i feel bad- leaving things to do for day shift

[sophie<3]

so i am a new grad..about a month and a half off orientation on a Bone Marrow Transplant Unit..our ratio is 1:3..I have been doing pretty well so far at managing my patients and getting everything done..until last night.

one of my patient's is having a stem cell transplant tomorrow..he was up walking and talking and fine. my second patient slept most of the shift, was on TPN and several IVFs with antibiotics, insulin, etc. and my third patient is 6 days following a stem cell transplant with IVFs, a PCA pump, pain and nausea and vomiting, and a fever of 103.9 as well as neutropenic and on a lot of antibiotics.

the majority of the night went as planned..i was all caught up but when my sickest patient's AM labs came back around 5 AM he needed 2 units of blood, platelets, potassium replacement, and Mag replacement..the day before his Hgb was 8.4, today it was 6.8..I never thought to question the Hgb level but knew he needed blood so I drew a current clot for crossmatch and while waiting for the results of that I hung up blood tubing, pre-medicated for platelets, did vitals for platelets, and started platelets, all while giving meds and charting..his PICC line was slow so the platelets were not running as fast as I had hoped but after flushing twice and a pressure bag, that's all I could really do. I had all my meds given and everything else done but yet felt guilty when I left work that I left too much stuff undone. The nurse taking him asked if I rechecked Hgb and I said no, even after telling my coworkers his Hgb in comparison to the day before they didn't say anything..they just said to draw the clot and set up the tubing and start the platelets first. So I did all this..so why did the nurse I give report to give me the death stare when I told her what I couldn't get to?? clearly I was running my a** off all morning doing the rest of the stuff..in that 2 hour window from the time I got results to the end of shift, there is only so much that can be done.

sorry for the venting..i just need some insight..should I have stayed past my shift and helped? Or should I accept what I could do and let the rest go?

[MommyandRN]

Oh honey I have BEEN THERE. Right now I am not in a position where I "give report" on a regular basis and do not miss it one bit. Report should be a brief report on the patient and what is going on. I always hated it when the oncoming nurse made report be actually about what work I did and what still was left to do. And if there are still things left to do, it's like I didn't do my job. It seemed like when I gave report and the nurse had exactly NO work to do besides drink coffee, was the only time they were satisfied. I would walk off the unit while they sat and sipped coffee and chatted with people. But God forbid someone had a lab to look up or something. It was as if I am abandoning my pt. This is why there is a change of shift. I work till 7 then you pick up where I left off. I could see if there was a nurse who consistently didnt do their job. But for those of us who work hard, don't act like I am a horrible nurse if you have to do a few things in the first hour!

[NeoPediRN]

You'll get over the feeling guilty thing in time. Nursing is a 24 hour job for a reason.

[Good Morning, Gil]

Don't worry about it. You did what you could do; you're only one person. If you're consistently leaving things to do, that's one thing, but it's clear that you had a busy night. Some nurses give attitude because they don't want to have to work hard, and when they walk into something like that, they know they're actually going to have to work as soon as they get there, and not eat their danish lol.

I used to feel like you do. I'd feel bad about leaving things that were clearly beyond my control, and say "sorry, but you'll have to do X", but there's nothing to feel sorry for if you're working efficiently, safely, and your patient is just crashing. There's really no way around not having work left to do in that case since there is constantly work to be done lol.

As long as you're working hard, efficiently, which it sounds like you are, you have nothing to worry about. I always leave my patients, and their rooms like I would like them to be when I get there (when possible). The Golden Rule. All new tubing, baths, ensuring lytes are already replaced, if applicable, and any new issues resolved. For instance, if it's appropriate for my patient to go for a CT, I go with said patient before I leave, not time it for 0730 lol. And, it's also in the patients' best interests, too.

I've had other day nurses apologize to me, too, about undone things, and I am always kind, saying, "I'm here for 12 hours. Don't worry about it." If we treat each other nicely, report doesn't have to be a dreaded time.

[caliotter3]

Rest assured that the other shift will be leaving things to the following shift. The work flows around all three shifts. If it could all be done in one shift, there would probably be only one shift. Give yourself credit for what you are accomplishing and don't focus on what you couldn't get done in eight hours.

[tri-rn]

If it could all be done in one shift, there would probably be only one shift.

Exactly!!!