Was I wrong?

  1. I normally work in a cath lab and on rare occasions, we will have no procedures scheduled. On these days, we are floated to various floor as "helpers" (BTW, we are all RNs doing the floating here). We are not given assignments because something nasty always comes through the doors and we are called back to the cath lab.

    The other day I had to float to our cardiac step-down unit. When I arrived to the floor, the charge RN gave me my assignment. My assignment was to do the first assessment of the shift on 6 patients. She started to give me a mini-report on each when I asked, "Am I being assigned these patients?" I had no problem with this as long as she had a back-up plan in case I had to leave suddenly. But she said, "No. These are Betty's (an RN) patients and she wants you to do her assessments."

    Me: "What will Betty be doing?"

    Charge: "Passing meds and dressing changes. You know, tasky stuff."

    Me: "Wouldn't it be better if I did the "tasky stuff" and she assessed her own patients?"

    Charge: "This is how she wants to do it."

    I refused in the nicest way I could, but ended up with the manager of the floor, who for some reason felt she had to get involved, being very rude to me in the process. But I still refused.

    So I started doing the tasky things. . .started a couple of IVs, passed meds, gave a few pain meds, answered call lights, walked a patient, etc.

    After a couple of hours, the charge RN approached me and asked me if I would help Mary RN admit her new patient. "Sure!" I said. I get into the room and Mary tells me, "Why don't you do her physical assessment while I go check her orders." Huh? What is it with this floor? I again refused. And again I was the bad guy. And you guys, I have to interject at this point that I am very nice and easy going. It really bothered me that I was making people mad at me, but I felt like no one was listening to my reasoning. I was made to feel like I was being lazy or acting like a "snooty" cath lab nurse which was not the case at all.

    The reason I was refusing to do these assessments is: When an RN accepts her assignment, is it not her duty under her state practice act to assess her patient and then plan that patient's goals around that assessment? (I realize I way over-simplified that, but for the sake of time. . .) What I was being told was that the law requires each patient be assessed by an RN each shift and they didn't care who the RN was doing the assessment just as long as it got done.

    I just could not get through these nurses heads that THEY SHOULD WANT TO DO THEIR OWN ASSESSMENTS!!!!! How would they know what was going on with their patients if something would go wrong? Sure, it would have been documented. But, honestly, I just could not believe a nurse would accept her assignment and not want to do her own assessments. Especially a new admit!

    I have had a few nurses on that floor stand up for me, which makes me feel better, but I am the type of person that wants everyone to like me and it really bothers me if someone thinks bad of me. (I think this is my "Middle Child Syndrome" rearing its ugly head!)

    Anyway, does anyone out there think I was wrong? Should I have done those assessments?

    Please be nice. . .I bruise easily.

    Thanks!:roll
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  2. 32 Comments

  3. by   oh nurse
    hello sherri,
    i am an lpn in a hospital and take care of patients on the floor everyday.. i dont have to deal with doing admissions but i do my own assessments... i would never ask someone else to do it for me!! how could anyone feel comfortable not knowing for themselves about their pt's assessments!!!! that person wouldnt know what was going on if you were pulled away quickly...
    i hope you understand what i mean.. i dont do this often...but plan to start..
    kelly
  4. by   Mary Dover
    Sherri,
    I can empathize. I too am the kind of person who just hates to think that I would be "ill thought of" in any situation. But I have to say, I really admire your guts and courage for speaking out for what you felt was right, which by the way, I agree with 100%.
    I would think that anyone who is going to be assigned for the ultimate care of the patient, would WANT AND NEED to be as directly familiar with that patient as possible. Makes the most sense to me for that nurse do be the one doing the assessments.
    GOOD FOR YOU for standing your ground. As scary as that can be at times, the more you do it, the easier it gets. And OH the feeling of empowerment!!!
    And let me add to that last statement just for the sake of clarification, empowerment does not necessarily lead to aggression. Assertiveness is an appropriate and invaluable skill.
    The more you are able to act assertively, the better your self esteem becomes. You go girl!
    Mary
  5. by   Stargazer
    When an RN accepts her assignment, is it not her duty under her state practice act to assess her patient and then plan that patient's goals around that assessment?
    Yep. IMO, you were absolutely in the right here. I don't understand nurses who skimp on, or avoid doing their own assessements either--but maybe they haven't had nearly as many patients who crumped mid-shift as I have.
  6. by   fergus51
    I am with you. If it makes you feel better, you're nicer than me! I won't do most meds when I float to a med-surg floor.
  7. by   traumaRUs
    You are 100% right!!. I work in ER, and want to do all assessments on my pts. What are these nurses thinking???!!!!
  8. by   Zee_RN
    I can't imagine a nurse NOT wanting to do her own assessments! My lord, how do you know what's happening with your patients if you just pass their meds?! I would be DELIGHTED to have someone do "the taskey stuff" while I did assessments! What a wonderful assessment you could do without all the taskey stuff to accomplish too.

    You are absolutely right in your stance, Sherri. I just can't believe the other nurse(s) couldn't see it!
  9. by   hoolahan
    Sherri, I agree with you 100% and second everything that Mary & everyone else said! Good for you!
  10. by   P_RN
    It sounds to me like THEY are the powertripping ones. What would happen if you DID the assessments, got called away and something happened to one of the patients they had made YOU assess? How in all honesty could that nurse say that something was a CHANGE?

    When you got back to the cath lab, did you compare notes? I'd wager the other cath-nurses have had the same experience on that one unit.
  11. by   Brownms46
    All I can add in the face of all the preceding excellent feedback you have received is

    DTTTO......DITTO....DITTO.....DITTO!...
  12. by   aimeee
    Same thinking here.
  13. by   grouchy
    If one RN said this I'd just write her off as the bad apple in the bunch. To have several RNs think this is normal is disturbing. To have the charge nurse AND manager backing them up is beyond shocking. Doing your own assessments is the expectation where I work!
  14. by   Teshiee
    I think they get too comfortable that nothing will happen and that is a dangerous way to be. I think you were 3million% right! They ought to no better. Screw what people think of you you know what kind of person you are. You can't please the world and don't stress over doing so. You keep being the great caring conscienscious (sp) nurse you are! :-)

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