Given bad report all the time.

Posted

I guess I just wanted to post this to vent because it is very upsetting to me. I am a new grad who was hired a couple months ago by a ltc. I was "oriented" for a couple weeks and have been on my own for 3 weeks. Since I'm new i have no idea who is and isn't competent and whos report should be questioned. There's an rn there on days who I have learned is sort of flaky. She's given me report and not told me patients were loa or she tells me orders are "all set" and they arent. She isn't new, she's been an rn for years. What kills me is she doesn't know how to use or program a kangaroo feeding pump. No one ever showed me how to use one and I figured it out because it prompts you. Once before she came up to me because one pts pump wasn't working. I looked at it. The machine prompted me to enter rate and vtbi and it was fine. So on to last night. She's giving me report and tells me a different pts feeding pump isn't working. She left to check and returned saying oh the pt got it to work its fine. The pt is quite good with his GT so that made sense. Now here is my mistake. I should have specifically looked at that machine when I made first rounds, but you know I'm new, never worked in healthcare, crappy orientation, 24 patients and things were going nutty with some other pts. So after 3 hours he's due for meds. Mind you this man's feeding was supposedly turned on at 1 and now it's 6. I go in and look at the pump. He's supposed to get 70 ml/hr for 20 hrs. It was set to a 70 ml bolus q 20 hrs!!!! So I easily fixed it because I'm sorry the kangaroo pump is self explanatory if you know what bolus means, but the pt probably didn't so he thought he did it right. So he's short 350 mls and I just imagine what if I had never looked, what if he had gone the whole night without food. I wasn't even sure how to report this. It's the first time I got teary about the job. I ended up telling the night nurse and the other nurse that was working with me. They were like, well now you know never ever trust her, apparently this nurse that always gives me crappy report is like this. So at least they helped me make it right and do what needed to be done. I feel so upset with myself for not checking the numbers on my first round, but what makes me more upset is thinking about that poor man with cancer who's feeding was 5 hours late and could have gone a whole night without food. Idk, it feels better to write about it and that's my spiel.

Emergent, RN

Specializes in ER. Has 29 years experience. 2 Articles; 3,982 Posts

Ok, it doesn't sound like an earth shattering mistake. Now you know to check this gal's stuff. If the cancer guy didn't get his feeding for the night, it also wouldn't have been the end of the world. Probably management needs a warm body, it sounds like this woman is tolerated, and as a newbie, it's probably better not to rock the boat.

CoffeeRTC

CoffeeRTC, BSN, RN

Has 25 years experience. 3,734 Posts

I think we've all worked with someone like this. Try and get in a few minutes early, read thru your 24hr report to see if she missed some thing during verbal report. After you get your verbal report, do a quick round of your patients.

TriciaJ, RN

Specializes in Psych, Corrections, Med-Surg, Ambulatory. Has 41 years experience. 4,291 Posts

When you find a serious mistake, are you required to complete an incident report? It doesn't matter who programmed the pump; you found it to be in error and the patient missed several hours of feeding. Is there a senior person in your facility who can provide some mentoring? That way you can focus on the issues and not make it be about another person.

If the issues that cause you concern seem to have the same person behind them, that is for management to sort out. But you should not be afraid of filing incident reports, whether it is from your error or someone else's. They are learning opportunities and can uncover system errors that put everyone at risk.

Hope this takes off some of the pressure from having a less than reliable coworker.

LeChien, BSN, RN

Specializes in Emergency Nursing, Pediatrics. Has 10 years experience. 277 Posts

We do walking rounds for this purpose. Yes it takes longer, but you can have her correct any problems right then and there.

Been there,done that, ASN, RN

Has 33 years experience. 6,823 Posts

Ok, it doesn't sound like an earth shattering mistake. Now you know to check this gal's stuff. If the cancer guy didn't get his feeding for the night, it also wouldn't have been the end of the world. Probably management needs a warm body, it sounds like this woman is tolerated, and as a newbie, it's probably better not to rock the boat.

It would have been the end of the world if it was your father that didn't get his prescribed feeding.

Newbie or not, incompetence needs to be written up.

