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 struggled with this too. There is no way you should be staying till 9 or 10 if you worked the night before. No way. No how. Are these nurses staying until 9:30 at night to help you?
The climate of "everyone does everything at all times" is what makes hospitals inefficient. Get your charting done by 6:30 AM if possible so you are ready. You have to prioritize it and it means delegating things that can be done without you to your CNAs. It stinks but the CNA cannot stay late to do your assessment. The other nurses are taking advantage of you. Even if you report them YOU look like the liability staying that late. It is costing the hospital OT as a previous poster said. Medicate your people by 6 AM. If they want something after 7:00 that's for the day shifter. I still struggle with these issues at almost 3 years out, so you're not alone.
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.
The whole original topic you've brought up isn't easy. But try very hard to give it a go from the standpoint of expecting the best of people. Some of what is going on here is that you are avoiding doing a very normal thing because you assume others won't tolerate that. Well, guess what, if your ducks are otherwise in a row and they don't want to play fair, that's not going to be your problem. Meanwhile assuming things and fearing the worst is contributing (a great deal) to the situation, and if you think about it, it's really not fair to others for you to assume that they are incapable of doing the right thing (which, in this case is being reasonable about which tasks fall to them).
So, when it's already way past your time to leave, you're still giving report and a patient calls for pain medications? Easy. No fear required. "Okay, I'll wrap this up so you can get on with your day."
Actually, if they are getting report from you still @ 0845, now they're getting behind because of all of this, too.
Here's a lesson I had to learn. Some other person is not worried at all about implying or outright stating that you need to do something that is clearly off-base (do their work for them). So why should you feel any worse making a reasonable and pleasant alternative suggestion, than they felt about the totally wacky thing they said without any regard for you?
Don't get frazzled and snap at people, which honestly you are at risk for doing because now you know there is a problem here but you're afraid to deal with it.
Have things in order, then expect the best from others. Expecting and fearing the worst will cripple you.
Actually, if they are getting report from you still @ 0845, now they're getting behind because of all of this, too.
***THIS**** so much. It actually helped me get past my bad habits of staying late to finish things. And lately I've been on the receiving end of a night nurse who hangs around and milks the clock, and it's irritating to me. She is obviously dragging her feet on purpose but it gets annoying because she'll do small tasks without any pattern. So sometimes I'm like "are you getting that med? Or am I?" Basically she's in the way, dragging her computer around the room as I'm trying to get started.
Specializes in Psych, Corrections, Med-Surg, Ambulatory.
***THIS**** so much. It actually helped me get past my bad habits of staying late to finish things. And lately I've been on the receiving end of a night nurse who hangs around and milks the clock, and it's irritating to me. She is obviously dragging her feet on purpose but it gets annoying because she'll do small tasks without any pattern. So sometimes I'm like "are you getting that med? Or am I?" Basically she's in the way, dragging her computer around the room as I'm trying to get started.
Next time ask her "Is there something I can help you finish up so you can get out of here? Two of us doing the same thing is an error waiting to happen."
chacha82, ADN, BSN
626 Posts
I struggled with this too. There is no way you should be staying till 9 or 10 if you worked the night before. No way. No how. Are these nurses staying until 9:30 at night to help you?
The climate of "everyone does everything at all times" is what makes hospitals inefficient. Get your charting done by 6:30 AM if possible so you are ready. You have to prioritize it and it means delegating things that can be done without you to your CNAs. It stinks but the CNA cannot stay late to do your assessment. The other nurses are taking advantage of you. Even if you report them YOU look like the liability staying that late. It is costing the hospital OT as a previous poster said. Medicate your people by 6 AM. If they want something after 7:00 that's for the day shifter. I still struggle with these issues at almost 3 years out, so you're not alone.