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!

[mtnmom]

Thank you and you are very right. I have been searching the net for signs of burnout and I have every one of them besides the fact I've been a nurse for 30 years, I am 50 years old and I am going through menopause on top of all that. My husband and I discussed all this tonight and I am going to give a two weeks notice. So far home health seems like a nice break. I am first going to take 6 weeks off to just relax with my new and first grandbaby that is coming by c-section Nov 7th at 0730. Now that's some good news. Thanks again for the nice post. Have a blessed weekend.

good luck with your new endeavor. It sounds good!

and congrats with the new grandbaby. A new life is such a refreshing thing and this may be just what you need to lift your spirits.

[ceecel.dee, MSN, RN]

When I'm in charge I feel like I should be getting combat pay.

Totally empathize with this!

Home care will be culture shock for you at first, but after that, you'll probably love the autonomy and pace. Good luck!

[steelcityrn, RN]

I Feel There Is Enough Blame To Go Around To All 3 People Involved. Would Have Been Nice For The Charge Nurse To Consider The Fact That This Is A Relatively New Nurse To Walk Right Into A Full Patient Assignment At 7am Including A New Admit With Blood Needed. Part Of A Charge Nurses Job Is Understanding This.

[Tweety, BSN, RN]

Hogwash. she was a new nurse. the charge nurse was been contacted by the bloodbank she should have been on top of this.

true, but the nurse that was 6-9mos experience was probably a little slower and the charge nurse should have known.

Things may be differently where you work.

As a charge nurse I am only aware of what the staff brings to my attention. I can't know 37 patients and 12 nurses and techs comings and goings.

New nurses know when I am in charge to come to me with problems and difficulties and I will help gladly.

But I'm not following around a nurse with six to nine months experience to check on him/her. He/she is off orientation with a license of their own.

Maybe you, or where you work, the charge nurse role is different. But it's not like that where I work.

[Tweety, BSN, RN]

I think resigning is probably the right thing to do- I speak from experience- I was in charge of a 56 bed med/surg/tele floor-- very similar to yours-- for 9 yrs. In addition to being the fulltime charge nurse, I was also in charge of doing the scheduling for the floor!! I just got to the point where I had to get away. I have never gone back to floor nursing & I have never been happier-- I had no idea how stressed I was-- and this is what is coming across in your posts- burnout. I wish you well- as I say- I've done my time!! How you have done that for 20+ yrs is a miracle- deep inside you probably knew it was time to move on a long time ago!! I think you need a long vacation first though!! (I sure did!!)

I left 3 charge nurse positions, within the same hospital, due to burn out. This example typifies the charge nurse delimena. We are working out butts off doing things and then have to be responsible for a scewup someone on our staff makes and put out the fires. We have to be able to read minds, make people happy with their assignments, watch after new grads off of orientation, on and on and on.

I got pulled to do charge yesterday and it was the same old stress again. I hate it.

[Tweety, BSN, RN]

I Feel There Is Enough Blame To Go Around To All 3 People Involved. Would Have Been Nice For The Charge Nurse To Consider The Fact That This Is A Relatively New Nurse To Walk Right Into A Full Patient Assignment At 7am Including A New Admit With Blood Needed. Part Of A Charge Nurses Job Is Understanding This.

I'm sure the charge nurse was understanding. With 30 years experience, I'm sure she's seen a new grad or two, and understand their needs. But still a patient wasn't seen for four hours. Part of a staff nurses's job, new grad or not is to be mature enough to say something when they are unable to safely perform their job. Their license and common sense dictates this. The board of nursing's first question is going to be "did you use your resources? Did you use the chain of command? Why did you accept this assignment?".

(Capitalizing the first letter of every word makes for a difficult read, FYI. :))

[marylyric]

Things may be differently where you work.

As a charge nurse I am only aware of what the staff brings to my attention. I can't know 37 patients and 12 nurses and techs comings and goings.

New nurses know when I am in charge to come to me with problems and difficulties and I will help gladly.

But I'm not following around a nurse with six to nine months experience to check on him/her. He/she is off orientation with a license of their own.

Maybe you, or where you work, the charge nurse role is different. But it's not like that where I work.

Maybe I did not make myself clear. I felt that when the BB called the charge nurse back for the 2nd time, she should have followed up with the nurse. She knew that the nurse had only 6-9 mos experience. I am not excusing the staff nurse. I am saying that when the charge nurse recieved the call, the responsibility became hers to find out what the problem was.

[weezer123]

As a nurse of 32yrs, I think the nurse, charge nurse and patient are all at fault, #1 What would make the patient sit for 4hrs? Didn't she know that after a little while maybe just maybe nobody knew she was there?

#2 The Nurse being a 6-9month New Nurse, they always try to be supernurse and handle things without letting others know they need help because like she told the Charge Nurse she would be afraid they would think she could not handle her job.

#3 Why did the charge nurse not know the nurse was overwhelmed? and Why did the charge nurse not make rounds that morning and see the patient had been sitting there that long? After all, the Blood Bank had contacted the Charge nurse, so maybe she could have said to the nurse--

Did you get the blood started yet On Mrs. so and so? The Charge nurse should ALWAYS know who is extra busy and WHO has the heaviest load for the day... Thank you...

[marylyric]

As a nurse of 32yrs, I think the nurse, charge nurse and patient are all at fault, #1 What would make the patient sit for 4hrs? Didn't she know that after a little while maybe just maybe nobody knew she was there?

#2 The Nurse being a 6-9month New Nurse, they always try to be supernurse and handle things without letting others know they need help because like she told the Charge Nurse she would be afraid they would think she could not handle her job.

#3 Why did the charge nurse not know the nurse was overwhelmed? and Why did the charge nurse not make rounds that morning and see the patient had been sitting there that long? After all, the Blood Bank had contacted the Charge nurse, so maybe she could have said to the nurse--

Did you get the blood started yet On Mrs. so and so? The Charge nurse should ALWAYS know who is extra busy and WHO has the heaviest load for the day... Thank you...

Thank you. I agree.

[Nurse Ratched, RN]

Closing this for a cooling off period.

[Nurse Ratched, RN]

Reopening this with a request to keep things respectful. There are a number of excellent observations in this thread, and I hope we can all use this as a chance to learn and be more effective in whatever our roles are.

[Tweety, BSN, RN]

Maybe I did not make myself clear. I felt that when the BB called the charge nurse back for the 2nd time, she should have followed up with the nurse. She knew that the nurse had only 6-9 mos experience. I am not excusing the staff nurse. I am saying that when the charge nurse recieved the call, the responsibility became hers to find out what the problem was.

This I can agree with. If I was in charge and got two calls, I would check in with the staff nurse to find out what the scoop was. I might have heard she was too busy, then I might have gotten the blood for the nurse and started it myself. I've done this many many times over the years.

If at that time I also found out no one had laid eyes on the patient I would have dealt with that issue as well. New grads deserve a break and understanding, and I've always got their back, but when they screw up, it's time to learn something new, not to punish or blame, but to learn. But ultimately the new grad has the same RN license that I have, and with that is a certain amount of accountability with that priviledge. :)

I'd much rather here, "I couldn't handle it, I've been too busy, I forgot, I messed up, Please help me" thant "It's not my fault, my preceptor didn't tell me".

But I agree the phone calls from the BB might have prevented a lot of the delay in "customer service".

(Thanks to the mods for reopening the thread. I wasn't done with my two cents. :rotfl: )