So, Is it really "On Me"?

Specialties Geriatric

Published

Hi friends,

I'm an RN (ADN) of 2 years - new to LTC and new to allnurses! I'd really appreciate any opinions anyone has to offer about a situation (or person) at work that is starting to worry me. In brief my question is....Who takes the ultimate responsibility for an order being missed or transcribed onto the MAR incorrectly? Is it the Day shift RN who notes that he/she has taken the order off of the chart but; forgets to fill out the lab request, transcribes meds onto the MAR incorrectly or doesn't remember to write a resident's doctor appointment on the calendar? Or is the night nurse to blame for the potential med error or mistake because she signs the 24 hour chart check? (I'm in LTC now but when I worked acute we had to sign q shift or 12-hr chart checks so at least you technically couldn't be blamed for another nurses mistake.)

I work 6p - 6a in LTC. My hall has 30 residents, with anywhere from 6 to 13 of them being skilled. As a newly hired staff RN I have various night shift duties such as; day shift staffing, Peg tube feeding changes with q day site care, O2 tubing and Foley cath changes, monthly MARs, etc.

My problem is with the day shift RN that I follow. After she gives me report she always tells me how harassed her shift was and she basically tells me that it's my job to catch her errors. She loves to use the expression, "It's on you!' Meaning she isn't responsible for her mistakes because I'm the one signing the final chart check. Well last night I had to send 2 residents to the hospital and I didn't even get to complete the chart checks. Am I still responsible for her errors?

This same RN admits to changing medication administration times so that more meds will be given on the night shift. She says she has to do this or she would have a "4-hour med pass". She also doesn't chart on skilled pts because she has too much to do. I think her "time constraints" may be due to a lack of focus. LPNs from other halls (who don't even know our pts.) fill-in on her days off and are able to pass meds on time and do the required charting.

Part of this nurses problem may be that she schedules herself for six 12-hr shifts in a row so that she can have lots of days off in a row. The problem is she gets too tired and starts making too many mistakes. I've had several heart to heart talks with this nurse but she refuses to change. The worst part of the problem is that she is in an addiction recovery program...I'm worried that if I complain and she gets fired she may not be able to find a "monitoring" friendly employer.

What a dilemma!!! Hey, venting here does seem to make you fell better. (Thanks for reading all of this.) -Carley

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Hi friends,

I'm an RN (ADN) of 2 years - new to LTC and new to allnurses! I'd really appreciate any opinions anyone has to offer about a situation (or person) at work that is starting to worry me. In brief my question is....Who takes the ultimate responsibility for an order being missed or transcribed onto the MAR incorrectly? Is it the Day shift RN who notes that he/she has taken the order off of the chart but; forgets to fill out the lab request, transcribes meds onto the MAR incorrectly or doesn't remember to write a resident's doctor appointment on the calendar? Or is the night nurse to blame for the potential med error or mistake because she signs the 24 hour chart check? (I'm in LTC now but when I worked acute we had to sign q shift or 12-hr chart checks so at least you technically couldn't be blamed for another nurses mistake.)

I work 6p - 6a in LTC. My hall has 30 residents, with anywhere from 6 to 13 of them being skilled. As a newly hired staff RN I have various night shift duties such as; day shift staffing, Peg tube feeding changes with q day site care, O2 tubing and Foley cath changes, monthly MARs, etc.

My problem is with the day shift RN that I follow. After she gives me report she always tells me how harassed her shift was and she basically tells me that it's my job to catch her errors. She loves to use the expression, "It's on you!' Meaning she isn't responsible for her mistakes because I'm the one signing the final chart check. Well last night I had to send 2 residents to the hospital and I didn't even get to complete the chart checks. Am I still responsible for her errors?

This same RN admits to changing medication administration times so that more meds will be given on the night shift. She says she has to do this or she would have a "4-hour med pass". She also doesn't chart on skilled pts because she has too much to do. I think her "time constraints" may be due to a lack of focus. LPNs from other halls (who don't even know our pts.) fill-in on her days off and are able to pass meds on time and do the required charting.

Part of this nurses problem may be that she schedules herself for six 12-hr shifts in a row so that she can have lots of days off in a row. The problem is she gets too tired and starts making too many mistakes. I've had several heart to heart talks with this nurse but she refuses to change. The worst part of the problem is that she is in an addiction recovery program...I'm worried that if I complain and she gets fired she may not be able to find a "monitoring" friendly employer.

What a dilemma!!! Hey, venting here does seem to make you fell better. (Thanks for reading all of this.) -Carley

No, it isn't on you. Don't let her pull that on you.

Each nurse is responsible for her own actions. If she takes the order off, and it's wrong it's her butt, not yours.

