did I do the right thing?

[Skylar86]

I am a newgrad nurse. I've been working in a busy ED for two months now and absolutely love it and I couldn't be happier.

Unfortunately this morning I came across a ''situation'' and am not sure if I dealt with it in the right way.

This morning I started my shift at 7am. The nurse who I was meant to receive a handover from for 3 patients had went home 10 minutes early (so i ended up getting the handover from another night nurse that only briefly looked after these patients).

One of the patients presented at 0230 that morning with severe abdominal pain. From his arrival time up until 0640 he received 15mg morphine IV, 100mg Norflex PO and 50mg oxycontin PO. I noticed that the ONLY set of V/S that the nurse documented was the baseline at 0230 . The nurse also failed to put a name bracelet on the patient, didn't provide the patient with a gown-- nothing was organized. To top it off, the paperwork (assessment sheet) was only 1/2 filled out. I had a look at the patient list for the night to see if it was insanely busy but it wasn't.

This particular nurse is a lovely, kind, funny nurse however he is also notorious for being very slack/lazy. I know this because he was my preceptor when I was a student nurse. I ended up going to the ACN to express my concern and show her the lack of documentation. She instructed me to write a note and document exactly what happened and that she would raise the issue with the RN. I did what she said and luckily I didn't have to sign my name at the end.

Did I do the right thing? I felt maybe I should have raised this issue with the RN and let him know directly my concerns rather than going straight to management.... but this isn't the first time this RN has done this so maybe not? Could I have just ignored it... would any of you just ignored it and moved on?

I also hate to be a complainer since I am still extremely new. I wrote in the ''note'' that i felt the patients safety was comprimised. Do you think that was okay to write?

Any advice or tips on how to deal with this situation if it ever arises again would be greatly appreciated. Thank you!

[classicdame, MSN, EdD]

you did the right thing. Confrontation will only lead to denial and maybe an argument. Your manager is the one who should handle conflicts. Also, the manager may need documentation to begin building a case.

[wish_me_luck, BSN, RN]

I think the nurse should have been told, not straight to management. I think, when I took my leadership class, they said you need to talk to the person first to make sure you are getting your facts straight and to make sure there's not another reason why it wasn't done (i.e. maybe they got really busy and didn't have time/or honestly forgot). Also, I would not trust someone who went straight to management without even saying anything to me. That's my opinion. If it went on and/or got argumentive, then go to management and they will handle it.

I don't think it's good communication between co-workers if you can't resolve problems among co-workers and always have to ask management. That's only my opinion.

[chevyv, BSN, RN]

Can I ask why the nurse left 10 mins early? Was there an illness? I hate getting dumped on by day shift, but I haven't gone to management. I always figured I would talk with days first to see what was going on. I hate coming in for pm's and seeing orders sitting from 1100 but time was spent organizing yet another closet room. If that pt would have gone downhill, that nurse's butt would have gone under as well. Lack of documentation is never good.

[GitanoRN, BSN, MSN, RN]

unquestionably, this happens more often that we want to admit to all of us in one time or another. the nurse in question should have given her report to the nurse manager in order to get a more complete understanding of the situation that evolved without your presence; that's the least that she/he should have done. needless to say, i hate to get incomplete reports specially from a 2rd. party that wasn't totally involved, for instance if something goes wrong right thereafter; you're the one held responsible... in my opinion it's just asking for failure.

p.s. i wish you the very best, and keep a lookout for this co-worker it seems to me that her behavior as you stated previously has become a habit.

[BostonTerrierLover, BSN, RN]

Just remember, You didn't go around and talk about her negatively. You didn't call her boss, and blast his ear on the phone. You didn't go in your boss's office demanding she be written-up. You felt it affected your patient's care.

I have to say, if you felt that it needed to be handled- and I was the "other" nurse, I would appreciate the way you went about it. Now, it's in the hands of the Manager. If there was a valid excuse, it will surface. If this has become my normal performance, and no one complains to me, why should I change it if everything is going "cool"?

If I had to hear something I did wrong, I'd rather hear it from one person, than 6 staff members in private, "Did you hear what that new girl/guy said about you?" If she/he is slacking around being the life of the party, maybe time for a gentle wake-up,

. . . . .and that's all it might take, but if not, the next nurse will not be alone- and a more serious discipline can justly take place.

Good Luck. There is consequences for every action, just always make sure the juice is worth the squeeze.