Courtesy Assessment

I was the night charge on a small 12 bed rehab unit for about 8 years. We had this issue all the time. Since we connected to a hospital, we had to have people going for procedures ready at 0700. I also refused to make it look like this was a day shift assessment. I drew up a separate pre-procedural flow sheet and documented what I did at the actual times done.

Of course this was back in the stone age of paper files. But it worked well. After I left and the unit went to computer charting, they did scan and rework my flow sheet into an on-line option.

Good luck.

Your fellow nurses are setting the facility up for a JACHO violation. The day shift assessment must occur on the 7-3 shift so crossing out 0800 and writing 0530 does not count for day shift. Yes JACHO will cross reference back and see what shift you were working and what time you clocked out on a specific day if they suspect something wrong. I would think your manager would put a stop to this if she knows about it. I work day shift and I know how busy it can be but I still do not trust another nurse doing my assessment and me taking responsibility for it. What if something changes in the patient from 0530 to 0800...that does happen and if the patient isn't assessed in the mean time no one would notice the difference.

Stick to your guns and be the proper role model your unit needs. Good job.

What is on this?

Can you describe it?

Sarah

I don't see any problem with your doing it as long as it is charted for the actual time done.

On the other hand, if you don't have to do it, and the other nurses are complaining about the way you are doing it, which is the correct way, charting it for the time actually done, then to heck with them, don't do it at all.

I would chart it for the actual time and in the block where it belongs.

Sounds like they are trying to bully you into doing it their way which is for their convenience.

I don't see any problem with your doing it as long as it is charted for the actual time done.

On the other hand, if you don't have to do it, and the other nurses are complaining about the way you are doing it, which is the correct way, charting it for the time actually done, then to heck with them, don't do it at all.

I would chart it for the actual time and in the block where it belongs.

Sounds like they are trying to bully you into doing it their way which is for their convenience.

:yeahthat:

Even if you do an assessment just before the patient leaves, they still need to assess the patient when the patient returns to the floor. Particularly if the patient had some sort of procedure!

If you do an assessment at 6:30, the patient leaves the floor at 7:15, then comes back at 9:00, it makes no sense whatsoever to wait until 2:00 to assess the patient!!

I don't understand this, nor why your head nurse has not addressed it with the day staff. As another poster said, things can indeed change in a short period of time!

frankly, these nurses sound lazy. not only that, but apparently documentation of patient care is more important to them than actual patient care itself. if you charted that you did the assessment on their shift, would that protect them in a court of law? no, it wouldn't. it would actually incriminate them, since they neglected to assess the patient they were assigned (if it wasn't charted, it wasn't done. and lawyers as well as JCAHO know how to check which shift each nurse was working at a specified time).

i can't believe that, if you've got the patient and the paperwork ready for them, and all they have to do is assess the patient (which takes all of 5 minutes if you are really slow), they are still so lazy and ungrateful as to try to get out of charting, too. i know charting's a beyotch, but it HAS to be done by each nurse each shift. i would just tell them that if they don't chart their own assessments for their own shift, that's considered patient abandonment. therefore, by my refusal to chart for them, i am forcing them to protect themselves and their licenses. they'd probably hate me for it, but i doubt they'd ask again.

as a better alternative, i'd inform the nurse manager of the situation and insist that somebody do some teaching or inservice on the situation and the proper way to handle it. they may not take your reasons coming from you, but they will (grudgingly and b*tchingly) take it from management. and if there are still problems, you can remind them that "Sally, NM said it's to be done this way, so that's how it's to be done. Didn't you make it to that staff meeting?" in the meantime, it might not be a bad idea to get together with the rest of the night staff and determine if anyone else is charting for them, and explain your reasoning for why it's not a good idea. if none of the night nurses does this for the day shift, then not only will they stop taking their anger out on you personally (instead, it will be displaced to the entire night shift), but after much griping they will either shut up and and just do what they're supposed to or go to the nurse manager. who, if you've already explained the situation to him/her, will just tell them that you are doing the correct thing and they need to get their acts together.