Getting report- need advice for dealing with "Frantic Nurse."

  1. I am at my wits end and need advice.

    I work what is considered, in nursing, to be an unusual shift. As such, I typically follow one of two nurses. Neither one of them is fabulous to follow for various reasons, but one of the two is an...extreme challenge. The other nurse who works my shift and I curse each other when when we are the unlucky one to get report from Frantic Nurse.

    Frantic Nurse is a nurse with many years experience. Getting report from her seriously stresses me out and it is a rotten way to start the shift. One day last week, it took 75 minutes for her to give me report on FOUR patients. I kept trying to redirect her back to the task at hand (my shift is only eight hours to begin with) to no avail. So I tried to go get a few things done while she regrouped. Every time I started to do something (signing off orders she should have signed off hours before I got there, contacting doctors about stuff she hadn't addressed all day, etc.) she kept asking me where I was going. Keeping her focused is nearly impossible (and shouldn't be my job- I'm not her nurse, I'm her co-worker.)

    Today, she made me wait 30 minutes to get report while she wrote a note on a patient she was transferring to hospice (charting typically gets done after report if there is any left to be done. The transfer note is in the computer and could have waited ten minutes as the hospice people don't need it because though they are in the hospital, they are a separate entity and don't really read our notes.) I did manage to clean up some of her messes while I was waiting. Once she was finally "ready," she wasted my time by complaining to me that the charge nurses wanted her to take her patient to hospice (a five minute proposition, and one I consider a duty and a privilege.)

    I honestly don't know what else to do. Nobody likes getting report from her. This is not an exaggeration (and for the record, I like her as a person, I just can't stand getting report from her. I'd almost rather just create my own by reading through the chart.) Nobody likes giving her report- she often doesn't actually listen to what the prior RN is telling her. I don't have this problem with any other nurse.

    I work a very stressful shift on a very stressful floor, and I am definitely a team player, as long as it isn't always 75% me and 25% them; I really just can't handle all the added stress of dealing with her.

    I didn't mean to be so long-winded and I honestly don't mean to complain- I am looking for some constructive/creative/tried-and-true wisdom that will help make the start of my shift less stressful and more productive. Thought?

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    About dandk1997RN, MSN

    Joined: Feb '10; Posts: 368; Likes: 224
    RN- Cardiology; from US
    Specialty: 4 year(s) of experience in Cardiology


  3. by   jadelpn
    First off, you should probabaly not start fixing her messes until she is done reporting. This is also something to bring up to your manager. Perhaps she is nervous about speaking (and perhaps forgetting something). Maybe for her, a report sheet to give to you at the end of her shift could accommodate this. Don't open the chart and start reviewing until she has had her say. Ask if it would be better if we just hit the highlights--SBAR--that the nurse can't stay focused and on task is really not your issue to solve, it needs to be a supervisor's issue to solve. Which will become crystal clear if consistent overtime of this one nurse is reviewed.
  4. by   chrisrn24
    75 minutes for four patients?

    I take it she is recapping every minute of the shift.

    If it is that she is chatty, say "you can continue on quick, looks like I've got a lot to do today and I need to get started."
  5. by   dandk1997RN
    Thanks for the input. We are supposed to review the chart during report to ensure that the prior nurse hasn't missed anything/neglected to do their work. That being said, I don't want you to think I jump in and fix things before she's told me about them. She'll give me half of a report on a pt, tell me I'll need to fix something because she just couldn't manage to grab one of the many available mid-levels on the floor during the day to say, get a Coumadin order, then she'll literally disappear. It's at those moments that I'll try to page the now-gone mid-levels to get those things fixed. Then she'll come back and say we're done with that pt, neglecting to tell me she is diabetic and had a blood sugar of 350.

    You have both given me things to think about as I try to figure out how to handle this mess. I'm not sure my manager is going to want to hear it- the people who have been there a long time just say, oh , that's just Frantic Nurse," but they aren't the ones who have to get report from her every day. The manager knows there is a problem- she and FN got into it in the middle of that 75 minute report last week.

    Thanks for the input- I'd love more thoughts. I think I have to start with what I can do myself to make things better, then move to the manager if that doesn't get me any where.
  6. by   chrisrn24
    Ok so maybe if she gets up to go flit off you could say something like "would you please finish report so I can get my shift started?"
  7. by   beeker
    We have one of these on my floor it is dreadful giving report to her. I am hoping someone here offers some advice that could help. Honestly I thought she must be new and not adjusting well and then I learned she has been there 5 years. We all fight over who has to give her report and we take turns. It takes forever, and no matter how hard you try you cannot redirect her. She hyper focuses on minutia and freaks out on small unimportant details. Report with her takes FOREVER. The funny thing is if you work after her, you get the worst report of your life and she hands you a giant mess with nothing done. She wants every little detail IN report, but does not return the favor. I have tried redirecting her to no avail. I usually end up frustrated and walking away from her. One of these days I am going to snap.
  8. by   nurseprnRN
    Ativan atomizer, SOS prn.

