Blow out at the desk, who was at fault? both share blame I think?

Nurses General Nursing

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I was in charge yesterday and when I got there at 0700 I was told we would be getting a patient (a GI doc's receptionist) for 3 units of blood and go home. I assigned the patient and told the nurse that the patient had arrived. At 0815 the BB called to say that the blood was ready and I told the nurse. At 0845 BB called back to say the blood hadn't been picked up yet. (they never do this but figured hey she works for the GI doc) I told them the nurse was almost through making her morning med pass and would be there shortly. Now fast forward to 1100.

The tech comes to me and tells me that the lady in room #_____is really pissed and wants to see the charge nurse. I go down there and she is sitting on the bed in her street clothes, madder than h*** because her blood hasn't been started yet, no IV, no breakfast, no lunch, no nothing. I asked her why she hadn't used her call light, she said "why should I you all have known that I was here." I apoligized to her, assured her I would find out what the problem was and that I would get her food, her IV and blood started. Which I did.

Then I called the nurse to the desk. I said what is the problem? She said well I've been so over whelmed with my other 5 patients I haven't had time for her and I figured she'd be here all day anyway so no big deal, also I blame the night shift for not settling her in.

I said

# 1 whenever a patient is assigned to you for any reason you "always" go in the room within the first 30 mins, even if just to stick your head in, and introduce yourself and see if they need anything. If you don't you may someday find that a patient has been dead for hours.

# 2 If you're ever overwhelmed you come to the charge nurse and ask for help. If I can't help I'll find someone who can even if we have to call the supervisor. In this case I would have been able to help you out, no problem. She said she didn't want to ask for help because it would appear she couldn't handle her job. I said no we all need help sometimes (She been an RN about 6-9 months)

#3 the patient herself bears some responsibility for not using her call light. I wouldn't sit in a room for 4 hours waiting for something to happen, she may be somewhat of a marter.

#4 it is not the fault of the night shift. She arrived at 0700 and assigned at that time and the night shift nurses didn't even know she was there. She got really mad "well my preceptor never told me I had to check on patients at the beginning of my shift", well I'm telling you now you need to, no matter what, at least stick your head in the door.

She raised a fuss, called the supervisor, who backed me up, but then the nurse also talked to the other nurses about me making a big deal out of her not seeing a patient for 4 hours. I'm not letting it bother me because I'm right and I think I handled it right, I'm just needing to vent a little.

P.S. I know this GI doc pretty well. Do you think I should mention to him that she had not used her call light in 4 hours and may have acted like a marter or just apoligize for what happened? Thanks!

Good Job!!!

Specializes in MS Home Health.

I think you did fine as well. When I read the thread I was thinking BM blow out!!!!! LOL.

renerian:rotfl:

Specializes in OB, M/S, HH, Medical Imaging RN.
a lot can happen from 7 to 10:30. i am curious to know why she didn't feel the need to check on the patient until 3 1/2 hours until her shift.

yep, that's what i would like to know also.

When the blood bank calls to tell the charge nurse for the second time the blood is ready, thats your cue to investigate the delay and take charge. I have been in similar positions and understand when a new nurse is overwhelmed.

Specializes in OB, M/S, HH, Medical Imaging RN.
When the blood bank calls to tell the charge nurse for the second time the blood is ready, thats your cue to investigate the delay and take charge. I have been in similar positions and understand when a new nurse is overwhelmed.

Read post # 115 . That's all I've got to say about that...

Specializes in Transplant, homecare, hospice.
Hogwash. she was a new nurse. the charge nurse was been contacted by the bloodbank she should have been on top of this.

I'm a new nurse too (

Forgive me if it's already been discussed, but there are a lot of pages to this thread. Anyway, the OP said the the patient was one of their GI doc's receptionist's, and was wondering if she should say anything to the doc about the situation, along the lines of an apology. She wasn't clear on if the patient was admitted as that doctor's patient, or if the pt was just supposed to be some sort of VIP. If the pt wasn't his/hers, then she doesn't have any right to talk to the doctor about the pt at all. Just wanted to point that out.

Specializes in OB, M/S, HH, Medical Imaging RN.
Forgive me if it's already been discussed, but there are a lot of pages to this thread. Anyway, the OP said the the patient was one of their GI doc's receptionist's, and was wondering if she should say anything to the doc about the situation, along the lines of an apology. She wasn't clear on if the patient was admitted as that doctor's patient, or if the pt was just supposed to be some sort of VIP. If the pt wasn't his/hers, then she doesn't have any right to talk to the doctor about the pt at all. Just wanted to point that out.

The patient was the doctor's receptionist but also his patient. I did talk to him about it the next day and apoligized for what had happened and explained to him that the nurse had been reprimanded by the nurse manager. He said well she (the pt) should have come to the desk instead of sitting there fuming, he basically felt it was her fault.

Don't barage me, I said "he felt" it was her fault. I don't feel that way although I do know that had it been me I would have been up to the desk or at least turned on my light within an hour. She wasn't too weak by any means, she had driven herself to the hospital.

The patient was the doctor's receptionist but also his patient. I did talk to him about it the next day and apoligized for what had happened and explained to him that the nurse had been reprimanded by the nurse manager. He said well she (the pt) should have come to the desk instead of sitting there fuming, he basically felt it was her fault.

It was unnecessary and inappropriate to tell the doc about any disciplinary action that was taken against the nurse. Even a nurse manager shouldn't disclose such details. That nurse's right to confidentiality was violated, big time, and if she found out that you told him about it, she'd be well within her rights to take it to HR.

And I'm sorry, but part of being a charge nurse is to actually "take charge." A second call from the blood bank was a cue. Regardless of what the other nurse "should have" done, when you're in charge, ultimately, you're responsible. And yes, I have had to do so myself when I was charge (in M/S, peds, and ED).

i agree with you iam a cna and when i start a shift i allways try to check on the pacients iam going to have that night. well if i where the pacient i would ring my call bell and be like no one has come in here to see how iam doing or to start my producer. but 4 hrs is extreme and you did the right thing . and thats good that the supervisor backed u .

Specializes in Med-Surg, Geriatric, Behavioral Health.

Just a friendly Mod reminder to post respectfully.

A second call from the blood bank was a cue. Regardless of what the other nurse "should have" done, when you're in charge, ultimately, you're responsible. And yes, I have had to do so myself when I was charge (in M/S, peds, and ED).

I agree with this. My concern is that when the blood bank called again, the reminder was meant for the nurse and wasn't passed along. As a supervisor myself, I know how easy it is to assume things are taken care of. I'm sure that if you were in that nurse's position you would have had the blood picked up and hung. It's easy to assume that she is as competent as you seem to be. I've had times that I assumed such myself. However, when the second call from the blood bank came, I believe you should have told the nurse "The blood bank just called again, you are going to take care of this, right? Can you call then and tell them when you'll pick it up?" or something similar. When you told them she would take care of it after her med pass, you were assuming too much. Obviously the blood bank thought a reminder was in order, and so do I.

By the way, congratulations on the birth of your grandchild- Wyatt is simply beautiful.

Lori

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