I know nursing is a 24 hour job but...

  1. Where do you draw the line in finishing work that should have/could have been done on the previous shift? I can understand to a point, but when I get put behind several hours finishing up stuff the other shift didn't get to do (ie. tallying I&O's, etc.), it puts my shift's work behind too. Is this just the nature of nursing? Just wondering how other people handle this, or if I should get used to it.
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  2. 20 Comments

  3. by   caliotter3
    Very hard question to answer if your supervisory personnel are not heavily involved. Of course, everybody should be considerate and helpful, but this is usually not the case. You should be able to speak to each other in a civilized manner and work out any differences if problems arise. Well, there's always someone who tries to take advantage of the situation it seems. When we brought problems of this nature to the attention of the floor supervisors, they did nothing. We learned not to bother with them. If you feel like you have reached the end of your rope and do not want to be stepped on anymore, you just have to assert yourself and stop doing the work of others. But you should cover yourself by documenting and bringing the problem to the next supervisor. And, of course, do not do or refuse to do anything that will compromise patient care. (Then there is always the payback option. If you need to spend two hours doing the previous shift's tasks, it only makes sense that you leave two hours of your own tasks behind, despite the protests.) It really burns me that the supervisors are ineffective. After all, part of their resp is to take care of these matters.
  4. by   micro
    prioritize, patients come first, and the priority charting.....
    the rest take to your management and your coworkers, because hours behind is not manageable.......
    if doesn't change,.........don't become part of the problem if no one willing to work on solutions.......

    micro
  5. by   deespoohbear
    I usually make sure "all my ducks are in a row" before the next shift comes on. Especially stuff such as recording I & O's, VS recorded and so on. I don't think it is fair to leave that stuff to the oncoming shift. I have had in the past nurses who were notorious about not restarting IV sites, leaving dry bags, not completing an admission. If it becomes a problem, I will address it with them one on one. Fortunately, most of the nurses on our floor (all shifts) are great about not leaving unfinished business for the next shift. Have a couple though that need to be re-educated about finishing stuff. If it does become a major problem, our managers are pretty decent about addressing the situation. My pet peeves are nearly empty IV bags, and bad IV sites. For pete's sake, if there is less than a 100 to count in the IV bag with an hour of the shift left, change the bag. And don't leave the questionable IV's. If it is bad, it is bad and needs changed. Period. Well, now that I have that off my chest back to the question at hand. No, I would not get use to it. Ask your managers how they would like it if the previous shift left stuff undone. (I bet none of them work the floor anymore, correct?) Document it. Kind of hard to argue when it is documented. Good luck and hang in there. No one can take advantage of you without your permission.
    Last edit by deespoohbear on Sep 21, '02
  6. by   night owl
    To tell you the truth, if the previous shift didn't chart VS, I/O, do their nurses notes it becomes their problem, not yours. I certainly have enough to do without having to do their charting too. I believe in "team nursing," but when it gets to the point where you're always doing their "leftovers" it then becomes "sucker nursing." I personally used to do previous shift work, but not anymore! When the Doc is looking for VS from evening shift and they're not there, he/she runs to the NM and tells on them. The staff then hears about it from NM. I can't be worried about them anymore b/c there's just too much to do. I can just about get my own work done in 8 hours. (Wish we had 12's some days) Besides, a responsible person will see that every VS is charted and every note is written even if they have to stay over to finish their work.
    Last edit by night owl on Sep 20, '02
  7. by   caliotter3
    I worked at one place where I was oriented that I would have to clock out and finish on my own time, regardless of circumstances. Also required to report 15 min early to receive report and do a walk through before starting. The offgoing nurse was required to clock out on the dot, no matter what we were engaged in at the time. We always started by counting the controlled substances so we wouldn't be interrupted. Just part of what was required to work there. But somehow it seemed that there was more cooperation between shifts. I guess that was b/c we all felt that we were being used, and we were all in the same boat. Shared misery I suppose.
  8. by   live4today
    Originally posted by 502Nurse
    Where do you draw the line in finishing work that should have/could have been done on the previous shift? I can understand to a point, but when I get put behind several hours finishing up stuff the other shift didn't get to do (ie. tallying I&O's, etc.), it puts my shift's work behind too. Is this just the nature of nursing? Just wondering how other people handle this, or if I should get used to it.
    Hello and welcome aboard Allnurses.com 502Nurse!

