Has anyone ever refused...

[Tait, MSN, RN]

to hand their patient off to the next shift?

I posted in my vent thread about being concerned over patient safety when I handed off this week to a nurse I thought wasn't taking my concerns seriously (or the fact that our pt was bleeding all over from yanking his central line out).

I know this would be a very hard thing to do, but has anyone ever refused to hand off?

Tait

[SharonH, RN]

I have handed over patients to nurses who I felt were not the best choice for taking care of this patient either due to inexperience, indifference or whatever. Instead of refusing to give report, I took my concerns to the charge nurse, in effect giving him or her some ownership in what happened as for the care of that patient. That would sometimes annoy them but they always kept an extra eye on that person because no one wants something bad to go down on their watch especially if they've been told to support the nurse in question.

[Tait, MSN, RN]

I have handed over patients to nurses who I felt were not the best choice for taking care of this patient either due to inexperience, indifference or whatever. Instead of refusing to give report, I took my concerns to the charge nurse, in effect giving him or her some ownership in what happened as for the care of that patient. That would sometimes annoy them but they always kept an extra eye on that person because no one wants something bad to go down on their watch especially if they've been told to support the nurse in question.

Yeah I have done that too...at least it made me sleep a little easier.

[bigsyis]

I have handed over patients to nurses who I felt were not the best choice for taking care of this patient either due to inexperience, indifference or whatever. Instead of refusing to give report, I took my concerns to the charge nurse, in effect giving him or her some ownership in what happened as for the care of that patient. That would sometimes annoy them but they always kept an extra eye on that person because no one wants something bad to go down on their watch especially if they've been told to support the nurse in question.

I have done the same thing. You can't live w/your pt, but I do understand your concern about the best follow-through care possible. You can also make the Supervisor aware, when they round, about any "iffy" pts that you have and your concern about adequate staffing assignments. Then, to my mind, you have done all that you can do.

[EmmaG, RN]

When I'm in charge, I do my damndest to match up the patients with the skill levels (and sometimes personalities) of the staff coming on. (it's not as easy as it looks, folks lol) I have no problem at all switching assignments if need be.

If I'm giving a patient to a nurse that I feel is an inappropriate assignment, I'll go to the charge nurse and explain why and ask the assignment be changed. Usually, they respect my opinion and try to switch things around. If that isn't possible, then the charge nurse is aware that person is going to need assistance with a particular patient and can be ready to help them out.

In a case as you describe, I think it goes much deeper than that; the nurse manager needs to be made aware of a potential safety issue. It sounds as though it wasn't so much a question of skill level as it was simply being clueless or lazy or ... something =\

[showbizrn]

:nuke:

I HATE leaving LOOSE ENDS and I have to fight my compulsion to TIE ALL THE BOWS in patient care before I leave but...

Nursing is 24-hours and I DO have to leave...

It's tough because I hate to leave stuff undone but the patient's condition does not always stabilize within the time-frame of my shift so...

Answer to the question: Sometimes I refuse to sign-off, but it's rare.

[fultzymom]

I have given report to someone then also warned another nurse to help watch out for a patient. If I am not sure about a nurse I am giving report to then I want to make sure that the patient will be taken care of. I hate that feeling that I am turning a patient over to someone who does not feel the importance of the situation.

[diane227, LPN, RN]

I have had people refused a hand off. As charge I have had the oncoming nurse who was to charge refused to do it. This was a nurse that rarely did charge and the unit was full (34 pts). On nights they are charge and also have to take a pt. load of 5-7 patients. It is just too much for an inexperienced charge person to do. The charge nurse from another floor did not take a patient assignment and just floated between floor and too charge of both areas.