You don't have time to go behind her checking for her mistakes.

Also, she needs to stop changing the meds around so more are given on nights. The patients have the right to sleep at night and not be awakened, and the more meds you have scheduled, the more you're going to be waking up.

She's just bullying you.

Stand up to her. If you really want clarification, write or call your state board of nursing, and see what they say about the wrong orders.

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Specializes in Trauma ICU, MICU/SICU.
The worst part of the problem is that she is in an addiction recovery program...I'm worried that if I complain and she gets fired she may not be able to find a "monitoring" friendly employer.

I'm not a nurse yet, so I can't help with your questions re: accountability. However, as an addict in recovery I can tell you that her problems were created by her. It is not your responsibility to cover for her so that she doesn't lose her job. If she needs her job that badly, than she needs to do a better job. I am an addict with 7 years recovery. I still have consequences from my years of active addiction. Some will remain for the rest of my life. That is My problem. Not yours or anyone else's. No one forced me to take that first drink or drug and no one forced your co-worker.

Stop taking her crap. She's using you.

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To the OP....

Wow, your posts are really nice...all punctuated and stuff...wow...no really :)

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Hi friends,

In brief my question is....Who takes the ultimate responsibility for an order being missed or transcribed onto the MAR incorrectly? Is it the Day shift RN who notes that he/she has taken the order off of the chart but; forgets to fill out the lab request, transcribes meds onto the MAR incorrectly or doesn't remember to write a resident's doctor appointment on the calendar? Or is the night nurse to blame for the potential med error or mistake because she signs the 24 hour chart check? (I'm in LTC now but when I worked acute we had to sign q shift or 12-hr chart checks so at least you technically couldn't be blamed for another nurses mistake.)

My problem is with the day shift RN that I follow. After she gives me report she always tells me how harassed her shift was and she basically tells me that it's my job to catch her errors. She loves to use the expression, "It's on you!' Meaning she isn't responsible for her mistakes because I'm the one signing the final chart check. Well last night I had to send 2 residents to the hospital and I didn't even get to complete the chart checks. Am I still responsible for her errors?

This same RN admits to changing medication administration times so that more meds will be given on the night shift. She says she has to do this or she would have a "4-hour med pass". She also doesn't chart on skilled pts because she has too much to do. I think her "time constraints" may be due to a lack of focus. LPNs from other halls (who don't even know our pts.) fill-in on her days off and are able to pass meds on time and do the required charting.

Welcome to the allnurses.com.

As I understand your situation, you day shift counterpart is dumping on you. First, to respond to that, understand that she is 100% responsible for her actions. My question--Is she being held accountable for her actions? It sounds like you are hesitent to do so and doesn't sound like anyone else is holding her accountable either, so will not ever be held accountable until she lands before a jury or the BON. Consequently you become a martyr, and it goes downhill from here.

Now as for your being responsible for her actions. Absolutely not. You are responsible for only your own actions. However if it is your job to do chart and MAR checks and you don't do so, then you too become 100% accountable for an unfortunate occurrence (sentinel event for example) if you didn't catch the error to prevent it from ocurring or treat it before it's too late, even though it was the day shift's error.

Back to being dumped on, or specifically changing med times to nights...If your facility has a protocol for medication times, and if the day nurse is changing those times for any other reason than having a MD order, then that is a med error on her part, and should be treated as such, because once again, the behavior will not subside on it's own.

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cover thy own butt...if she is making mistakes then it affects you, the residents..in short all...her impairment issue of past is on her..her lack of job performance in present is now your problem..and more to the point should be yourDON's problem....(i believe in sharing the wealth... :rolleyes: )

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Specializes in med/surg, ortho, rehab, ltc.

Great reply...."Share the wealth."

cover thy own butt...if she is making mistakes then it affects you, the residents..in short all...her impairment issue of past is on her..her lack of job performance in present is now your problem..and more to the point should be yourDON's problem....(i believe in sharing the wealth... :rolleyes: )
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Specializes in Med Surg/Tele/Ortho/Psych.

I Was In A Monitoring Program For Substance Abuse And Not Allowed To Work More Than 8 Hours Shift And No Overtime At All D/t The Stress. I Was Only Allowed To Work Day And Not Allowed To Give Any Narcotics For The First 6 Months. We Are Responsible For Out Own Action Is Right. If You Find Errors Fill Out A Med Error Form Or Write Her Up. That Is What I Do.

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I would believe that whoever takes the order is responsible for following through with it. I suggest if she knowingly tells you that she did not do something then I would refuse to take report from her until she finsihed her duties. Maybe even keep your self a notebook where you can mark down on a daily basis what was dumped onto you, then take this with you and speak to your DON.

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