Shift Change Question

[Tweety]

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?

[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?

[canoehead, BSN, RN]

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.

[CMERN]

Assess...(first thing they teach students) and you did Assessed pt..check. Assessed situation...check. assessed pts last chart and last dose...check.. all bases covered. ( legal ramifications?) NOT..... I see why you orient new nurses.. YOU are apparently a great and CARING nurse... YOU GO third shift guy

[BBFRN, BSN, PhD]

Legal ramifications???? Is the Pt. going to COMPLAIN that his pain medicine was given??? I always give it- I assume that I'm responsible for my team as soon as I clock on anyway.