Oncoming nurse refuses report and leaves the room...

  1. Ok so, to start with, I'm generally someone who will stay over and help if needed with no qualms and no complaints... that being said, I experienced what I feel is an extreme reaction by an oncoming nurse to a pretty small thing and he was downright rude and unprofessional...

    So to set the stage, I had a crazy night... very busy with a transfer out, a new admit that was somewhat unstable, a post op with pain management issues, heparin drip and PCA pump, as well as an external fixation to right tibia with a freshly dc'd Foley, as well as a behavioral problem patient in restraints...

    In my last 2 hours I was running ragged trying to get everything settled for next shift when unstable patient has a BP of 85/55, and post op patient retaining urine... by the time day shift arrives, BP is under control in the one room and I've done all I can for the lady retaining urine because the night intern finally said (at 630) "well we can let the team decide when they get here in a half hour"

    So when shift change comes on, I tell the oncoming nurse to meet me in unstable patients room because I'm gonna clean him up before I leave...

    Said nurse comes into the room, sees what I am doing, goes to bed 2 (behavioral problem patient) and states " I refuse to accept handoff until bed 2 has been cleaned" and this said in not a nice way at all!!!

    I respond with "I'm cleaning bed 1 right now and still need to give you report... you guys have 4 techs today...." I don't even get to finish when he says, " I will not accept him like this" and leaves the room!!!

    I finish what I'm doing, track down the nurse and give report amongst sighs and eye rolls as I outline a couple issues for the day team to make decisions about on post op patient, etc.

    After report, I do a rudimentary cleaning of behavioral issues patient and walk back saying "okay, he is clean" as I wash my hands at the nurses station... his response is a grumble and I merely say "your welcome" in as light a tone as I can manage at this point...

    To make matters worse, I leave then backtrack when I find the PCA key in my pocket and catch him complaining to another nurse about me!!!!

    To say the least, I am peeved.... Any advice on how to best handle this in the future as well as dealing with unprofessional behavior both in front of patients and to coworkers???

    I have never had a problem with this nurse before and I'm very upset at the whole thing....
  2. Visit Kharma711 profile page

    About Kharma711, ASN

    Joined: Apr '16; Posts: 33; Likes: 51
    RN; from US
    Specialty: 1 year(s) of experience in Step-down medical

    17 Comments

  3. by   cleback
    I don't really have any advice but I agree that his behavior was totally unprofessional. Unfortunately, I know a lot of times there is rivalry between shifts (no one be lives the other works hard). And I haven't had much success confronting surly nurses or management with behavioral issues. I guess I would report it to charge. They should have an idea of how busy you were. If they get annoyed at him too, he may change his tune to save face and not tick off all of his coworkers.

    I think though I would have been crying after a shift you described. Congrats on handling it with grace!
  4. by   Kharma711
    Quote from cleback
    I don't really have any advice but I agree that his behavior was totally unprofessional. Unfortunately, I know a lot of times there is rivalry between shifts (no one be lives the other works hard). And I haven't had much success confronting surly nurses or management with behavioral issues. I guess I would report it to charge. They should have an idea of how busy you were. If they get annoyed at him too, he may change his tune to save face and not tick off all of his coworkers.

    I think though I would have been crying after a shift you described. Congrats on handling it with grace!
    Shifts like this happen more often than not and in my year on this unit I have learned to accept that.... but seriously the crap after shift ruined everything for me... I might have been busy and stressed but I wasn't upset in the least until all this happened with the oncoming nurse... I just tried to handle it as best I could...
  5. by   whichone'spink
    Write it up, and write an email to your manager. Even if you have to come in early after getting some sleep after your shift.
  6. by   jlouise2319
    Oh, I'm so glad I found this post today. I just signed up to Allnurses today a few minutes ago for the first time because I have this EXACT issue going on and I'm hitting a brick wall with what to do. I've been an RN for ten years, all in the ED, and I'm also a CEN and halfway through my FNP program. I say this only to give you an idea of who I am, my background and unit I work.

    I work days in a 15 bed ED. The hospital has been open for only three years and we are already seeing over 60 patients on day shift alone. (Yes, I worked in larger EDs but keep in mind the scope of this unit and hospital). The night shift is so used to walking into an empty department and not having to hit the floor running. Lately, as the census has increased significantly, we still have a full house at 1900 and all the "tasks" have not been completed by day shift. Obviously, this irritates the night shift RNs to no end. Report usually consists of "what time was that ordered and why has it not been done?" I'm so sick and tired of this attitude. Management is involved (great!). But I'm just over their attitude. And yes, I had to go back to the nurse's station after I left and turn something in that was in my pocket, and they were just going on and on about me....

    Management needs to be involved. But, then what??? I've done some pretty intense self-reflection...what can I do better, prioritize better/faster, but in the end I ask myself "What the heck do you expect?"

