Shift Change Question - page 2

I was orienting a new nurse the other day. (We have three new nurses on night shift!!!!!! Plus I don't do charge when I orient!!!!) Anyway, I happened by the call light on the way into report,... Read More

  1. by   sjoe
    I would certainly have talked with the day nurse first, to make sure she HADN'T already given this med (and it hadn't had time to take effect, etc.), just hadn't yet signed it out, or the doc's order had changed but she hadn't yet updated the record, or...before I gave it. There are legal and health ramifications in cases like this and sometimes acting on one's instincts and "heart" are NOT enough.
  2. by   OBNURSEHEATHER
    I would have checked with the other nurse to double check that she hadn't given the med. If she was busy, she could have forgotten to chart it. But pain is pain. So I would have medicated the pt.

    I'm glad you did yoo

    Heather
  3. by   Babe
    You may find new nurses scared to do lots of things because it is being drilled into us that any action we take may send us straight into court. Don't say it this way charting. some times it leaves us feeling like we're lieing about everything just to cover our little a---- !! not a good feeling!!! To much concern over being sued, loosing lic. ect. being drilled into our heads now days. I personally do not think that kind of fear belongs in new or old nurses We need to learn the right way because it's right not out of fear!
  4. by   SharonH, RN
    Originally posted by 3rdShiftGuy
    I was orienting a new nurse the other day. (We have three new nurses on night shift!!!!!! Plus I don't do charge when I orient!!!!)

    Anyway, I happened by the call light on the way into report, a patient in my assignment was asking for pain medicine. The day nurse was busy with another patient. I've known this nurse many years, she was not going to medicate this patient, she was going to finish up, come into report and go home. Period.

    I said the the new nurse, "why don't we make things easier and medicate this patient now, instead of making him wait until we are finished, which could be about 30 minutes". I'm real big on making people comfortable, and I fussy about prioritizing pt's in pain and not making them wait. It just makes life easier for all concerned.

    I explained I would check the narc record, and check with the day nurse and do a pain assessment on the patient before we medicated him. She said she wasn't comfortable with this at all. It wasn't our patient until we accepted the assignment from the day nurse. She was worried about the "legal ramifications".

    I was more concerned about the patient and not getting *****ed at for him waiting so long. So I medicated him.

    I know I could have gotten ugly and insisted the day nurse do it, but I'm not ugly and she was very frazzled, and I have a good rapport with the day shift I would like to keep.

    Any thoughts?


    I would have done the exact same thing you did. You checked with the day nurse and you checked the narc record plus you assessed the patient's pain prior to medicating. You were right on target. Why get the shift off to a bad start with the patient in pain and possibly very angry and annoyed because he/she had to wait for pain meds? Like you, I believe in taking care of pain and bathroom issues IMMEDIATELY. I wouldn't want to wait.
  5. by   MollyMo
    Originally posted by 3rdShiftGuy

    I said the the new nurse, "why don't we make things easier and medicate this patient now, instead of making him wait until we are finished, which could be about 30 minutes". I'm real big on making people comfortable, and I fussy about prioritizing pt's in pain and not making them wait. It just makes life easier for all concerned.

    I explained I would check the narc record, and check with the day nurse and do a pain assessment on the patient before we medicated him.

    Any thoughts?


    Sounds good to me.
  6. by   indynurse
    Where I work this isn't much of an issue. If a pt calls for a pain med during shift change, that pt's current nurse gives the medication. Once the on-coming shift has finished listening to report then the pt belongs to them. If the pt calls out before or during report, the off-going nurse medicates the pt. If the off-going nurse is tied up with something at the time then usually, one of the other off-going nurses medicates the pt for her. Rarely is it ever left for the next shift to do.
    I'm not saying that other things aren't ever left for the next nurse to take care of, but giving a pt their pain med isn't usually one of them.
  7. by   charissa
    Maybe its just my hospital, but i usually get a ton of crap left from day shift nurses, and i work some days, so i know how it can be. But i recently had surgery for the first time(my 2nd daughter was a crash c-section) and i will tell you, i didnt really complain but i had to ask for pain meds twice and then wait another 20 min at one point and i felt like i wanted to throw my call button at the first person that opened the door. I have always made it a practice to have pain at the top of my priority list, but from this point on, man as quickly as possible. Do a quick vital check, check with the off-going, quick assess, and meds please! We cover for each other at times during shift, like if my coworker is tied up and asks me to medicate her pt, so why not during shift change time. No one on this board seems to dispute it and we are all correct, pt comfort is a top priority
  8. by   MRed94
    I would have done the same thing, check, check, and give.

    Not a screaming patient on my shift because of pain meds!! No thanks.

    By the way, I think we ALL work with a nurse like your day one.



    M
  9. by   Tweety
    Thanks for everyone's support. I feel a little better.

    I believe she was concerned that since we didn't report on the patients we weren't allowed to medicate the patient by law. I feel I was operating withint he scope of my practice.

    We have a nurse with narc restrictions and I'm passing narcs for her all the time, trusting her assessments, so I guess it's kind of the same thing.
  10. by   bagladyrn
    I think it's perfectly appropriate for you to medicate this pt., but remember that the new nurse you are orienting may fell she has to do everything "by the book" because she is new and under scrutiny if on probation.
  11. by   MollyMo
    Yeah, let the newbie get some time under her belt. She'll change the "to-the-letter" attitude real quick.
  12. by   New CCU RN
    I can understand the new nurse's hesitance. She does not know the patient, the reason why the patient is here, if the patient was recently medicated, etc etc. While I personally would have done the check over and then medicated the patient. The new nurse was correct that technically she shouldnt be provided care to a patient regardless of what it is until she gets report.
    It is a little different than helping out someone on the same shift b/c generally you have some idea of the patient and you have that nurse right there if you need to ask any questions.
    What if the prn order for the pt was Demerol (i know not a drug of choice), you asked the nurse if he could get pain meds she said yeah, check what the prn order is, you go in to give the pt the demerol, ask pt if they are allergic to anything....elderly person poor historian.... no allergy band yet... you give the med and the pt is allergic?
  13. by   canoehead
    If you take great care of your patients the lawyers will take care of themselves.

    If you know that there is a problem with a patient you are obligated to do something about it even if you are walking by in street clothes and notice someone lying on the floor. We'd all stop and help then right? You need to consult with other assigned personnel prn, but above all eles the pt needs to be taken care of.

    The other thing is- if you(or the student) aren't prepared to solve the problem you shouldn't answer the call bell. I think you did a good thing answering the bell, and giving the med, and giving your orientee something to think about.

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