End Of Shift Report - The Sapnish Inquisition

Mississippi_RN · Oct 29, 2005

Some people are just unhappy in general... Don't let it bother you. IMO, if she doesn't like her job (which obviously she doesn't) then let her quit...

irshnrse · Oct 29, 2005

I am an agency nurse and I am on a different floor everyday. I was a recovery room nurse and I think that I give a pretty thorough report, but there is always someone who frowns and makes passive-aggressive comments throughout my report. The worst part is the things she is complaining about really aren't relevant to the care of the patients. I am exaggerating here but it is like, "Are they a Gemini? Do they like long walks on the beach?", etc. When I am giving relevant info (i.e., hx, vs, fsbs, labs, etc.) I am interrupted, patronized, and have to deal with multiple sighs and eye rolls. I just smile sweetly and, like you, find humor in these people who are so miserable that they want everyone to join them!!

babynurselsa, RN · Oct 29, 2005

There is one of these in every crowd. They have to keep probing until they find something you cannot answer. THey get some sort of perverse satisfaction out of this. THen they can complain about the "incomplete" report that they recieved.

I have little patience for the great inquisition.

I guess you could get a ruler and make her her own special shhet with a perfectly aligned box for all info she demands. ( I hope you know I am kidding.)

Catsmeow · Oct 29, 2005

I guess you could get a ruler and make her her own special shhet with a perfectly aligned box for all info she demands. ( I hope you know I am kidding.)

Acccctually... if you did print ya off a little sheet at home with pretty boxes for those extra-info-type-things she wanted to know, then gave her your notes (like the one you had, just on your little print out or whatever) she would very likely be so stunned she'd tell everyone how good a nurse you were. lol. I had a lady (I forget now what she did, this was awhile ago, nurse manager for HMO insurance or something, had to track those particular patients) that always complained about not getting her reports for a certain type of insurance admits. We always put her reports in the same place, wasn't like we were hiding them from her. hehe. Anyway, after running the reports one night I highlighted, counted, and circled in a big circle the info she was looking for, and made sure it was on top of her cubby. Ooooooo she was so delighted (I kept this up til I went off third shift) that she went to my manager and told her how wonderful that person that highlighted all her patients for her was! LOL. S'only way I found to deal with these people, cater to them just slightly. :rolleyes:

graddock · Oct 29, 2005

Hey,

Though I am not a nurse just yet, I would make a special sheet just for her and get so critically perverse in all reporting and then turn it in. All the way down to patients color and BM. For BM's just put in color and doc the odor. I know that may be way out there but if I were on the Rx(Recieving-radio speak) end I'd probably get the point. I realize that this is not easy due to time constraints but hey, if the time is right go for it. At least get your kicks w/ this nurse. She's getting hers w/ you.

Sorry for the vent as this is a similar problem I have been dealing with and am in the process of doing just what I wrote above.

Good Luck,

Garrett Wynn

Daytonite, BSN, RN · Oct 30, 2005

This, I think, is just one of the reasons your facility has nurses coming and going. People just can't give that kind of attitude to the nurses who they work with or they'll drive them out the door and be even shorter of help.

When I was working staff in LTC I always went through the list of patients who were currently on antibiotics during report. Reason is because the oncoming nurse needs to have these patients identified because they need to have V.S. taken and they need to be charted on every day if not every shift. The antibiotic is being given for some sort of infection or prophylactically and needs to be identified as such in the charting. The care plan nurse will have care planned the antibiotic and the reason it is being given and needs the vital signs and charting to back it up. I always listed the fingerstick results on my report sheet along with any insulin given and reported this to the oncoming as well. This served as a double check for me that all the fingersticks and insulin had gotten done. Occassionally someone gets accidentally skipped over for some reason or another. The other group of people that I told the oncoming about were people who had had a recent fall or skin tear (read that as incident report made out) and had to be charted on every shift for 72 hours, part of the follow-up of the incident report. This is important information for LTC charge nurses to have to know.