    Seriously, give her a formatted report sheet to fill in and hand to you, and don't let her talk until you have finished reading it. If you have questions, ask. Otherwise, say, "Thanks, very helpful."
  9. by   hiddencatRN
    If she can't be redirected by subtle nudges, I'd be blunt: "I need you to focus on the important highlights and not get up and do other things during report, so that we can get report done in a reasonable amount of time and I can get started on my day." And I'd follow up with discussions with management- it sounds like they should be doing some coaching on her report skills.

    There's a nurse I get report from who will work on things for several minutes after I get there to take report. On the one hand, I appreciate that she doesn't want to leave me unfinished tasks or anything hanging, but on the other hand, sometimes that's just how it is. At least she's pretty concise once she gets to report.
  10. by   iluvivt
    I think a lot like Grn Tea lately because I was just going to say make a report sheet for her to fill out..just what you need to know.
    Once she gets the hang of it it may help with all report. If she does have to to give you a verbal report in addition to the written one you need to limit each patient to no more than 5 mins.

    If for any reason she does NOT fill out her report sheets (very likely) she can still follow the format you have given her. You also have to STOP her from constantly leaving during report and she needs to understand why. She needs to know that it really impacts your ability to get your work done in a timely manner. So you take control of your shift right away...give her structure..set the rules down..limit the communication time.....find a good place with the least amt of distractions.

    I would also tell her that at least 45 minutes before it is time for her to give report that she needs to start planning to do that by finishing any last min tasks. If she realized she forgot something during report..tell her you need to finish giving me report ..then go ahead and take care of XY and Z. You need to be more assertive. She sounds very disorganized,frazzled and has horrid time management skills and it will likely take her a long time to improve without some help.
  11. by   chrisrn24
    Quote from GrnTea
    Ativan atomizer, SOS prn.

    Seriously, give her a formatted report sheet to fill in and hand to you, and don't let her talk until you have finished reading it. If you have questions, ask. Otherwise, say, "Thanks, very helpful."
    I disagree. Unless this op is charge, I don't think she has the right to thrust a sheet at another nurse and say "use this!"

    If it doesn't work to talk to her, get the manager involved. You could tape her report one day and play it for your manager.
  12. by   dandk1997RN
    Thanks for all the great ideas.. GrnTea, I love the Ativan atomizer idea, especially. If only... :~)

    I'm not sure that my manager would allow the report sheet situation, but I really like the idea and will tuck it away in case it becomes a possibility.

    I don't generally have a problem being assertive, but this is a second career for me (I used to be a supervisor in another field in the hospital) and I have only been a nurse for 8 months. This woman has been a nurse for 30 years, so I feel like a jerk trying to tell her what to do, even though it seems she needs it. That being said, I think it is probably what needs to happen, if only I could actually get her to listen. I asked her a question four times the other day before she actually paid attention to me and answered, so I think her lack of listening skills is part of the problem.

    I actually ended up approaching my manager about this situation yesterday framed in the "what can I do to make this better" and she told me I remind her a lot of herself...which made me feel better, because I have a lot of respect for my manager. She told me she is aware of the situation in regards to this nurse and ALL the other nurses (not just me) who are having a tough time with her and that it is being dealt with and I should see changes soon. I take her at her word, because she quickly and effectively addressed the one other issue I took to her.

    Love the ideas- thanks for the awesome tips!
  13. by   Blackcat99
    Perhaps direct confrontation would be best. Tell her exactly what you want her to do. Perhaps say something like "I only want a 20 minute report. I don't have time for anything longer. I have my own work to do". I have someone like that at my job too and when they start babbling on and on I cut them off and say OK. That's enough. Next patient. If she tries to leave me in the middle of report I say " Oh No, don't do anything else right now until after you are done giving me report. I hate having to do this at my job but I have no other choice. If I were to be quiet and polite, I would have to listen to a 60 minute report all the time.
  14. by   MJB2010
    Be direct. ANd keep being direct. This nurse is not going to change over night, she has been doing this for 30 years exactly this way. Odds are even being direct won't work, but you need to keep telling her to get to the point. If she tries to walk off, stop her and tell her to do that after report. Good luck!