Vent about a charge nurse....

Virgo_RN, BSN, RN · Apr 9, 2008

Vent away! Those days from hell do happen. Just a suggestion, do you have house floats? If so, next time, see if a house float can go with your patient.

squeakykitty · Apr 9, 2008

Did she even check on your patients? If so, what did she do?

CareBayer · Apr 9, 2008

Did she even check on your patients? If so, what did she do?

Fortunately, another nurse on the floor was able to look in on my patients......she witnessed the pandemonium that I was going through. Most of the nurses on my floor are awesome team-players.....it's the few that aren't that negatively effect us all!

squeakykitty · Apr 9, 2008

Fortunately, another nurse on the floor was able to look in on my patients......she witnessed the pandemonium that I was going through. Most of the nurses on my floor are awesome team-players.....it's the few that aren't that negatively effect us all!

Is there any way to talk to the DON about this? I hate it when there's no teamwork.

bollweevil · Apr 9, 2008

I am a new nurse....this is my second week on my own (off of precepting.) I have been taking care of five patients on a busy step-down floor with no major complications...until yesterday. There is a nurse on our floor who is sometimes charge. This nurse cannot even handle the stress of being a bedside nurse let alone being able to be in charge of the unit!
I had the day from hell yesterday....two patients scheduled for procedures (at the last minute) that the charge nurse failed to tell me about (the charge usually enters in MD orders and lets us know about any stat drugs, procedures, etc.) Both patients were refusing the procedures....one patient was playing me for a fool the whole day (a serious personality disorder!) I was trying to call the patient's families to talk with the patients, get them all pre-medicated, get consents signed, trying to pass morning meds to my other patients, etc., etc.
The charge nurse was zero help. I finally convinced one of the patients to go for her MRI. Unfortunately, I had to go with her (because her MD considered her to be unstable...I begged to differ!) So now I had four patients on the floor without a nurse. As you all know....an MRI can be lengthy. I was off the floor for almost two hours. When I asked for the charge nurse to please check on my other patients while I was off the floor she said "I'll try." Thanks a bunch!
I am ever so grateful to those charge nurses on my unit who really excel and step up to the plate everyday in order to keep everyone on track. Everyone is human and makes mistakes and has a bad day, but this particular nurse has ZERO teamwork-skills.
Thanks for listening to my vent!

There are at least 2 huge problems here. First, it is NOT the nurse's job to obtain permits. I don't care who tells you it is or how many other nurses at your place do this for the doctors. The doctor doing the procedure is responsible for explaining it all to the patient, answering questions, telling about complications, what it is hoped will be gained from it, limitations of it, and so on. Stop doing the doctor's job.

Secondly, it is not safe for you to be gone from your 4 other patients without knowing that they will be cared for. Is there not one in MRI who can care for the one patient while you care for the 4, maybe get a little break, do some charting, etc.? This is a disaster waiting to happen. Is this the standard procedure at your place? Are your patients stable enough to go without a nurse seeing them for 2 hours? Do the families of the uncovered patients know their nurse was gone for 2 hours?

Speak up, friend, and soon.

As for the incapable charge nurse, that's harder because you are new and don't want to make waves. But she needs to speak up and refuse to be Charge if it stresses her so badly. Some nurses hate charging and she must be one of them. The place sounds like a mess. Consider leaving if it doesn't change significantly soon. Maybe Doctor should bring his own MRI nurse if hospital won't supply one.