LTC_LPN2

LTC_LPN2

10 Posts

Im not justifying her actions or lack thereof just to make it known that hectic shifts, high census, incidents and such do carry the risk of forgetfulness. I even at times forget to log residents out on the 24 hour report but my coworkers ask me, "who do we have out, any status changes?" It prompts me to think about what I have not done that needs doing in order to transition shift change smoothly and prevent another nurse from going behind me to fix it. That will get you a bad reputation like the one she seems to have. Pumps are cut in and off through out shifts to provide IC, flushes, med pass, and to give the tummy a rest for a couple hours. My advice...get a notebook, ask questions instead of relying on a report sheet, make your rounds and provide care as needed. You can't rely or trust that another nurse will do their jobs efficiently, they'll allow you to cover their tracks until you stop them from it...you cover your own behind. Round first, intervene when necessary, ask questions!

dream'n, BSN, RN

Specializes in UR/PA, Hematology/Oncology, Med Surg, Psych. Has 29 years experience. 1,162 Posts

As you are a newbie nurse I'll tell you a little secret; nurses are human...if you work nights, you will occasionally find a day nurses mistake and the day nurses will find yours. The part of the OP that bothers me is that it sounds like you and some nurses had a little grip/gossip session about this nurse. That is not appropriate. If you don't think it will get back to this other RN, you are sadly mistaken. I also don't care for the OPs attitude that the other nurse is an idiot because she didn't know how to program a Kangaroo Pump. Well I'm an experienced RN and the first time I used one, I had someone with me that was familiar.

And if the OP thinks this is a whopper of a mistake, just wait. You will see some mistakes that will blow your mind. Plus, a patient should not be programming their own pump and you, OP should have checked asap when informed of it. It took you 5 hours to notice? So honestly, much of the blame resides with you OP. And never trust anyone's report, always verify and review.

crj96

crj96

Specializes in Rehabilitation. Has 4 years experience. 37 Posts

You will learn who is trustworthy and who isn't. I make it a point to have the reputation as a nurse who owns up to mistakes and gets stuff done. Having said that, I can't do it all and sometimes I'm letting things go to the next shift because I have to. But I always give an accurate report, even if the report is, "I wasn't able to complete this task..."

I agree with the replies that suggested you get there early, go over your patients, and find tasks that are either due on your shift or haven't been completed yet. You'll also learn, with experience, what questions to ask during report. Do walking rounds. Make statements like, "You'll take care of that before you leave?" when things are noticed during report. Lay eyes on the patient and see what their pump reads. And if she doesn't know how to program it - show her! We are all teachable, or we have no place in healthcare.

As a final note, don't ever take any report as gospel. We all make mistakes. When you find one, correct it.

ProgressiveActivist, BSN, RN

Specializes in ICU. Has 20 years experience. 670 Posts

If a coworker programs the kangaroo pump for 70 q 20hrs instead of 70/hr management needs to provide corrective action. A new employee on probation should let management know and let it go and keep it in the vault. No conversations about omigod have you followed shady nurse? No one trusts a gossip either.

elkpark

14,633 Posts

I should have specifically looked at that machine when I made first rounds, but you know I'm new, never worked in healthcare, crappy orientation, 24 patients and things were going nutty with some other pts. So after 3 hours he's due for meds. Mind you this man's feeding was supposedly turned on at 1 and now it's 6. I go in and look at the pump. He's supposed to get 70 ml/hr for 20 hrs. It was set to a 70 ml bolus q 20 hrs!!!!

You do realize that none of that is an excuse, right? Once the other RN is gone and you've had this gentlemen for three hours, it doesn't really matter what the other nurse did or didn't do, it's your mistake and responsibility.

Been there,done that, ASN, RN

Has 33 years experience. 6,823 Posts

Ok, it doesn't sound like an earth shattering mistake. Now you know to check this gal's stuff. If the cancer guy didn't get his feeding for the night, it also wouldn't have been the end of the world. Probably management needs a warm body, it sounds like this woman is tolerated, and as a newbie, it's probably better not to rock the boat.

"The cancer guy" ??? I am astounded at that description and your alleged lack of any compassion.