Frustrated and need to vent

[QuenymamiRN]

I work in a LTC facility which is very heavy. I work on a floor with 52 residents, all which need a lot of care, and quite a few are dying (not stable). Just for background there is one other long term floor with 52 residents and an acute rehab floor with 47 residents. Rehab floor has more nurses and is a breeze. Day shift is rough but there is usually 3 nurses on each floor plus the DON and a supervisior. On Evenings the long term floors have 1.5 nurses. One nurse gets split between both long term floors for treatments and the other nurse does meds (same for days on weekends only). Then the rehab floor has 2 nurses and there is 1 supervisior. On nights long term has 1 nurse on each floor, rehab has 2 nurses and we have 1 supervisior. If schedule is tight, the supervisior does the floor (on rehab).

The day nurses often want to give the evening nurses what ever they do not finish which is causing a lot of friction. Of course one particular evening nurse always says why isn't this done... blah blah. Well the next day I have to listen to the bickering (I work nights).

Usually I say, you know its really hard on evenings... Well, recently there is a Rt who was not able to be hemodialysised (she has an emboli in the AV graft). She is do not hospitalize. So, we are caring for her. She had a STAT BMP done and potassium was 6.4. Day nurse received order for Kayexalate, but did not put in the computer nor did she give it. I know its hard on weekends blah blah, they have less staff. However, that is a med that should be given STAT, we have in the E box, so no excuses! This nurse is very good and I respect her, but come on!! I am so sick of BS! All morning the two nurses are going back and forth, why is evenings complaining... Oh she worked Saturday on days so now she knows how it is haha. No, maybe they should work eves and see how it is!! No one, and I mean no nurse gets out on time! That evening nurse often stays an hr past her time. No one gets paid for leaving late, but most people finish their job and then gripe about not getting paid.

Regardless, of how much work each shift has, work should not be passed along to the next shift especially important orders!

[joanne1medicaidlpn]

I agree with you. I'm used to the kind of place that runs efficiently even with no staff and noone would EVER leave anything for the next shift.

I work per diem now at a nursing home, and I had many concerns I took to the DON in regard to things not being done when staff leaves (2 hrs late charting every shift) but they don't have time to take their own orders off... really?

Her response was.... "we are open 24 hrs a day. what doesn't get done one shift needs to get done the next"

So rediculous, because now every shift will be behind from now until eternity.

And plz explain how orders that are written for q shift can just get "passed on"

[Ruthiegal]

Where I work, passing of work is an unfortunate byproduct of cutting labor and overtime. But not the STAT stuff. That should be done STAT. So, the morning shift should be faxing their INR results right away, so they get orders sooner. I used to work with this AM nurse who would wait until 1:30 to fax her stuff out... ALL OF IT and I would come in on PMs and guess how much crap would be getting faxed to us at 5 PM. GRRRR... But passing things to the next shift (again, non urgent), is the nature of the beast and it should be mentioned in report.

There is nothing more irritating than getting yelled at by a doc when the afternoon or day shift has left stat results to be called on midnight shift.... Wowser.... It does happen... received at 5pm passed off at 11pm...

[Vinniesguy]

Her response was.... "we are open 24 hrs a day. what doesn't get done one shift needs to get done the next"

Actually I do agree with that statement - nursing is a 24 hour job and if we've had an emergency like an arrest call or an influx of admissions from ED because they need to clear their department to prepare for multiple casualties then some of the duties normally assigned to our shift aren't going to get done and will need to be passed on. It doesn't happen ALL the time but we work as a team and we all know what it's like to have a nightmare shift and not be able to get everything done.

[maelstrom143]

Her response was.... "we are open 24 hrs a day. what doesn't get done one shift needs to get done the next"

Actually I do agree with that statement - nursing is a 24 hour job and if we've had an emergency like an arrest call or an influx of admissions from ED because they need to clear their department to prepare for multiple casualties then some of the duties normally assigned to our shift aren't going to get done and will need to be passed on. It doesn't happen ALL the time but we work as a team and we all know what it's like to have a nightmare shift and not be able to get everything done.

Nursing may be a 24h job, but orders still need to be executed in a timely manner for patient safety. There is a reason there are protocols in place. Passing things in report is logical, as long as it is not an all the time thing. PT/INRs are a dayshift thing and need to be executed in a timely manner. I do pass things on to the next shift (i.e. meds not received from pharmacy, new admit who arrived at 1845h , calls that may need to be done). However, I do not make a habit of leaving things for the next shift all the time, nor do they do it to me. We are not perfect. Things get passed to the next shift and that is the nature of the beast.

However, when it is a chronic issue it compromises patient care and that is not acceptable. Making excuses for never having your work done is not acceptable. We are all grownups and need to stop expecting to be babysat. A few things passed on here and there are to be expected. A bunch of stuff constantly being missed by the same individuals time after time, however, shows poor time management and lack of common courtesy to our colleagues.