CareBayer · Apr 9, 2008

There are at least 2 huge problems here. First, it is NOT the nurse's job to obtain permits. I don't care who tells you it is or how many other nurses at your place do this for the doctors. The doctor doing the procedure is responsible for explaining it all to the patient, answering questions, telling about complications, what it is hoped will be gained from it, limitations of it, and so on. Stop doing the doctor's job.
Yes, it is practice that the patient has no idea what the test is that they will be having...yes I know that it is not my place to be the one explaining the procedure, but this is how the universe works at my hospital.
Secondly, it is not safe for you to be gone from your 4 other patients without knowing that they will be cared for. Is there not one in MRI who can care for the one patient while you care for the 4, maybe get a little break, do some charting, etc.? This is a disaster waiting to happen. Is this the standard procedure at your place? Are your patients stable enough to go without a nurse seeing them for 2 hours? Do the families of the uncovered patients know their nurse was gone for 2 hours?
I try to explain to my patients who are left on the floor (time permitting) that I will be off the floor for awhile and make sure that they have what they need. Yes, it is practice that have to go "nurse and monitor" to procedures. It's the MD's way of covering his (or her) own butt should the patient code while off the floor. It is not safe. The hospital has employed nurses to be stationed at procedure areas, but unfortunately, there are often none there when they need to be
Speak up, friend, and soon.
As for the incapable charge nurse, that's harder because you are new and don't want to make waves. But she needs to speak up and refuse to be Charge if it stresses her so badly. Some nurses hate charging and she must be one of them. The place sounds like a mess. Consider leaving if it doesn't change significantly soon. Maybe Doctor should bring his own MRI nurse if hospital won't supply one.

I'm trying to make my way for awhile before making too many waves....

racing-mom4, BSN, RN · Apr 10, 2008

There are at least 2 huge problems here. First, it is NOT the nurse's job to obtain permits. I don't care who tells you it is or how many other nurses at your place do this for the doctors. The doctor doing the procedure is responsible for explaining it all to the patient, answering questions, telling about complications, what it is hoped will be gained from it, limitations of it, and so on. Stop doing the doctor's job.
S

I did not know this~~ I am also a new nurse. Passed boards in Jan and at my hospital, we nurses do get all the permits signed. Yes it makes complete sense now that you say it but we do go over the consents and have them sign them. What about consents for blood? We are the ones hanging that, does the Dr technically need to do that too? What about in the middle of the night, the labs come back, Dr is called and blood is ordered? Are you saying legally they need to come in and go over that? But ya we do all consents we even do surgery consents. Come to think of it, even when I was having my babies, the RNs had me sign the consent for epidural.

As far as leaving the 4 patients for 2 hours,I would be flaming mad. I would not have done that,( easy for me to say sitting here at my computer) were you even able to give report off on the 4 patients to another nurse? I would think that you could get in trouble for that one, did I miss something, did the supervisor tell you to go?

I am sure you were down there going CRAZY and only to come back 2 hours later, now 2 hours behind!!!

Good luck~~nursing is a hard job, so much to learn and so much to be responsible for, school barley scratches the surface.

All and all though---I still am in love with my job!!! Hope you are too.

2nd career nurse · Apr 10, 2008

There are at least 2 huge problems here. First, it is NOT the nurse's job to obtain permits. I don't care who tells you it is or how many other nurses at your place do this for the doctors. The doctor doing the procedure is responsible for explaining it all to the patient, answering questions, telling about complications, what it is hoped will be gained from it, limitations of it, and so on. Stop doing the doctor's job.

At my hospital, the person doing the procedure and the CRNA or whoever go in and explain about what will be done. the RN go in later and confirm that they understood everything then have them sign it. all you have to do is sign as a witness that you saw them sign the consents. Dont know about other places. But as an RN, you are not supposed to explain procedures to patients if you are not the one doing them because how will you even answer questions regarding surgeries you have never even observed....let alone performed?:uhoh21:

wjf00 · Apr 10, 2008

Leaving the floor for any period of time without arranging for someone to accept care for patients is abandonment. It might be wise to clarify that the Charge Nurse is accepting care of the patients you leave behind. Give a full report before you leave the floor or don't leave. If you explain to the doctor that you can not leave the floor and that the Doctor must accompany the patients, then perhaps the appropriate fire will be lit under the Charge Nurse. .... by the way, Step Down units are 3:1 per the ratios in California.