    The line is drawn when NURSES grasp the reality that NURSING is a 24 HOUR NEVERENDING JOB!!! Having said that.......one shift merges into the next shift, and so forth NONSTOP. Nurses need to STOP thinking 'oops...I'm frustrated because I can't tidy up my shift and go home without worrying about what I finished or didn't finish' because nursing care is.........what?????.......24 HOUR CARE!

    Now.....unless you want to be the sole nurse on duty 24 hours a day, 7 days a week...you do what you can safely do within the time frame you are scheduled to work and let the next shift continue that care into their shift...then the next shift continues that care into their shift.......and so on and so on. There's nothing hard about that.....it's all in the mind.......requiring the ability to grasp the fact that you are ONE PERSON.....who cannot and should not leave work thinking you didn't give to the nurse corp. You gave.......you gave good......now pass on the care for the next 12 hours....or whenever you have to return to work again.....and rest rest rest your mind, body, and soul so that you are able to return to work refreshed to relieve the off going nurse who has given a good 12 hours of her life to the ongoing...neverending...process of nursing care to the many patients in need.

    When you clock out......sign out.....whatever is required of you after your shift ends.....PAT YOURSELF ON THE BACK AND SAY 'SELF...JOB WELL DONE' and start to WIND DOWN from that point on. Say "Goodbye to the oncoming shift, wish them well in their shift, turn and breathe a sigh of calm, and go home about your life until it's your turn again. PLAIN AND SIMPLE!!!

    Nurses need to LEARN when to TURN ON THEIR SWITCH.....and when to TURN THEIR SWITCH OFF! Nobody died and made nurses 'SUPERNURSES'......so we need to get over ourselves and realize our 'limitations'......life DOES go on after we clock out...believe it or not.
  9. by   Eastclif
    I think there are two issues here. Having charts completed properly before going off duty is very important, and if necessary, I think the nurse should stay past her shift to make sure all meds are signed, vitals charted, balances done and notes complete. It is something that only the nurse that gave the care and medications can do, and the information is essential in order for the medical team to make a proper assessment and adjust the treatment plan. But the reality is that there are always nurses who are sloppy in this department. They need to be told directly to clean up their act. And if that doesn't work, it should be taken further.

    On the other hand, and I see this all too often where I work (CV-ICU), is that many nurses feel their work is not done unless the patient is extubated, deep lines out, washed and sitting up in a chair when the day nurse arrives, EVEN IF the patient is not really ready, and could benefit from the lines being in for a couple more hours. For example, taking out the PA catheter and art line when the patient is still on a bit of Nipride. This means that the main IV and antibiotics must be given in the same line as the Nipride (with potential peaks and troughs in the BP, and the BP is not being properly monitored). The patient can't go to the ward on Nipride, so why rush to pull out the lines??? It only takes a minute (5 for the art line), and can be done more safely when the extra meds are off. I see this as a case of nurses doing things for other nurses and not for the patient. The theory is that it speeds things up for transferring patients to the ward, but they can't go till there are beds available on the ward (10 or 11 am) - it's not as if they are being rushed out at 8 am.

    Does anyone else have this problem, which is kind of the opposite end of the spectrum from leaving charting undone??

    The bottom line is that everything we do (or don't do) should be in the patient's best interest, and neither of the practices serve that purpose.
  10. by   adrienurse
    Although I work my azz off on a daily basis, there are some times when I draw the line at cleaning up other people's messes (literally). It may be a little childish, but id someone leaves something disgusting lying aroung and I know they're coming back the next day, I don't touch it.

    For example, I came on Thursday to find two hairy plastic glasses of rubbing alcohol that had hairy pieces of the "unit" shaver soaking in them (I know, oy infection control).

    I refused to touch that. Let the perpetrator clean it up.


