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!
You did the correct thing, but should have been done behind closed doors so no one could hear, or talk about the incident. I have been yelled at from behind closed doors and in the nurses station, i prefer away from nurses station, so the patients and other staff wont hear it. Its more professional. If a patient heard that conversation, he would loose trust in his nurse, and break the patient/nurse relationship. I have found that it is better away from the nurses station, say in break room, and try and do it calmly. If the nurse was that over whelmed, she should have come to you for help, or delegate tasks, to pca's for instance. I also go by rule of thumb with patients......treat them the way you would want to be treated or your family member. Introduce yourself and explain the plan of care and give them a time frame, if unable to keep time frame, explain to patient that you will be in as soon as you can.
I agree completely except for the fact that the nurse blew up at me at station not visa versa. I simply asked her what's going on with the patient in room____?". She blew, she yelled, she caused her own embarrassment. Other than that I'm 100% with ya and welcome to allnurses. :kiss
Bottom line, each nurse has a pt assignment she/he is responsible for. To not tend to a pt is negligent, regardless of admitting dx. To not ask for help when you know you need it is also negligent. If something bad had happened to this pt due to the nurse not checking on her, this would probably be a lawsuit. I don't see how passing the buck here (in this case putting the responsibility on the charge nurse) would help anything. When a nurse makes a mistake, they need to learn from it and be held accountable. By blaming someone else, this nurse could feel like she did nothing wrong and the same incident happen again.
You are a "true southern belle". I am also a G-R-I-T-S . Great minds think alike. Thanks friend!!!! Truely, Thank you very much for saying it like it is!
You are a "true southern belle". I am also a G-R-I-T-S . Great minds think alike. Thanks friend!!!! Truely, Thank you very much for saying it like it is!
I agree completely except for the fact that the nurse blew up at me at station not visa versa. I simply asked her what's going on with the patient in room____?". She blew, she yelled, she caused her own embarrassment. Other than that I'm 100% with ya and welcome to allnurses. :kiss
Dear Dutch,
"Pain (any pain--emotional, physical, mental) has a message. The information it has about our life can be remarkably specific, but it usually falls into one of two categories: "We would be more alive if we did more of this," and, "Life would be more lovely if we did less of that." Once we get the pain's message, and follow its advice, the pain goes away."
This is a quote from "life 101."...maybe it will help here. You did the right thing, sorry it is causing you pain. The other nurse needs to learn form her painful mistakes. We all react differently to pain....she needs to learn new ways of dealing with her pain, as well as, what the pain means to her, as a person and as a nurse. She sounds very young. Good luck working with this person.
I read this with much interest... I am a charge nurse and in house supervisor when the bigger suits leave.... I have had similar situations... I do have a couple of issues I would like for you... the original poster and all to take into consideration...
As you were/are the charge nurse, I know you are busy and given that this situation has happened, in the future, as you circulate, maybe assessing the assignments and touching base with the floor nurses as the shift starts would help to minimize things like this... I hit the floor running, and I communicate with my newer nurses, and I have found that this makes transitioning very smooth, as sometimes their prioritizing skills are not fune tuned... talkng with them and listening to their gameplan and helping them to make adjustments as needed, helps them hone their skills ( i am not critizing you, just giving a little food for thought)) That being said...
In regards to the new nurse, I would take the situation as a opportunity to be an approachable resource to her as "poop flows uphill" this would be in your best interest... ( you kinda sound a bit bitter towards her and this will serve no purpose)
I always find something complimentary to say to my staff each night and I thank them for the hard work they do each shift and that seems to go along way.... I am well liked as a supervisor and I think it is funny because I am walking policy, best practises book. My DON calls me a bee-charmer....
I personally think you did the right thing.... I have have had Nurses Blow up... start a tirade in the nurses station and I stop them and say... not here...let's go... and name the closest private area...
YOu are doing well... this is just some food for thought... I do not think the other posters are trying to be insulting....Take everything with a grain of salt and a large margarita..(lol)
In regards to the new nurse, I would take the situation as a opportunity to be an approachable resource to her as "poop flows uphill" this would be in your best interest... ( you kinda sound a bit bitter towards her and this will serve no purpose)
I'm not at all bitter about her. She and I have spoken since. She clue'd me in as to what was really going on with her at the time. mcdmom made a comment about pain standing for something. You were absolutely correct.
I do get bitter against those who read things into my posts and offer criticism as if they have stood in my shoes.
Now, I am very interested, what is a "poop flows uphill" resource? Thanks!
