Let the next shift deal with it...

  1. Often wondered if this has happened to other nurses and if so, how was it handled?

    You come to work get report make rounds and find a pt very dyspneic, or spiking a high temp, or crashing or even expired? Just last week
    in report it was mentioned that one particular res. was was c/o ABD pain at 2330, but she went on to say, "I just couldn't deal with him." It has happened on our unit so many times that I can't even begin to count and it always seems to be after one particular nurse was in charge of that particular wing. Makes you wonder if these residents weren't sick prior to the beginning of our shift and just brushed off for the next shift to deal with. Why just last week a resident was buzzing the nurses station as I'm walking on the unit with my coat still on c/o ABD pain, the same res. as mentioned above. Went to check him out, noticed no urinary OP in drainage bag from foley, ABD very distended, rigid. Ask res. if anyone emptied his bag lately and he replied not since this afternoon around 0230...It is now 12MN! Asked him about having pain prior to "now" and he says, "I've been c/o pain since about 2230, one nurse came in and said she'd be back and never returned." Well the foley needed to be changed, but this same thing happened to the same res. with the same nurse with the previous foley! I'm just getting annoyed that problems like this could have been taken care of earlier. Not that I don't mind taking care of the res, but these people are made to suffer needlessly due to her "Let them take care of it" attitude. I would say it's pt neglect and involves serious ramifications. hmmmmmmm..... Believe me, I don't like to rat on other people, but this is becoming a nasty habit with her. Ever come across this type of co-worker?
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  2. 26 Comments

  3. by   SICU Queen
    I've come across similar problems, but on a med-surg floor, which I worked years ago. Rarely anything quite so neglectful as what you mentioned, mostly just things that were overlooked or couldn't be gotten to due to a high patient load, and on occasion, pure laziness.

    I work only ICU now, and I hve to say that it is truely a rarity to find a patient in substandard condition, and NEVER in my unit. I guess that's why, despite my hospital's problems, I stay.

    As far as your situation goes, I would definitely document these occurrences and report them to the appropriate person. This nurse needs to be dealt with. What a cruel person. Makes you want to stick a foley in her and then clamp it for 18 hours while giving her some saline boluses...
  4. by   canoehead
    Me too, although I've been noticing poor pain control and lack of followup. Takes forever to get it back under control, and it is very difficult to document and pinpoint one nurse, even though we all know who it is.
  5. by   thisnurse
    we dont see that too much where i work. i dont dump on the next shift either unless its something that cant easily be handled on nights, say for example, starting an iv (no iv team at night) if the patient is a hard stick.
    you leave a blood draw for the next shift where i work and they will have your neck. the older nurses expect EVERYTHING to be done. dont even leave an iv bag with less than 200 running.
    and oh god if you leave an order on a chart...
  6. by   mtgirl63
    I have seen this too, but not as serious as in your case. One case was a sore throat that had been going on for a few days (through the week-end) but was getting more severe. A strep test had been done that Friday and was negative. But by Monday the res. was having a lot of pain and it gone into her ear as well. When I came on shift at 3pm, the day nurse still had not bothered to call her doctor to see if he could see her (our clinic is right across the street). Her theory of priorities seems to be "if they're not bleeding or throwing up" they're not on my list of priorites. Not always like that, but often she is. I called the doctor, he saw her, and she had a severe sinus infection.
    Her favorite thing to try to pass on is the 2pm meds (remember I come on at 3pm) - "oh I forgot so and so's pills". She usually has them pre-set and asks me to give them. NO WAY!!!!!! I didn't set the pills up, I don't give them!!! The other day she had MS CONTIN in a med cup to administer and asked me to give --- a really big NO WAY. She signed the narc book, the med book --- she can give it! The real kicker ---- she had meds crushed and in applesauce ready to give and asked me to give them ---- a huge NO WAY!!!!
    It is very frustrating, and I think in your case ---- I'd rat on the co-worker.
  7. by   RoaminHankRN
    Any work ER night shift.. when day shift comes in does it seem they take their time to get report. Have a cup of coffee and chat. Just love the looks on their face trying to awake as we tried to stay awake.
  8. by   deespoohbear
    We had a nurse one time who had a long history of not tending to problems similar to yours. Well, finally she screwed up big time. She was taking care on an elderly gentleman who kept c/o abd distension and pain. She kept brushing this off, even when the family complained to her. Well, the next nurse came on duty and found his bladder to be extremely distended and tender. The man also hadn't voided in about 16 hours. She notified the doctor and got an order to cath him and anchor if necessary. She cathed him and had over 1000 cc's out in just a few minutes. The family was ticked!! The one granddaughter just happened to be best friends with our assistant executive administrator and the situation got reported. Finally, after a year and a half of complaining and documenting this nurse was relieved of her position. Too bad that it took a family with connections to our adminstration to get the job accomplished.

