Blow out at the desk, who was at fault? both share blame I think?

[DutchgirlRN]

I was in charge yesterday and when I got there at 0700 I was told we would be getting a patient (a GI doc's receptionist) for 3 units of blood and go home. I assigned the patient and told the nurse that the patient had arrived. At 0815 the BB called to say that the blood was ready and I told the nurse. At 0845 BB called back to say the blood hadn't been picked up yet. (they never do this but figured hey she works for the GI doc) I told them the nurse was almost through making her morning med pass and would be there shortly. Now fast forward to 1100.

The tech comes to me and tells me that the lady in room #_____is really pissed and wants to see the charge nurse. I go down there and she is sitting on the bed in her street clothes, madder than h*** because her blood hasn't been started yet, no IV, no breakfast, no lunch, no nothing. I asked her why she hadn't used her call light, she said "why should I you all have known that I was here." I apoligized to her, assured her I would find out what the problem was and that I would get her food, her IV and blood started. Which I did.

Then I called the nurse to the desk. I said what is the problem? She said well I've been so over whelmed with my other 5 patients I haven't had time for her and I figured she'd be here all day anyway so no big deal, also I blame the night shift for not settling her in.

I said

# 1 whenever a patient is assigned to you for any reason you "always" go in the room within the first 30 mins, even if just to stick your head in, and introduce yourself and see if they need anything. If you don't you may someday find that a patient has been dead for hours.

# 2 If you're ever overwhelmed you come to the charge nurse and ask for help. If I can't help I'll find someone who can even if we have to call the supervisor. In this case I would have been able to help you out, no problem. She said she didn't want to ask for help because it would appear she couldn't handle her job. I said no we all need help sometimes (She been an RN about 6-9 months)

#3 the patient herself bears some responsibility for not using her call light. I wouldn't sit in a room for 4 hours waiting for something to happen, she may be somewhat of a marter.

#4 it is not the fault of the night shift. She arrived at 0700 and assigned at that time and the night shift nurses didn't even know she was there. She got really mad "well my preceptor never told me I had to check on patients at the beginning of my shift", well I'm telling you now you need to, no matter what, at least stick your head in the door.

She raised a fuss, called the supervisor, who backed me up, but then the nurse also talked to the other nurses about me making a big deal out of her not seeing a patient for 4 hours. I'm not letting it bother me because I'm right and I think I handled it right, I'm just needing to vent a little.

P.S. I know this GI doc pretty well. Do you think I should mention to him that she had not used her call light in 4 hours and may have acted like a marter or just apoligize for what happened? Thanks!

[DusktilDawn]

I think what we all need to bear in mind here, is that anothers place of work is not like our own. How things run where you work, is not the way it may run elsewhere. Also how the Charge nurse functions where your at, may not be how a Charge nurse functions at another facility. Same goes for what the responsibilities of the Charge nurse role may be.

When others post in regards to a situation at work, we tend to relate to it from our own perspective, which includes our work environment perspective. We need to bear in mind how that may color our perception when someone makes a post in regards to a work related incident.

[LoriAlabamaRN]

I think what we all need to bear in mind here, is that anothers place of work is not like our own. How things run where you work, is not the way it may run elsewhere. Also how the Charge nurse functions where your at, may not be how a Charge nurse functions at another facility. Same goes for what the responsibilities of the Charge nurse role may be.

When others post in regards to a situation at work, we tend to relate to it from our own perspective, which includes our work environment perspective. We need to bear in mind how that may color our perception when someone makes a post in regards to a work related incident.

You're absolutely right. I hope I made that clear in my above post- I AM comparing it to my facility. However, unless anyone here actually works there, doesn't that sorta go without saying?

[oldiebutgoodie, RN]

I have read this thread ad nauseum, and I have several observations:

1. Playing the blame game is usually counterproductive

2. Yes, the nurse needs some re-educating on prioritization

3. This re-educating should be done in private

4. There is a concept in business in which the process, not the people, are investigated when there are problems.

5. This is not to renege on personal responsibility, but it seems that far too much energy is being spent in this situation on blaming everybody--the charge nurse, the nurse, the patient. Figure out how to fix this and move on, for heaven's sake.