You did a great job handling this. One thing that may help is bedside reports. Nurse to nurse at each patients bedside so the nurse going home can introduce the nurse coming in. Charge RN's can report off to each other as they stop in front of each room. This is what's done here. Hope it helps. This will force each nurse to see every pt. in the AM and NOC shifts.
you did the correct thing, but should have been done behind closed doors so no one could hear, or talk about the incident. i have been yelled at from behind closed doors and in the nurses station, i prefer away from nurses station, so the patients and other staff wont hear it. its more professional. if a patient heard that conversation, he would loose trust in his nurse, and break the patient/nurse relationship. i have found that it is better away from the nurses station, say in break room, and try and do it calmly. if the nurse was that over whelmed, she should have come to you for help, or delegate tasks, to pca's for instance. i also go by rule of thumb with patients......treat them the way you would want to be treated or your family member. introduce yourself and explain the plan of care and give them a time frame, if unable to keep time frame, explain to patient that you will be in as soon as you can.
i agree completely except for the fact that the nurse blew up at me at station not visa versa. i simply asked her what's going on with the patient in room____?". she blew, she yelled, she caused her own embarrassment. other than that i'm 100% with ya and welcome to allnurses. :kiss
hiya dutchgirlrn,
i think you've missed the point here on a few occasions....i believe what the ops meant was....*you*should've brought up the question/situation to the nurse at hand behind closed doors or in privacy. by questioning this nurse the way you did only may have added to said nurse's defensiveness. it's sort of like...they blew-up at you to save face...see. i understand your motives were not to embarrass them...but that's what ended-up happening...understand?
please try to be patient with us here as some are only seeking clarification in order to understand fully what went on. sure some of us are opinionated...but most are really here to support each other. try not to become reactive/defensive when someone require more info or reached a conclusion that differs with you. after all, you did start this thread seeking our opinion whether or not this nurse was out of line & if you'd handled the situation appropriately.
i believe approx 92% of us agreed that the nurse in question was inappropriate & needs further guidance. that being said...some of us also see that the patient had no baring of any responsibility & feel that perhaps *some* part of the responsibility *is* with you *as* the charge nurse on duty.
you're correct in stating we don't know what it's like to be charge at your facility...only you & others who work there do. we, however, can only speak from *our* experiences as charge nurses from our facilities. after all...at my facility, the charge often take patient loads of their own...they get an over-view report of the patients on the unit...& go from there. they basically know who can be bumped out of the unit (icu) & who's there to stay another shift or day...etc. there's times where charge will take a full patient assignment load of two & don't really have time to *manage* someone else's patient(s) and manage their assignment and charge duties.
so it all depends on what's going on at the time. that's reasonable...but in this case...i do have to agree that four hours *is* a long time for someone to have to wait for a transfusion & maybe you should've "following-up" a lot sooner into the shift before the patient got to the point of outrage? i know some nurses are highly insulted if they're managing skills are placed into question...especially if they *usually* do have everything in hand...however...this fact can not always be taken for granted. somehow...i sense that in this situation...a question say like..."are you o.k.?" or "is everything alright?" might've clued this nurse to say...no. may be if the question was asked earlier on, it would've made this person realize 'o.k....i'm getting behind...may be i should confess that i do in fact need help.'
example...say you'd asked her a hour into the shift..."do you need any help with the new admission?" or "i know you've got that new admission...do you need me to do anything for you?" & say she'd of said "no...everything is fine" (& may be in her eyes...it *is* earlier on)....then you as charge could've re-asked the question say in another hour. sometimes being in charge require micro-management...especially if the nurses in your charge are giving non-verbal cues. look back...ask yourself...."was this person looking flustered?" "were they running around extra than usual?" or..."was this person running in circles?" then think of her usual behavior during previous shifts. "does this person ever ask for help before?" "do this nurse utilizes uaps regularly enough?"...then pull it all together. perhaps then you can re-evaluate the entire scenario from *fresh* eyes so to speak :blushkiss.
I think, letting your patient wait for 4hrs without seeing him or her is not fair.But But I understand maybe she had a heavy patients, the Nurse in Charge should have known better to assign a reasonable amount of pts. to a new RN and also within the fisrt Two hours Nurse In Charge should go around to ask the Nurses how they are doing with their assignment and also to get a brief report on each pts.If she would have done that within that Two hrs she would known that one pt is being leftout. The Nurse also should have known that receiving blood is a First priority on the list.It is part of the ABC's. Both of you guys share a responsiblites and you both fail.
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DutchgirlRN, ASN, RN
3,932 Posts
I agree completely except for the fact that the nurse blew up at me at station not visa versa. I simply asked her what's going on with the patient in room____?". She blew, she yelled, she caused her own embarrassment. Other than that I'm 100% with ya and welcome to allnurses. :kiss