Another silly "what should I do" thread...

[Anna Flaxis, BSN, RN]

Here's the situation. Pt. BIBA for N/V/D onset that a.m.

In my initial note, I made a note that pt. requested bedpan on arrival, and described the contents; the amount, color, consistency.

An hour and a half later, pt. requested bedpan again, so I put it under her. Zone mate comes back from long lunch, starts to walk off without offering to cover *me*, I stop her and say "Hey, I'd like to go on break too...".

I report off to my zone mate, and it slips my mind that the patient is on the bedpan. Bad form, I know.

I return from my break, zone mate barely glances in my direction as she ducks into a patient room. I check my charts to find "1425 Pt. removed from bedpan" noted. Oh crap, I think, I totally forgot about that. I feel bad.

But then, I start to get angry. How passive aggressive of her to just chart "Pt. removed from bedpan" without mentioning the quantity, consistency, and color of the contents. What is the purpose of such a note? Plus, since I hadn't charted "1400 Pt. placed on bedpan" (which I wouldn't do anyway), one could argue that it looks like this is the same bedpan from my initial note two hours earlier!

Yes, I should have talked with her at the time. However, as with most days in the ED, we were getting our butts kicked, and I figured the LOM who couldn't breathe was probably a little more important.

I'd hate for anyone to think I'd leave a patient on a bedpan for two hours, and also, using the patient's chart to communicate in a passive aggressive way is inappropriate, and I think she needs to be called on that.

Now, I'm wondering....should I talk to her about it next time I see her, or let it go and be the wiser for it?

[merlee]

I think you are overreacting here. Although it would have been appropriate to chart the contents, I think your embarrassment about forgetting to tell your relief about the pt being on the bedpan is getting in the way here.

No real harm here, and minimal foul.

Get over it. At the most, ask what the contents were.

[joanna73, BSN, RN]

Unless the patient is being monitored for some reason, I would not bother to chart the contents of a bedpan. I wouldn't worry about this situation either way. It's a waste of your energy.

[Esme12, ASN, BSN, RN]

BIBA???? is that an official nursing/medical abbreviation? I assume that means Brought In By Ambulance.....right?

As an ED nurse I would include in report that so and so was on the pan.....and ask if that was ok. I probably would not have left until I removed that bedpan, but if the patient was talking a long time I would bargain to get the other nurses bedpan of equal excrement when I get back. It usually gets a good laugh but the offer is made and the other nurse doesn't feel dumped on. I also would not have left the patients bedside without being sure the patient has the call bell AND knows AND can use it......before leaving the patient let alone the floor. I too have been dumped on (pun intended) by N/V/D patients with explosive diarrhea conveniently placed on the pan by another that just went to lunch and itsu#ks.

I would take to her about it but not in the way you think. I would go up to her and acknowledge her caring for your patient. I would apologize for leaving the patient on the pan without telling her before I left and I would thank her for caring for your patient while you were gone. I would do this for the sake of peace and harmony. We do get our butts kicked in the ED which makes it all the more important to have each others backs and play nice in the sandbox......

[Anna Flaxis, BSN, RN]

I just feel a little thrown under the bus by my co-worker. What is the purpose of charting that the bedpan was removed? None, unless you're going to also mention the contents, which were significant, since diarrhea was part of this patient's chief complaint. Otherwise, it just makes me look bad, since it looks like this is the same bedpan from when the patient first arrived two hours earlier.

But this is why I posted about this. Maybe I am overreacting.

[Anna Flaxis, BSN, RN]

Unless the patient is being monitored for some reason, I would not bother to chart the contents of a bedpan.

The patient's chief complaint included diarrhea, so my observations of her stool are relevant findings to document.

[Anna Flaxis, BSN, RN]

Esme, I would not leave for break if a patient were on the bedpan unless the covering nurse offered to deal with it. I just plain FORGOT. It happens. I just wish that if she were mad at me about it, she would have just said something instead of making me look bad on the chart.

[joanna73, BSN, RN]

Right. Ok, well, notice in my post I said "Unless the pt is being monitored for some reason...."

Diarrhea would be a reason to chart contents. However, I still think you are making a little much of the situation.

[Double-Helix, BSN, RN]

If you didn't talk to your zone mate after this incident, how do you know there were even contents to report? Maybe th patient had an urge to go and then it passed? Is it policy to document contents, or just your preference? Perhaps the other nurse was being passive aggressive, or you could be reading into a simple documentation of events. If it bothered you that much that someone might think the pt was on the bedpan for so long, you could have documented a late entry at the time the pt was placed on the bedpan.

I probably would have addressed this with the other nurse when I got back from break, if I were going to address it at all. If you brig it up next time you see her it just looks like you were obsessing over one simple note. The nurse will either think you're nuts or will know that the comment really got to you. And if she were being passive aggressive, that's exactly what she wants.

I think you've got to let this one go. The note has been written, the patient is gone, the shift is over. The agenda behind the note doesn't matter anymore.

[Anna Flaxis, BSN, RN]

I probably would have addressed this with the other nurse when I got back from break, if I were going to address it at all. If you brig it up next time you see her it just looks like you were obsessing over one simple note. The nurse will either think you're nuts or will know that the comment really got to you. And if she were being passive aggressive, that's exactly what she wants.

I think you've got to let this one go. The note has been written, the patient is gone, the shift is over. The agenda behind the note doesn't matter anymore.

Yes, clearly if I was going to address it, I should have done so at the time. I just think that sometimes, it can be helpful to address issues in retrospect, just to "clear the air" for the sake of team cohesion, and wonder if this might be one of those times. But the opinions so far seem to be that this is a "let it go" situation.

[Anna Flaxis, BSN, RN]

Oh, and if you guys think *I'm* overreacting, some nurses would have chewed her a new one for such a charting maneuver.

[Sylv]

Why do you think it makes it look like it was the same bedpan you put her on when she arrived?

You documented what the contents looked like, therefore you took her off the bedpan.

Or do you look at the contents and chart them and leave the person sitting on the bedpan?