be unsafe for the patient.

Study after study show that unplanned overtime assignments have a high potential to be unsafe.
… Read more about: Mandatory overtime: just say no  »

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In: Elections, Minnesota Nurses Association

National Nurses United this week endorsed the U.S. Presidential candidate who agrees with nurses’ values and is an ardent advocate for issues important to the nursing profession, like expanding Medicare, the Robin Hood Tax to ensure Wall Street pays its fair share, and proper safety and protections from infectious diseases for nurses and patients.

National Nurses United announced on August 10 the endorsement of Vermont Senator Bernie Sanders for President at a “Conversation with Bernie” at NNU’s national offices in California.  Hundreds of RNs cheered Sanders on at the California event, and thousands more watched on live stream at 34 watch parties in 14 states, including Minnesota.
… Read more about: National Nurses United endorses Bernie Sanders for President  »

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In: Insurance, Minnesota Nurses Association

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By Mathew Keller RN JD, Regulatory and Policy Nursing Specialist

Last fall, my grandmother was admitted to the hospital after a TIA that left her oriented only x1.  Or, more correctly, we thought she was admitted.  As it turns out, she was in the hospital for several days in an outpatient status, known in Medicare parlance as “observation status.”

Unfortunately, what “observation status” meant for Grandma was that she did not meet the Medicare requirement for a 3-day inpatient stay at the hospital in order to qualify for discharge to a skilled nursing facility.  Thus, despite the fact that Grandma was certainly not in any shape to discharge home; and despite the fact that she had entered the hospital from a nursing home, she was not able to go back to the nursing home.
… Read more about: The Problem with Observation Status  »

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In: Activism, Home, Minnesota Nurses Association

Nurses throughout Minnesota know of instances of employers intimidating and retaliating against staff for a wide variety reasons, like reporting unsafe staffing,  speaking up when they disagree with a program or pilot, reporting managerial unethical or illegal behavior, engaging in union activities, and many more.

These types of incidents can cause managers and administration some headaches, but they are all part of the ebb and flow of the employer-employee relationship. Unless, of course, the employee is punished for legal and ethical actions.

Unfortunately, retaliation in the workplace is all too commonplace – and not just in hospitals.

For nurses, the opportunities for retaliation are higher than in many other fields.
… Read more about: Retaliation is a real issue in nursing  »

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In: Minnesota Nurses Association, Patient Safety

Filing Concern for Safe Staffing Forms and speaking out about unsafe staffing do make a difference. Just ask Surgical/Trauma/Neuro RNs at Hennepin County Medical Center in Minneapolis.

Nurses mobilized and forced the hospital to end a pilot program in the STN unit that increased the number of patients a nurse cared for at one time.

The pilot was implemented in January 2015 without Nurses’ input. They knew from day one the pilot was endangering patient safety and stretching each nurse too thin.

The increased number of patients was “overwhelming” to the nurses and other staff.

“You can’t keep track of that many people,” said RN Sue Oberg.
… Read more about: HCMC RNs stop 'really awful' situation  »

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In: Home, Minnesota Nurses Association, Nursing

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By Mathew Keller RN JD, Regulatory and Policy Nursing Specialist

It is with growing concern that MNA has received reports of increasingly ineffective charge nurse utilization in our hospitals.  If you’ve been in nursing for more than a few years, you’ve seen the trend yourself: charge nurses have quickly gone from having no patient assignment, to having a few admits or discharges as needed, to always having half of an assignment, to always having a full assignment… to having two floors?

This alarming new trend is to assign the nurse variously described as a given unit’s “resource,” “foreperson,” and “air-traffic controller” to two units at once.
… Read more about: Is this the End of the Charge Nurse as We Know It?  »

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In: Minnesota Nurses Association, Nurses, Nursing

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By Mathew Keller RN JD, Regulatory and Policy Nursing Specialist

With Minnesota’s medical cannabis law set to take effect on July 1, Minnesota nurses will likely be asked to administer medical marijuana in the hospital setting.  But are you ready to do so?  Here’s what you need to know about the new law.

  • Patients will not receive a medical marijuana “prescription” from a physician or APRN. Instead, a patient’s provider will certify that the patient has a medical condition that qualifies for medical cannabis use.  The patient will then need to register with the Minnesota Department of Health in order to be eligible to utilize the medication.

    • … Read more about: Are you ready to administer marijuana?  »