first admission all the time

[TA123]

Every time I work with this RN weekender they always put me on first to get admission. I have big problem with it but I dont want to make it an issue. should I say something or just work with it for the sake of team work.

[MedSurgeMe]

I agree that you should talk to her. Also, are you able to be charge nurse? I'd ask to be allowed to be charge nurse sometimes. When you also have charge power, suddenly your assignments get a lot more reasonable.

[MomRN0913]

In the ICU we would track the admissions in a book. It also depended ont he acuity of the patient. As one poster said, I used to get 3rd admit and that would be the messy code blue on the floor at 6am and I would be there until 9pm. 1st is good sometimes.

My coworkers were trying to be nice to me when I came back fron maternity leave and gave me a stable vent and a DNR on Bipap and an easy 3rd so i wouldn't admit. Well, the DNR recsinded his own DNR when he couldn't breathe anymore (only 60 years old) Well, my night became a living hell when he was a hard intubation, with bp dropping....

Anyways speak up if you feel like it is unfair. I always fine when I say something something worse happens!

[I<3H2O, BSN, RN]

I was the charge nurse accused of this type of behavior a while back. I have since started keeping a log of who gets assignments and when. :)

[headinsandRN]

i would rather have the first admit and get it done early than have one later in the shift. it gives me more time to make sure i did not miss anything.

Agreed.

At least as long as the last shift didn't leave you a big mess that you have to work on before you even get started with what needs to be done on your shift.

Nothing like walking into a total care's room at 1900 and seeing a tray of food that was not touched, a diaper that is so soiled the bed is wet and an ac piv beeping that won't flush with a bag of potassium that is 2/3 full still hanging.

[BluegrassRN]

I've been accused of this, too, that on Monday morning I always gave the same person the first admit.

Here's the deal: I *was* leaving the first admit to the same person all the time, but not on purpose. See, most of us work somewhat set schedules. On every Sunday that I charged on nights, the entire crew on Monday morning would be new (meaning, none of them had worked on Sunday). Staffing came up, and I would fill out assignments. Inevitably we would be staffed to where everyone would have four, except for one person. So I'd give her three and leave her to take first admit. Since I filled out the names in the order they came up on the staffing sheet, which was alphabetical order, it just happened that most often the one who only had three was the last name on the list.

I wasn't even thinking about it; I was thinking in terms of numbers. She fumed about it for weeks, and finally griped to the day shift charge, who told me about it. I didn't think I was doing it at all, since I wasn't doing it purposely, and then when I went back to check, I realized that I was doing it and why. The next Monday, I told that particular nurse that I hadn't purposely always given her the first admit, it had just fallen that way because I was putting down names in alphabetical order and assigning pts in a methodical manner, with her always being last on the list and so often being one down. I also told her if she had a problem with how I did staffing, she needed to talk to me directly.

Now I'm more aware of doing this. I purposely mix up the names on the assignment sheet, placing them in a different order. I also, on my shift, don't always distribute admits by virtue of who has the least pts and is first on the list. I start at the bottom of the list, or in the middle, if there is more than one person with fewer patients than the rest of us.

The point of this long story: she may not know she's doing it. There may be a reason that she's doing it...everyone else was there the day before and gets their pts back and you get the leftovers, leaving you with fewer pts and open for first admit; or your name comes up on the staffing list first, so she just mindlessly assigns you first admit; that sort of thing. If you don't calmly and professionally talk to her about it, the situation won't right itself.

[TA123]

Thank you all for all the advice. I wont mind getting first admits if the floor i work isn't so hectic. From all what i've gathered here so far...1. I will keep records of the admit assignments, 2. let the charge nurse know that she always put me on first admit based on the facts, 3. if no change let the supervisor/nurse manager knows. Appreciate all the inputs.