    I have had a couple of nurses leave me tasks that I thought should have been done before I came on duty. If it becomes a habit I let them know about it!! One of my pet peeves is leaving an empty IV bag or feeding tube bag. If it is less than 100 cc's to count and it is less than an hour or so till the next shift, change the bag for pete's sake!!!
  9. by   skap
    Roamin-
    I think it's a problem for all night shifters. We are mostly on time if not 10 minutes early..sitting in the break room. Boy do they all want to give report to us right away, early if we let them. In the morning you'll have a few who are on time or early..but then you always have the couple who are talking, or late. I think it happens everywhere. It can get annoying.
  10. by   Huganurse
    Yes I have been in similar situations. This is when I write up an incident report. Sorry, but when a patient suffers because of lack of care and follow-up, I believe that the situation should be documented. I don't write it up as something against the nurse, but as a reflection of the improper staffing of nurses that lead to the incidents and as a reflection of the facility hiring other caregivers with lack of training and experience. On the report there is usually an area for contributing factors, I alway try to list the number of patients and general acuity levels of the staff assignment. If these aren't contributing factors then the nurse should take accountability for the lack of follow-up. I notice that nurses shy away from incident reports. I think they are the only way we can prove that we need better staffing and show where improvements need to be made. We need changes especially in bedside nursing but changes will never be made without documented proof that those changes are needed. I think the hospitals love the fact that we don't write up incidents as they occur, it might make them look bad and then they'd have to do something. Perhaps some of the other posters patients problems could have been averted or resolved more quickly if reports had been written! JMO
  11. by   horsecrazy
    If i found a patient who was having substandard care, first i talk with the nurse. Face it we all hate it when 10 minutes before your shift ends all hell breaks loose, but we don't have nice 9-5 jobs and we all have to do overtime. If an emergency arises such as cp, sob, or a code it's our job to take care of it, it's not fair to drop it in the other shifts lap.
    LAst week, had a 22 year old patient with gall bladder pain. This patient I knew, she's an aide on another unit, but since i float occasionally i know her well. There's a new nurse who's been on the floor for about 9 mos. The pt supposed to get iv demerol for pain every 3 hours, her last shot was over 8 hours ago. It's almost 1130, i ask her to give a shot please, so i can listen to report, she says i got to get going. She's single, she says her mom will worry if she's late. I wasn't happy, but said fine, and let it go. I went to see my patient,crying, writhing in pain, the iv looked all puffy and red. I said that iv's coming out, well the pt had complained all 3-11 shift that the iv was painful and burning with just nss going through. After placing in another line i thought how could one leave a pt in this condition, i would have been worried all night! I talked to the pcm and wrote her up, i hate writing other nurses up, but i hate lazy nurses, and if she is timid she needs to go to the charge nurse and ask for her assistance, there is also a float on eves(great nurse), nights we never have that luxury!
  12. by   live4today
    Oh how I remember those days! There was nothing worse than starting my shift out with a bunch of "undone tasks" from the prior shift that could have easily been done had the nurse not been the lazy one on the unit.

    When the unit is busy for all, it's busy for all, and I have a greater understanding when things can't be helped by the offgoing nurse whose patients I am taking over, but when you know what you know about "Lazy Nurse", there's NO EXCUSE!!!

    One of my "nursing pet peeves" was coming on duty and receiving report regarding everyone's heplocks and IV sites being "A-OK" and "flushing without difficulty", only to enter my assigned patients rooms and find the "opposite scenario".
    Now, if you really don't know about the IV site and how it's doing or not doing, PLEEEEEZZZZ, DON'T LIE ABOUT IT!!! Prepare the oncoming nurse that an IV start is needed on Patient so and so!

    Full urine bags are another nursing pet peeve of mine. Why are the bags so full they could get up and walk into the bathroom themselves?

    What has nursing come to?
  13. by   lever5
    I will have the next bag of fluid ready to hang, but I will not hang a 1000 cc bag of fluid when the dr may come in and d/c it in the am. On one unit I worked on they put the next iv bag outside the door. This made it easy to hang if it was dry or easy to put back if not needed. Sometimes you know the fluid will continue and then I label and hang it next to the bag. I learned this by comming in the next night to see 950cc of fluid I had hung the night before to please the day shift. Why charge the patient for a bag of fluid that they did not get? By throwing away 2-3 hundred cc's of fluid every day you increase the cost of health care, just to avoid flack. I never judge what another nurse does. It is hard enough trying to avoid their judgement. So to each their own. People seem to take it well when I explain why I do certain things.
  14. by   nursedawn67
    In every facility (LTC) I have ever worked in this has happened!

    One evening one of my fellow evening nurses took report from a day nurse and he had an admit that day and instead of checking the orders he left them for the evening nurse and said I couldn't make out what these said you'll have to do it!! The lady had been there for hours and he just pushed it off, mind you if there are questions about these orders us night nurses have to call the doctor at home to ask him. If the day nurse had done his job and checked them he could have called the doctor at his office instead of us taking up the docs personal time.

    This post could be a hundred miles long with examples!

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Let the next shift deal with it...