Shift Change Question

  1. 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?
    •  
  2. 27 Comments

  3. by   Youda
    I probably wouldn't have, either, IF I didn't know the patient and IF I didn't know the off-going nurse. But, when you've worked somewhere awhile, it's different. I probably would've said, "Hey, Day-Nurse! ____ wants a pain pill. Do ya want me to give it before we go into report?"
  4. by   Merry1
    Thought number 1: Why are we in nursing??? To help people (tis much more than a job, it is an adventure. Thought number 2: I hope when I need a nurse someday you are it! and not the day shift, and Good Heaven Above not the new trainee! Thought number 3: Can you look at yourself in the morning mirror and know you did your best for your pts?? That is what it comes down to and that is what life is all about.
  5. by   baseline
    Yes. The nurse objecting needs to lie in bed in pain for an hour or so......readjust the thinking.......I've been a patient in pain....waiting for pain relief....5 min is 5 hours. That being said, it is also a big issure with JCAHO..... and perhaps with good reason?
    Geeze... I don't usually get myself too worked up in most of these threads, but ....... LEGAL RAMIFICATIONS????????? For what? doing their job???? My red hair is showing thru the blonde dye............
  6. by   traumaRUs
    Baseline - you are right on target!!!! Legal ramifications??? Give the pt some meds and NOW!!!

    I work in the ER and we medicate till pts are comfortable, our motto is "we have more meds than you have pain" and we are very generous.
  7. by   CMERN
    ah, geez.... I know some First shift nurses who would...not medicate...and would have been the one screaming "legal ramifications" if you did medicate before recieving report......bottom line..if you assess, do it and document it..then you have taken care of the patient per expected nursing standards today.( conciderering PAIN being the 5th vital sign) Would you go to report or ignore the patient with a 170/112 bp for the next hour????? No... so there's your "ramification". always er in CARING for the patient....and document! document! document!.....whats the worse could happen ? Report time would be delayed and she could not go home (yet). oh well like THAT is a sentinel event (more like a commanality)... Just my revved up thoughts thanks!
  8. by   baseline
    originally posted by CNERN:

    "bottom line..if you assess, do it and document it..then you have taken care of the patient per expected nursing standards today.( conciderering PAIN being the 5th vital sign) Would you go to report or ignore the patient with a 170/112 bp for the next hour????? No... so there's your "ramification". always er in CARING for the patient....and document! document! document!.....whats the worse could happen ? Report time would be delayed and she could not go home (yet). oh well like THAT is a sentinel event (more like a commanality)... Just my revved up thoughts thanks!"

    I know! I tell you my hair is ON FIRE!!!! I know JCAHO is a pain...but maybe we should stop giving them reasons to be!!!!!
  9. by   nursedawn67
    Originally posted by Youda
    I probably wouldn't have, either, IF I didn't know the patient and IF I didn't know the off-going nurse. But, when you've worked somewhere awhile, it's different. I probably would've said, "Hey, Day-Nurse! ____ wants a pain pill. Do ya want me to give it before we go into report?"

    I agree I would have done the same thing and given him the pain meds. You still are acting immediately and not letting him suffer, but covering your butt too.
  10. by   CMERN
    <I know JCAHO is a pain....but maybe we should stop giving them reasons to be!!!> Ditto.... Butt (I mean but) my guess is a couple JCAHO peeps have met MR. PAIN to and had to lay in bed with him.. Dont give a report on me if IM in pain just give me my d@mn*d medicine some time in this century (preferably) O k off the BOX now...bow , bow thank U
  11. by   baseline
    :-) yeah...me too...Gee, 3rd shift guy....I guess you know our thoughts! Feel free to pass them on !!!
  12. by   WashYaHands
    Personally, I would have done the same thing that you did (give the pt. the pain med, document, and then go to report). I also think it's important to remember though that the orientee is new, and operates off of "text book" guidelines. New nurses often learn by watching experienced nurses, so maybe he/she saw how you handled the situation and learned from it. You served as a role model in this situation, which is why orietees have preceptors. Don't discount the impact that you have on the orientees, they notice more than we give them credit for. Hopefully, they learned from it.

    Linda
  13. by   ohbet
    You did the right thing.
    Question,what are the legal ramifications the new nurse is talking about?Are there any? Wouldnt there be possible legal ramifications if the patient suffer in pain needlessly?
  14. by   finallyRN
    I agree, as long as you do a quick assess on the patient and check with the current nurse there isn't any reason why you shouldn't medicate this patient. Hasn't anyone medicated a patient for another nurse if she was buzy during the shift. Is this any different?

close