When does your shift begin?

  1. Last week, on my last night to work before 5 in a row off, I had the night from hell. I had one patient who was actively dying (DNR, on vent, family was almost ready to let him go) and another patient I had to take to MRI at 6:15 am. I got back from MRI at 7:15 am (the time I should be done with report and clocking out) and got the patient reconnected to cardiac monitor, CVP, arterial line, pulse ox, bp cuff, and IV fluids. The day nurse came in to help me and I started telling her about the night but not really giving report. She proceeded to start assessing the patient (the patient was a neuro, so I can understand checking hand grasps and following commands, but for god's sake she broke out the stethoscope and started listening to breath sounds!!) so I stopped her and said, I need to give you report, then you can come back and do your assessment. (I was to give her report on my other patient too.) As I walked around the desk, she mumbled under her breath, "You're lucky I came in and helped you get her back to bed." I asked what she said and she wouldn't repeat it, so I went ahead and started giving her report. I won't get into any more gory details, but I'll just say that I didn't get out of there till 9:30 and I was about ready to rip her f@#$ing head off by the time I left.

    So my question is this: when you come on to a shift, when do you think your work actually begins? Do you feel obligated to help the leaving nurse with the patient if he/she needs it, or should the leaving nurse have everything done before you take over? 99% of the time, I have everything done and I'm leaving a clean patient in a clean room with up-to-date vitals (for 0700 if they are qhour), pain med given, new bags of IVF/gtts if they will run out in less than 4 hours, supplies for the next dressing change, chux if needed, etc, etc, etc. But if the patient takes a dump while we're in report, would you expect me to clean up the patient without at least helping me? Just curious...
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  2. Poll: When does your work begin?

    • When I clock in

      58.33% 21
    • When I get report

      38.89% 14
    • When I get report and look at the patient and make sure everything is to my satisfaction

      2.78% 1
    • Work? What's that?

      0% 0
    36 Votes
  3. 14 Comments

  4. by   nimbex
    I'm a team player, for the sake of the patient...not patting self on back just stating.

    If I walk in and a code is in progress I go into the room, if' it's handeled I monitor the other patients.

    If my patient poops, I try not to hold up another night nurse, I ask the oncomming RN for help, it's a great chance to listen to lung sounds and assess skin.

    I never thought of a specific moment in time in which I begin.... If I walk in and the phone is ringing... I don't ignore it... go clock in.... then answer it. It's ringing... pick it up!

    Legally, I am not relieved of my patient care until I have reported off, same goes for charge report. But comming on? happens the second I step on hospital property and smile at a staff member leaving, and give directions to lost family.... long before I enter my unit.

    Ignore others with small thinking such as this.... If they don't want to help... they'll be trying to find help to catch up or turn their patient to assess them....

    carol
  5. by   moz
    When I clock in, work begins.
    Nothing more annoying than a busy 12hrs, no breaks and a change of shift delivery, and the oncoming staff sitting at the desk waiting report.
    I feel obligated to stay to help the oncoming shift when its super busy, I know how it feels to start a shift behind, and besides its good patient care.
  6. by   adrienurse
    Thank god, I've never worked in a place where I've had to clock in. How demeaning is that? What are we, factory workers? Because I am a professional, and because I value the work that I do, Work begins for me when I step onthe unit and change my shoes -- no matter how early I get there. I say Hello to the nurse who is going home, eyeball the assignment sheet, get the lowdown from her and wait in the conference room with the assignment sheet and report book for everyone else to arrive.
  7. by   NurseDianne
    Since I work at a small facility, I'm not sure from night to night where I will work, OB, ER or whereever needed. Sometimes all of these places in the same night. UGH. But, I think my work actually begins when I clock in. It is a nice gesture from me to help with a patient, not a requirement, prior to receiveing report. Many nights, I have walked into the ER, clocked in, and been caught up in a true emergency. W/o any formal report being given. The report comes hours later. OK< the previous statements sounded ugly. But, in all honesty, I don't have to stop what I'm doing to help in x-ray, lab, etc....it's just I don't think a patient should suffer because someone is lazy! This isn't coming out right. It annoys me to no end that the day shift will wham, want report when they see you are so busy, but won't offer to help. That's my half awake opinon for what it's worth today.
  8. by   nursedawn67
    In a sense it starts after report, but I do some things if needed while the leaving nurse gets her things done, usually they do only enough to give report and then finish up after that.
  9. by   RyanRN
    Since nursing is a 24 hour ongoing process things will never be completely tied up with a pretty bow. Nor should any of us expect that. As the others have stated I will usually jump in and give a hand where needed. However, when we come in we have to make a fair assignment out, count narcotics, check the crash cart, order stock , answer phones,etc. so there is always plenty to do. We go where needed, it's common sense and courtesy.

    If your general habit is to leave everything tidied up as you said then I, for one, would appreciate you GREATLY. It's the same people who consistently leave half done paper work, care plans, teaching,MAR not updated, daily flow sheets not completed, lab work not ordered and the patients in a mess that cause tension between the shifts. We all know who they are. "They" seem to get away with this forever!

    Since you are not doing this, you should NOT feel the least bit guilty or obliged to stay so late past your shift for the occasional bad night! Especially if you are not paid for it. Me work for FREE, NAW! I work hard enough and feel confident about that.
  10. by   Nurse Ratched
    I consider one of the first tasks of my day is to help the night folks get out if I possibly can. They've done their hitch, and if I can assist in the speedy exit that *I* sure crave at 3:30, then I will.
  11. by   SmilingBluEyes
    When I clock in......and I don't clock in early because we get in trouble for it....BIG NO NO......see I live outside work. When I am at work, I give it my all....when i am on the clock. When not there, I am NOT THERE. No guilt, no bad feelings here. I do all I can to ensure I tie any loose ends I can before I go and rarely stay late, cause again, we catch hell for being there on OT. So I work on the clock, period.
  12. by   dawngloves
    I think it's just common courtesy to help out if you come in and see the s#%t hitting the fan.
  13. by   misti_z
    My work begins when I clock in. If I'm walking down the hall toward the station to get report and a call light is going off I'll step in to see what is needed. I help the outgoing shift as needed. But I do not go ahead and do assessments before getting report due to the fact I don't want to be asked questions re: care or procedures or test results before I even know their name and Dx.

    P.S. moz that little red head is soooo cute!!!
  14. by   Ted
    . . . . .steamy-hot coffee!!!

    Long Live Java!

    Happy caffeine, folks!

    Ted
  15. by   JailRN
    I also do not clock in, they expect us to work EXACTLY our shift then leave. No OT, for a nurse being late, etc.
    Of course, I don't work in a hospital setting, anymore, but when I did, I was one of those nurses who checked my pts minutes before report, to make sure they were clean, etc, but if there was a problem after report, would stay sometimes to help out. If I had to be somewhere, no, if not yes. That way, the next shift didn't expect it., but were greatful when it happened.

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