24 hour facility

Forever Sunshine, ASN, RN · Apr 16, 2011

5:30am and about to leave for a cruise but I most post this first! lol

I so know what you mean! I was stuck with an admission, a pile of untouched labs and orders, and a full assignment on the floor. and I was charge nurse so I had to do CNA assignments and call the dr for all these orders and labs too. The 11-7 nurse who was on is new so I started her off on the right foot and left the orders for her. They were taken and documented in the nurses note(which i like to do for my own orders) she just had to pick them up. No problem with her. I felt bad leaving the orders but I had to get home I had school in the morning.

The regular 11-7 nurse on will get very .. not nasty but.. almost annoyed if we leave stuff that has to be taken care of. I try not to leave a lot but they stop paying me at 11. I'm not staying until 2am if someone else is here that could do it.

I totally get your frustration. Vent over.. time to leave for the airport. lol

LoveMyBugs, BSN, CNA, RN · Apr 16, 2011

I work in a LTAC/SNF, work 2-10pm and we are not allowed to pass anything off to the next shift, if we do it just makes it harder for that shift.

When I went through orientation I was constently told that you never leave anything for the next shift. For the most part it has been true, there are a few nurses that try to pass things off to you

I know at least in my facility that the NOC shift nurses are too busy to pick up anything from my shift, as well all the shifts are busy and if we dont get our work done you have to stay over, last week there were 2 shifts where I ended up working 12 hours because of dressing changes, new admits, orders and people falling out of bed, all of which can not be passed off.

I am learning to ask for help, the last time I worked the LTAC side I had a million different things going on and I asked my manager to help me and she was very supportive and she stayed untill 1am to help with the mess.

Another time another nurse was behind with orders and was sending 2 patients out to the ED at the same time, plus the MDs had made their rounds and she had a stack of new orders, so my self and a RCM went over to help her out. So both her and I ended up leaving late, but nothing was passed on to the next shift

So far no one has said anything to me about staying late, but I know that some of the NOC shift nurses got in trouble for coming in early to get ready for their shift (a lot of dressing changes are scheduled for NOC shift)

Kooky Korky, BSN, RN · Apr 16, 2011

I guess it depends on the culture where you work. I do know that you should not intentionally leave work for the next shift. Nor is it right for you to accept leftovers from the preceding shift but not be able to turn anything over to the shift following you.

Nor should you work for free - not only because it is immoral of an employer to expect or demand this of you, but because you could be in harm's way if you are clocked out but still working.

If you get hurt, you will have trouble getting Worker's Comp to pay for it or, if you make an error and harm someone, you might not be covered by insurance. So don't ever work for free. Talk with a lawyer for verifying this.

Chin up · Apr 16, 2011

This thread is a pandora's box. Bye!

Orange Tree · Apr 16, 2011

I don't mind when things are passed on to me from the departing shift as long as they are disclosed. In fact, I encourage people to go home and assure them that I've got it and don't mind. What I dislike, is walking into a room and finding out from a patient that a heparin drip was turned off at lunchtime (I come in at 7PM) because their IV blew. And when I come in after a nurse like that, there's usually a surprise in every chart/room.

I also have no problem passing things on when I don't have time to complete them. My personal rule is to complete the most PITA tasks first and leave the low priority tasks for the next shift (if I have to leave anything). I will stay a little late if there's a very pressing concern that the oncoming shift may not have time to get to fast enough. Otherwise, peace out!

makes needs known · Apr 16, 2011

Last night I asked the 11-7 charge nurse if she could help me finish up some tx. I was tired and asking for help. She gave me a blank look. We have asked this same charge nurse to complete tasks we could not do. "Please give this antibiotic when it comes from the pharmacy" She won't do it and her SV stands behind her,

I called her when I got home from work and apoligized to her for possibly making her mad. She did not accept my apology and I am sure she told her SV that I asked for help. I will probably hear about this. What happened to "Together Every Acheives More" TEAM. Thanks for your input.:)

LPNnowRN · Apr 16, 2011

I feel your pain--I have been left orders from day shift with no warning: one day I was left orders from 4 pts who went to the Dr that day, 4 pts who were seen in the facility on rounds that day, coumadin orders not done, 6 pts with labs with no notification to MD's, etc...and that day I ended up staying until 4am to process all the orders and fax to pharmacy. Days just shoved everything into the wall pocket and left on time. I would have made a med error on some of those coumadins which made me a little upset with days. Just let me KNOW they are left in report please! Just one or two nurses, but it gets old. Our facility also says we can ask Nocs to do stuff, but when I do, the stuff is still in the cart the next evening (also just a few nurses). So far I haven't been talked to about overtime, but I'm waiting!

NoviceRN10 · Apr 16, 2011

I have come in for my 7p-7a shift and had a nurse pass off a blood transfusion that was ordered at 8 am. I have had a nurse tell me during report that the PCA in my new pt's room is beeping. I understand that it is a 24 hr operation. I understand that pharmacy backs up and doesn't send meds expediently. I don't appreciate getting handed tasks that should have and could have been dealt with by the person who reviewed the order or encountered the beeping machine. I rarely pass anything off, I have too much of a conscience and I bust my butt racing around to get stuff done because I am paid to do that. If a med is not up from pharmacy I can't give it, otherwise my tasks are usually complete for the next nurse. I once had a fellow nurse tell me about a colostomy bag that was clogged and about to explode (it was actually more of a pigtail drain being used for that purpose, so the neck was narrow) about 3 hrs before I knew I was going to take over this pt. She actually wrote a progress note in the chart and thought she was going to leave it explode on my watch! You have to love following nurses like that. NOT.

psu_213, BSN, RN · Apr 16, 2011

Take me resonse in the light that I never worked as an RN in LTC...

How can a facility function if you cannot allow the next shift to help you tie up loose ends? I have worked after nurses who constantly leave a bunch of stuff that they should have finished, and that gets annoying. If, however, the nurse before me honestly has things they cannot get to, then I would have no problem finishing. I would also hope that if I cannot get to something, then the nurse after me would "have my back." On the other hand, I am certianly not going to leave a mess for the person following me (for example, I would not order blood for a pt at 6:30 am, and then leave right at 7:30 am as it arrives).

I would definitely have trouble working in a facility/on a unit that will not allow you to leave unless you have everything forseeable complete for the next shift.

caliotter3 · Apr 16, 2011

This is a problem that needs to be worked out with the assistance of the supervisors. Yes, in a 24 hour setup, the unfinished business is passed on. People who complain need to get a handle on that fact. There is a difference between not being able to get everything done on your shift, and not even trying to get as much possible, done. We all know the difference and who shirks work versus who makes the honest effort.