The only way to really know the precise amount of liquid in the bottle of methadone is to actually pour it out and measure it. I would call and check with one of the pharmacists to find out exactly how they recommend that can be done. Was this bottle plastic or glass? We were always told that the inside of glass bottles, in particular, were a different thickness throughout all it's sides and the measuring marks on the bottle were only for our convenience and should not be assumed to be accurate. We were told not to try to make up for any shortage we were showing on the sign-off sheet as the "missing" liquid would show up by the time we finished off the bottle. We were also warned not to give the patient a little extra with a dose if it looked like we had more than we were supposed to in the bottle. Sure enough, sometimes people would short the patient a little with each dose and then by the time they got to what was supposed to be the last dose in the bottle, there was enough for a whole extra dose. There was also the vice-versa situation. I wonder if this also occurs with plastic bottles? Might be a good question to ask the pharmacist. I would write the pharmacy number down and call them later in the day when I got home. Also, I would mark the actual level of the liquid in the bottle with a black Sharpie marker and mark and date and time by it. Sharpie ink is permanent and can't be rubbed off as easily as pen ink can. That is how I can prove what the level of the liquid was when I did my oncoming narcotic count.

prmenrs, RN · Oct 30, 2005

Methadone dispensed in the fashion you're describing is almost always going to be off. See if you can find out from pharmacy what the tolerance level is; every once in a while (q wk?), someone from pharmacy should check the bottle and reconcile the amount w/the records.

You can also make a little grid-type check list: pts name, voided/stooled, last blood sugar, insulin x units given, antibiotics?, reason?, etc., whatever the nitpicky ??s are.

I'm sorry you get to deal w/her; ask others what their experiences are, maybe they have tips.

I used to give report to a nurse like that: what's the CBC results, what does the CXR look like.... ok on a sicko, I can see it, but on a growing premie, they only get that stuff every week, If something showed up, someone woulda done something already!!

Nella · Oct 30, 2005

prmenrs,

I agree with you. I used a report sheet I made myself: had places to enter I&O's, telemetry strip readings, vitals, blood sugars, what IVs they were on at what rate, what labs I had drawn, breath sounds and the like.

And yeah, I wouldn't sweat the liquid methadone.

estrogen · Oct 30, 2005

When I worked med-surg I made up my special grid there too. Here, I.ve been using the roster we're provided and mostly it's worked fine. But yeah, maybe I could play around with it and make it a little more detailed. But on the other hand, I don't really want to cater to this nurse-princess either. This is LTC, the people don't change that much from one day to the next. Overall, I tend to take pride in giving a intelligent report that is pertinent to the pt's changes in condition. If the pt. is running an infection, I'll say so. Which abx they are on, often multiple of them, I'll admit, I don't allways know each of them of the top of my head. There is an allert sheet, that has all the abx and the incidents listed. Each nurse is obligated to check it and update it for changes during her shift, so why repeat it during report (unless there is some accute situation developing)?

wooh, BSN, RN · Oct 30, 2005

At my old job, there's one dayshift nurse that has that attitude. She quickly learned when she'd whine about something I'd give her a "why would I care look", shrug my shoulders and go "oh well." I know that I know my stuff. I have twice as many patients as she does. We only got into it once, when I had a bad night and wasn't in the mood for her crap. She dragged the nursing supervisor and her charge nurse into it. She tried to drag my charge nurse into it, but then found out I had been charge for the night (hehe!). The supervisor and her charge both took my side in the matter. We'd go a while getting along just fine, then she'd get a bug up her butt and I'd have to repeat my "I'm not going to roll over and do your bidding just because you can be a bigger b than me" act. She'd try her little prima donna act on the other nurses when I'd be charge, come running to me when they didn't do something she thought they should do. I'd look into it, and if it was something I wouldn't have done either, I'd say, "Well, looks like you've got your first task for the day." She insisted on my calling an "elevated" PT/INR on a knee patient once, so I called the MD to humor her, when the doctor asked if we were calling "normal" values now (because prophylactic coumadin is going to elevate your PT/INR strangely enough), I said that normally I didn't but that the oncoming nurse so&so, RN thought that it should be called. I passed along to her his message for her, with glee I might add. Funny thing was, when I was quitting, she told me she was really sorry I was going and was going to miss me. I see her in town and she thinks we're big buddies. I've really found that most people like this will actually give you more respect if you demand it. And by "demand it" I simply mean doing your job and ignoring their petty whims. I think you acted right in this matter. If you give in to her demands, she won't "get the point" that she's being ridiculous, she'll see that she can get you to do her bidding. Do your job, do it well, and if the next nurse doesn't like it, oh well.

fins · Oct 31, 2005

One thing that can be kind of fun to do - if you aren't in a hurry at the end of your shift. If you have a nurse like the one you're describing, give her the most mind-numbingly detailed report imaginable. Cover everything, significant or insignificant, about each patient. When she starts her day over 30 minutes behind, she might (just maybe) get the hint.