Oldiebutgoodie

[DusktilDawn]

I was in charge yesterday and when I got there at 0700 I was told we would be getting a patient (a GI doc's receptionist) for 3 units of blood and go home. I assigned the patient and told the nurse that the patient had arrived. At 0815 the BB called to say that the blood was ready and I told the nurse. At 0845 BB called back to say the blood hadn't been picked up yet. (they never do this but figured hey she works for the GI doc) I told them the nurse was almost through making her morning med pass and would be there shortly. Now fast forward to 1100.

Lori, my post wasn't specifically directed towards you, so I apologize if that is how it appeared.

It just seems that the big bone of contention on this thread is in regards to a 30 minutes between phone calls. Apparently the supervisor in this situation backed the Charge nurse, not the new nurse who called the supervisor. I think it bears repeating that the role of Charge nurse varies greatly depending on the facility.

[SmilingBluEyes]

I have read this thread ad nauseum, and I have several observations:

1. Playing the blame game is usually counterproductive

2. Yes, the nurse needs some re-educating on prioritization

3. This re-educating should be done in private

4. There is a concept in business in which the process, not the people, are investigated when there are problems.

5. This is not to renege on personal responsibility, but it seems that far too much energy is being spent in this situation on blaming everybody--the charge nurse, the nurse, the patient. Figure out how to fix this and move on, for heaven's sake.

Oldiebutgoodie

So well-said.

[Balder_LPN, LPN]

I've been a nurse for 30 years and clearly understand HIPAA and no I did not violate HIPAA. He is her doc, but thanks for your opinion anyway.

I was on the floor yesterday and was so overwhelmed, really really bad day. I asked for help and I got it. I never mind asking for help. I rarely do, maybe twice a year but I'm smart enough to know when I need to ask for help.

oops, posted before I read the quote. I did another HIPAA rant, and then saw that the pt was her bosses PT, that changes the picture.

there is no breach confidentiality per HIPAA since the information to be discussed is relevant for the MD to know about in relation to providing pt care. It would be another story if he was just the pt's boss who happened to be an MD and not part of her health care team

[DutchgirlRN, ASN, RN]

Just a post script. Not meant to re-start any of this controversy since it's been beat to death once already.

I worked last Sunday and was in charge. The nurse referred to in this thread came up to me and asked to talk. She sincerely aplogized to me and told me that she appreciated me being honest enough to tell her how dangerous it was for her not to be checking on that patient and that she had gotten so upset because she was scared something would happen to the patient. I told her Thank You. I told her most important was to ask for help anytime you need it. Not 15 minutes later two of her patient began circling the drain. She asked for help. I called the supervisor to take over the desk, had other nurses

assigned to watch over her other four patients. I took one who was going down and she took the other. After about two hours things were settled, we got a DNR on one and the other family desperately wanted the mother to die at home and we got her out on an ambulance. The nurse said "yup, it sure works better that way, Thanks for all your help." I felt really good.

[pugmum]

Just a post script. Not meant to re-start any of this controversy since it's been beat to death once already.

I worked last Sunday and was in charge. The nurse referred to in this thread came up to me and asked to talk. She sincerely aplogized to me and told me that she appreciated me being honest enough to tell her how dangerous it was for her not to be checking on that patient and that she had gotten so upset because she was scared something would happen to the patient. I told her Thank You. I told her most important was to ask for help anytime you need it. Not 15 minutes later two of her patient began circling the drain. She asked for help. I called the supervisor to take over the desk, had other nurses

assigned to watch over her other four patients. I took one who was going down and she took the other. After about two hours things were settled, we got a DNR on one and the other family desperately wanted the mother to die at home and we got her out on an ambulance. The nurse said "yup, it sure works better that way, Thanks for all your help." I felt really good.

Wonderful!

[DutchgirlRN, ASN, RN]

Wonderful!

Thanks S & T !!!!