    Other wise it fels like I am forever cleaning up people's messes -- chart-wise. I do it because I can't live with my anal self unless I do.
  11. by   caliotter3
    There is a difference between appropriately turning over the shift at the point left off and leaving unnecessary work for the oncoming shift. It is this second situation that is addressed in the first post. As a nurse or CNA gains experience, they learn to determine what was deliberately not finished and what is legitimately the stopping point of the previous shift. Prime example in LTC: NOC shift nurse arrives 20 min prior to start of shift and notices: CNA's scurrying out of rooms where they leave the chairs, blankets, and pillows they were using in front of the TV set the sleeping resident is paying no attention to, and a check of the resident's condition reveals urine, feces stains that have "rings" and are starting to dry. You can figure out who has not been attended to more than two hours prior to the end of shift. The nurse, finds six dislodged Foleys and residents lying in drying puddles of urine (some coincidence that it happened right at 10 minutes to 11PM for six different residents!) The offgoing nurse tells the oncoming nurse absolutely nothing about any dislodged Foleys she didn't have time to correct. Walk into a room, find an expired resident. Well, how far into the previous shift did he/she expire and the offgoing asst or nurse did not even check or better yet they knew and pulled a fast one on you because you hear through the CNA grapevine that they knew he/she was expired? There are many more obvious examples. With experience, you can learn to determine what is legitimately left. A dead giveaway: when the offgoing personnel can not get something done or even started, they have the professionalism to inform you about the situation in report. They own up to it. There is no deliberate leaving of "surprises".

    In Eastclif's post: my background is LTC, there are parallel scenarios, although not as critical. Requiring one shift to start taking on tasks previously reserved for the next time frame, such as getting people out of bed and bathing them at 4AM so day shift has less to do. Is it appropriate to expose someone to showering and shampooing at 4AM? Not hardly. Toying with pt abuse, if you ask me. Listen to them scream and cry as it happens. Particularly when someone comes down with pneu and everyone wonders why. DON's rationale (she is the proponent of this) "They don't know the difference between night and day anyway".

    A smaller example: if it is the resp of NOC shift to tally I & O totals, how can this be done when the majority of the entries from the other shift(s) are blank? All it takes is a simple "Hey Sue I didn't get time to get to the I & O's this evening, can you try to find the time?" is all it takes.

    Cheerfuldoer eloquently states how it should be from shift to shift, unfortunately what is being addressed here is when individuals deliberately slack off and cause more work for their co-workers on other shifts. There must be supervisory intervention to insure that smooth turn over takes place and a few conscientious employees are not allowed to be dumped upon by those who don't care to do their fair share.
    Last edit by caliotter3 on Sep 21, '02
  12. by   askater11
    I always feel bad leaving something for the next shift. But then again I'm left with a short list of stuff from the prior shift. (which I nevermind....one nurse always leaves me a LONG list but it's manageble)

    There's times I add up day shift I&O's...I don't mind unless its the "same" nurse not doing her I&O's.

    We have been SOOO shortstaffed that things are left behind. I truly believe nurses try their best to finish stuff (the nurses I work with)

    Last night I forgot to empty a foley. 4 years ago I would've been so upset at myself. But since our matrix has been changed making us take more patients...and that our new matrix they CAN't give us Enough staff....I tell myself..."I did the best I could". (I know a lot of nurses here on ALLNURSES FROM THE COMMENTS WOULD PUT ME DOWN)

    I am currently looking for a new job. (I'm sure you are happy since I look like a BAD nurse )

    I'm praying there's a job out there with a decent nurse patient ratio so I can get my job finished and feel I gave great care to my patients.

    Someone mentioned about not getting paid for overtime no matter what the reason was. My last job was like that...I will never stay at a facility like that. My current job we have to write in a book why we worked late. My comment for overtime is shortstaffed. The shortstaff is as consistant as my overtime.
  13. by   caliotter3
    In my previous long post I forgot to say this: if you have time to sit and eat a bagel in front of a TV show at the end of your shift, then you have time to have completed your tasks before report. This comment applies to licensed nurses and well as CNA's.
  14. by   Flo1216
    One time an 11-7 nurse on peds went home without signing that she had given the 7AM dose of Mestinon to an 18 year old pt with Myasthenia Gravis. So I (as a student) gave the 7 am dose. I was about to give the 12PM dose when the 11-7 nurse called and said that she had give the Mestinon at 7am but had forgotten to sign for it. This pt was in the hospital because she had accidentally overdosed on Mestinon. I know we are all human but thank God she callled and I held the 12PM dose or the consequences could have been disasterous.

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