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!
It took me a while after becoming an RN to feel comfortable in my role. I remember and thank the nurses who were patient with me and gave me good advice in a helpful and supportive way. I also remember the nurses who treated me like I was an incompetent idiot. I chose to listen to the former. It seems clear to a seasoned nurse what should be done and how to prioritize. A new nurse often feels overwhelmed and incompetent. I agree, 4 hours is way too long no matter who the pt. was, yet you can be a positive force in this case and help a struggling newby not to make this mistake again. She obviously needs some supportive guidance. Be the one!!!!
Specializes in Specializes in L/D, newborn, GYN, LTC, Dialysis.
I think you handled things admirably. The responsible/assigned nurse, on the other hand, bears culpability in not letting you know she was overwhelmed and needed help---nor making use of auxillary staff at her disposal. 30 minutes IS a long time not to at least get a quick baseline assessment, and tuck a patient in when he/she arrives on the unit.
Before anyone jumps on me, believe me, I know how crazy it can get; new admits come at the most inconvenient times and yet, we have no choices, really to make sure we do a very basic baseline assessment/vital signs and make the patient comfortable and let her know we will see to her needs as soon as possible. I realize It's my responsibility as the receiving nurse to do this---at least a cursory visit and baseline vital signs are always in order for new admits, would anyone not agree?
And yes, the patient COULD have used her call bell to ask sooner what the hold-up was before working herself up to a tizzy. But dont' expect much sympathy from admin or even the dr-----usually they take the side of the complaining "customer" as you know. All you can do is what you did---let the patient know you were aware and acting on her concerns and gave her the option to use her callbell for further needs. There was really nothing else to be done, except possibly an occurence report if a big stink is raised, to CYA.
I say again, you handled it all with aplomb and very professionally. Pat yourself on the back for a job very well-done.
Specializes in Specializes in L/D, newborn, GYN, LTC, Dialysis.
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I'm concerned about this young lady talking to the other nurses about your making a big deal of her not seeing a patient for 4 hours. These are dishonest reactions. This sends up red flags all around--this is a trouble maker in the making. Sorry, I can't stop thinking like a manager. Sadder still is that now that she knows she's made a pretty grave error(s) [or, does she? that could be an even bigger problem] she's broadcasting her own failure in an attempt to find some compatriots! Is she so dumb she doesn't have the wherewithall to act horrified at her mistake? I sincerely hope she doesn't find any buddies to support her position since she's trying to establish some power and authority over others, you in particular, that she has no right to.
I would pull this young lady aside and address this broadcasting she is doing. I would tell her it's inappropriate and she needs to come to me instead of talking to all the other staff about something she disagrees that I've done to her. I would also instruct all the other staff, as I run into them individually, not to listen to any of this nurse's whining about this incident. Stop her and tell her to go and talk to me about it, they are not to get involved with the situation. I'm telling you that if this behavior is not nipped in the bud right now, this employee is going to cause a lot of trouble down the road. This is a serious attitude problem.
You go to the break room and have a fit there where no one else can see you. It goes with being in a leadership position.
AGREE!
and in light of all this, an occurence/incident report is a MUST. I revise my position this much---do this ASAP, if not done already.
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!
:selfbonk: HIPAA HIPAA hooray
no no dont do either, clear violation, at least w/o pt permission and a bit awkward to get that
I begin to think, "What am I going to get yelled at about?" rather than "What are my priorities"?
That's a really good point. When I've been charge on nights, I have to watch the new grads really closely for falling into that trap. There are so many prima donnas that they get stuck giving report to, that instead of focusing on what they need to do to give good care, they focus on what they need to do to make the next shift happy. And yes, there's a difference.
no excuse for the whole floor. I have been on the patients end a lot this year and when you are admitted on the floor--they know that you are there. Where was the nurses tech for vital signs? It shouldn't always be the patients responsibility, its the personnels responsibility. They are there for a service. Yes, I have been on the busy nurse's end also, but there comes a time when you have to hollar for help. A new nurse can't do it all and she should come to know this. This probably won't happen again on her shift.
It took me a while after becoming an RN to feel comfortable in my role. I remember and thank the nurses who were patient with me and gave me good advice in a helpful and supportive way. I also remember the nurses who treated me like I was an incompetent idiot. I chose to listen to the former. It seems clear to a seasoned nurse what should be done and how to prioritize. A new nurse often feels overwhelmed and incompetent. I agree, 4 hours is way too long no matter who the pt. was, yet you can be a positive force in this case and help a struggling newby not to make this mistake again. She obviously needs some supportive guidance. Be the one!!!!
Specializes in Specializes in L/D, newborn, GYN, LTC, Dialysis.
Young nurses who behave immaturely and run to their colleagues, spreading bad words about their charge nurses, need a wee bit more than tender nurturing. They need a bit of counseling.
NO blame should be placed on the patient, regardless of the fact that she worked for a doctor. W/an H&H low enough to require 3 units of blood she may have been too tired/weak to make sure the nurses were doing their job! Responsibility needs to be taken by the nurse assigned to her care, and to the charge nurse for not checking on her when the lab called the 2nd time.
She's the GI doc's receptionist, but for this admission was she the GI doc's patient? Because unless she was, the entire affair is none of the GI doc's business, and doesn't need to be discussed with the GI doc at all.
I spoke with the doctor today and he thanked me for handling it the way that I did. He said she was upset but commended me highly to him for the way I jumped in and got it done once it was discoved that she had been abandoned by her primary nurse. He basically felt it was her fault for waiting so long and not using her call light or coming to the desk. He ended it with "oh well, it happens".
Well I certainly hope he was her physician for this admission then, because otherwise you violated HIPAA, just like if it was a construction worker that had the flu and you told his foreman about his admission, Thank you.
She's the GI doc's receptionist, but for this admission was she the GI doc's patient? Because unless she was, the entire affair is none of the GI doc's business, and doesn't need to be discussed with the GI doc at all.
I agree with this completely. Unless that's the pt.'s doctor, it's really none of his business what's going on with her.
And i really don't see any relevance for him to be contacted over this, from what i've read, his only true involvement in this is that he's her employer. Is that not a confidentiality violation, and not to mention HIPAA?
grooveyredhead
8 Posts
It took me a while after becoming an RN to feel comfortable in my role. I remember and thank the nurses who were patient with me and gave me good advice in a helpful and supportive way. I also remember the nurses who treated me like I was an incompetent idiot. I chose to listen to the former. It seems clear to a seasoned nurse what should be done and how to prioritize. A new nurse often feels overwhelmed and incompetent. I agree, 4 hours is way too long no matter who the pt. was, yet you can be a positive force in this case and help a struggling newby not to make this mistake again. She obviously needs some supportive guidance. Be the one!!!!