    I've made a conscious effort to run like crazy during that magical "witching hour" 1800-1900. But, now I'm exhausted. All my nursing "tasks" are done, I have maybe two discharges that are still up, and an hour of charting to do, but is that right? (I've been told that those are 'my discharges' to get out) Now, the next shift is complaining that I'm sitting at "their" computer while I finish my charting. Every day is unique, I get it, and there is no fixed formula. But I need help with too.
  7. by   NicuGal
    I would have gone to the charge nurse and told him/her that the oncoming nurse was refusing report and let the CN deal with it. I have no tolerance for stupid behavior.
  8. by   sandyfeet
    Quote from NicuGal
    I would have gone to the charge nurse and told him/her that the oncoming nurse was refusing report and let the CN deal with it. I have no tolerance for stupid behavior.
    YES. Also say "I guess you will be paying me overtime while you find another nurse to take report, because Nurse A refused to take report". That will get a manager's attention!
  9. by   NuGuyNurse2b
    that is unacceptable behavior. if he had a problem with the way the hand off was going, he needs to address it without interfering with patient safety, which he did by refusing the report. that is calls for a write up right there.
  10. by   Kharma711
    Quote from NuGuyNurse2b
    that is unacceptable behavior. if he had a problem with the way the hand off was going, he needs to address it without interfering with patient safety, which he did by refusing the report. that is calls for a write up right there.
    Sadly right now we are under temporary management aND the temporary manager is leaving in a few days... not even sure what to do or who to email... it's a mess on my unit right now...
  11. by   TriciaJ
    Quote from jlouise2319
    Oh, I'm so glad I found this post today. I just signed up to Allnurses today a few minutes ago for the first time because I have this EXACT issue going on and I'm hitting a brick wall with what to do. I've been an RN for ten years, all in the ED, and I'm also a CEN and halfway through my FNP program. I say this only to give you an idea of who I am, my background and unit I work.

    I work days in a 15 bed ED. The hospital has been open for only three years and we are already seeing over 60 patients on day shift alone. (Yes, I worked in larger EDs but keep in mind the scope of this unit and hospital). The night shift is so used to walking into an empty department and not having to hit the floor running. Lately, as the census has increased significantly, we still have a full house at 1900 and all the "tasks" have not been completed by day shift. Obviously, this irritates the night shift RNs to no end. Report usually consists of "what time was that ordered and why has it not been done?" I'm so sick and tired of this attitude. Management is involved (great!). But I'm just over their attitude. And yes, I had to go back to the nurse's station after I left and turn something in that was in my pocket, and they were just going on and on about me....

    Management needs to be involved. But, then what??? I've done some pretty intense self-reflection...what can I do better, prioritize better/faster, but in the end I ask myself "What the heck do you expect?"

    I've made a conscious effort to run like crazy during that magical "witching hour" 1800-1900. But, now I'm exhausted. All my nursing "tasks" are done, I have maybe two discharges that are still up, and an hour of charting to do, but is that right? (I've been told that those are 'my discharges' to get out) Now, the next shift is complaining that I'm sitting at "their" computer while I finish my charting. Every day is unique, I get it, and there is no fixed formula. But I need help with too.
    Try not to run yourself ragged just to appease the whiners. They have no qualms accepting a paycheque for the time they're there; they might as well plan on doing a little work.

    Learn to give an unapologetic report and waltz out on time. If the next shift wants to snivel and whine, too bad.
  12. by   Rocknurse
    Patients can't be expected to soil themselves on his schedule. If he wants convenient he should get a desk job. I used to come on to nurses from the previous shift cleaning my patients all the time. Firstly I was grateful that they were doing so, and secondly I would use it as an opportunity to assess the patient and check their pressure areas and alertness. What does he want...a perfectly primped and ironed patient sitting up in bed applauding him when he walks on to the unit? I would suggest to him next time that he is passing up on an excellent opportunity to assess his new patient and that you sincerely hope he is doing an adequate assessment because he is not taking the opportunity to get a really good at-bedside report. Unacceptable and unprofessional behavior in my opinion.
  13. by   BSNbeDONE
    Here's a new twist on your issue. His refusal and your complaining needs to continue to happen so that management will finally do something about this ongoing staffing issue. Just as you're trying to go home and cleaning up patients is interfering with that, his coming on and cleaning patients will delay his nurse-only duties. I've been in both positions more than I care to count.

    A few weeks ago, I was coming on and a patient that I was to get had soiled himself. I was pulled out of report that I was getting from another nurse to go change this patient without even knowing jack**** about the patient...bedrest? Back injury? Limited mobility? Dead weight? Name? Turn to which side only? NOTHING!! The tech was busy and the nurse that had the patient during the day could not be located. Really????

    I was fully engulfed in a code brown and complete bed bath before I could even get report. And of course, the family started firing off questions about the patient's issues that I had no clue about....no report, remember? It was 11pm before I finished 8-9pm meds because of all the PRN requests delaying starting routine med pass until 10pm. So of course, starting out behind means leaving an hour or more later every shift that this happens.

    Only management can fix these issues but because they don't, change of shift is an effin' free-for-all! However, at our facility, nurses do have the right to refuse to accept report until everything is acceptable with the patient. This is a two-way street, going and coming. This is management's alternative to avoiding the staffing crisis...put it in the hands of the workers; work it out amongst yourselves.

    We have to tend to our patients....bottom line. But we owe it to ourselves to make sure management is aware of what's going on. Your relief should not have been discussing this with another nurse; he should have been taking his concerns to management as well, to highlight the issue that lack of staffing is only going to cost the facility more in the long run if a simple exchanging of the guards is delayed because there is no one to tend to the patients during that time.

    You and your relief should team up and request a meeting with management. Safety in numbers is definitely enforced when your enemy becomes your ally (did I spell that correctly?).

    One tech or nurse assigned to an overlapping shift by a couple of hours will solve that problem. Enough professionally-worded 'concerns' from frontline workers (instead of arguing amongst ourselves) will convince the suits (or dresses) that something needs to be done.
  14. by   sevensonnets
    I think I'd approach the charge nurse with this issue and ask her to send a couple of techs to clean the patient so I could give report.

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