I am a nurse of 2 years and I am a new hire on a medical/surgical floor in acute care. This week concludes my first week off orientation. Overall, I feel somewhat prepared, however I am finding giving day shift report a challenge.
Per unit culture, report used to be given at the nursing station, but now we are doing bedside hand-off. Although this is best practice, it is very time consuming. I would generally give report between 07:00 - 07:45, however I am finding that I am ending report now at 08:00-08:30. There are many interruptions along the way.
The issue too is that, I am not really sure where my responsibility ends as a night nurse and where the day nurses responsibility starts. Being that I am new, I try not to ruffle feathers but I am beginning to feel like some day shift nurses are taking advantage of me.
I am asked (told) to medicate a patient to pain, retake a vital, e.t.c. Meanwhile, P.C.As. are on the floor and beginning their own shift with patient assignments. I always make sure to complete my obligations during my shift, and I feel like whatever happens after report is the day shift nurses's obligation (considering the patient is stable).
I have left around 09:30 - 10:00 all this week because I am occupied with these tasks, even though day shift has already come. It isn't that I wouldn't medicate a patient for pain if I had the time but is it technically my obligation?
Does my shift end when I'm off the floor or after I give report because I am having difficulty deciphering. Just today during report, a patient's blood glucose was 48. She was A&O. The on-coming nurse stated that "we" needed to stabilize the patient which really meant me pushing D50 while she sat at the nursing station and looked over vitals. Mind you it wasn't 06:59 - it was practically 09:00 at this point.
Just would like a perspective. My former preceptor says I am being too "nice" and that I need to be more firm, but I feel bad saying, "I need to chart. I'm not going to give pain medication" if I have a minute to spare.
I'll stay late for some stuff like helping with a new admit or code or someone circling the drain.
Those are the kinds of things I'd be inclined to stay for. As it is, I only stay late if we don't have enough staff at the end of my shift to care for the patients currently undergoing procedures. Or if we're running a true emergency/trauma, a code, someone is newly on MTP, someone has a suspected MH reaction - all of those situations require additional staff in the room.
The flip side expectation is expected too - if I walk in and am dressed and ready at 0630 or 0645 and we're running an emergency or code, ESPECIALLY if it's in the room I'm assigned to, I am expected to just go in and help. Night shift is supposed to help start anything that needs to be in the room before 0700, but that doesn't always happen (totally different story altogether).
Specializes in Psych, Corrections, Med-Surg, Ambulatory.
I completely agree with above responses. Also: are you clocking in overtime for all the hours you stay late? And is management okay with that? If you're working off the clock, then your facility can be penalized big time by the labour board. Unless someone's head just fell off, home time is home time.
Specializes in ED, Cardiac-step down, tele, med surg.
Develop the ability to set boundaries. Take care of the meds that are due at shift change, like the 0730 Protonix, things like that. Empty your canisters, have a new bag of IV fluids ready to go if it's getting low. Make sure to do this with tube feedings too. Those are curteous things to do for the next shift. New orders and such that happen during shift change are the next shifts responsibility. You shouldn't be clocking out at 1000 am, unless there was an emergency that you needed to stay for. Eventually management will talk to you about that. If you're working off the clock, you are in violation of labor laws and HIPPA and may not be protected by workmans comp if you have an injury. So never do that.
I'd allow a 5-minute handoff, which is all it should take and tell the nurse you need to move on. Practice doing this because you will become a doormat if you don't.
You need to discuss this problem with your supervisor. You are indeed, being taken advantage of. It would have to be an emergent situation for me to assist, if it happens after my shift has ended. You are going to have to learn to speak up for yourself.
I also think you should discuss this with your supervisor. Your coworkers are treating you poorly, its disrespectful and dangerous. You need to start saying no, and there will probably be conflict, your supervisor should know its coming before you engage. I think it would be a good idea to get some feedback from her on how to proceed.
I predict there will be other aggressions coming from your coworkers, and you might want to prepare yourself mentally to leave sooner rather than later. This is NOT your fault, you are working with abusive jackasses.
Specializes in Community Health, Med/Surg, ICU Stepdown.
This doesn't seem right to me! I'll stay a few minutes late if I see a patient calling while my oncoming coworker hasn't finished report but 2-3 hours?? Too much! You need to go home and get enough sleep! I agree with only helping out with truly urgent things that come up during bedside report and going to another area to chart if possible if you still have charting left to do after shift change.
Everyone has said it better then I can say it, but basically try not to screw over the next nurse (no matter what shift). Make sure all meds have been administered, nothing is going to run dry/overflow (IVF, chest tubes, etc), and VS have been charted/stable or are unstable and calls/interventions have been started. If it's a rapid response/code blue, stay. If it's "oh, Ms. So and So is requesting her Norco and I have to go get report for my others patient's, do you mind..." then you say: "Sorry, I have to go *give* report and head home".
Thank you all for your comments. I appreciate the validation. The general consensus seems that I have to put a stop to these inappropriate behaviors. I know that internally, but it is hard for me to do so. However, I don't want to be a push over and there are legal aspects to this issue as well. I am going into my second week so hopefully I can be firmer then I have been. I just fear retaliation or passive aggressive behavior. However, if necessary I will go to my supervisor.
Yes, a situation happened this past week. During report the patient asked for her scheduled pain medication and the day shift expected me to medicate her (and I did :/). At this time it was nearly 08:45. I feel ashamed for allowing myself to be bulldozed over but I didn't know how to go about the situation.
Thank you! Maybe I need to be more confident and this will translate into my nursing practice/report giving. I guess I feel like many of the nurses are my seniors and have been there much longer than I, so who I am to question them? But they always say trust your gut and something feels off about some of the behaviors I've seen.
You make sure the patient's pain is taken care of before 6am. Then when you give report you say "the patient had pain meds at 5.10am. Their post-pain assessment was 4/10 down from 8/10. They can have pain meds again at 9am. There is a new med just ordered due at 8am. I'm going to hand that over to you." If you keep staying late you're going to get dinged for going into overtime. If the med is due at 5am, then it's your responsibility and if it still hasn't been given at 6:45a I'm going to be wondering about your time management skills. The only time you stay is if your patient starts going down the tubes at 6:50a. Never EVER work off the clock, for two reasons: 1) you're not getting paid, and 2) you may not be covered by your institution if something happens and you weren't on the clock. Never work unless you're on the clock. They'd have us all working for free if they could. Set limits and boundaries. Don't ask the oncoming nurse "would you like me to give that med?"....you TELL her..."there is a med due at 7:30am". People only take advantage of you if you let them.
FurBabyMom, MSN, RN
1 Article; 814 Posts
Those are the kinds of things I'd be inclined to stay for. As it is, I only stay late if we don't have enough staff at the end of my shift to care for the patients currently undergoing procedures. Or if we're running a true emergency/trauma, a code, someone is newly on MTP, someone has a suspected MH reaction - all of those situations require additional staff in the room.
The flip side expectation is expected too - if I walk in and am dressed and ready at 0630 or 0645 and we're running an emergency or code, ESPECIALLY if it's in the room I'm assigned to, I am expected to just go in and help. Night shift is supposed to help start anything that needs to be in the room before 0700, but that doesn't always happen (totally different story altogether).