Holding each other accountable..

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Specializes in ICU/Critical Care.

deleted.

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Specializes in private duty/home health, med/surg.

I think that is a good idea to describe how you found the patient. It might be a good idea to start out by acknowledging how tough our job is, and could you maybe bring up something positive first? Even if this nurse has a pattern of leaving patients a mess, he/she might be more receptive to your comments.

For example, you could say "I appreciate that you did that complex dressing change on Mr. Jones, and it sounds like you had a hectic shift on Friday, but I just wanted to let you know that Mrs. Smith's bed was soiled when you left and that it was brought to my attention by a CNA that the patient is capable of using a bedpan. Also the patient's mouth looked like it hadn't been cleaned at all."

You could perhaps tie in that it is even more important for us to give careful attention to preventing skin breakdown by keeping our patients clean because now hospitals are going to be paying for treatment for hospital-acquired pressure ulcers. With the economy going down the tubes we need to be paying close attention to these things.

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Specializes in mental health; hangover remedies.

Don't be confrontational or put things as a question if you know them as fact - merely repeat the facts... (how do you know he was incontinent all day?)

"Last night Patient X was found on first check to be laying in a soiled bed. The CNA called me to view and I also noted that her tongue was scaley and dried mucous on the roof of the mouth. Is there any reason why he was left this way?"

... pause for no answers .. only briefly but long enough for it to be uncomfortable ... if someone speaks up it will be to defend themselves and probably attack you (or blame someone else) - so the longe you leave the pause the greater the risk of someone just blabbing for the sake of it .... if so, let them get their issues out then ignore them (as it's probably not worse than lying in your own poop all day) and continue.....

"She is capable of using the bedpan and it is expected that we assist patients to use them as well as ensuring their other hygeine needs are met. If anyone has a problem with how to do this then let me know so we can change what we're not doing so that we are doing it."

Then move on....

(I'm presuming you are an experienced and regular senior lead staff on the unit... if not.... tell the manager it's not your job to make people accountable, it's hers/his and her/his unit leaders)

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Specializes in ICU/Critical Care.

delete.

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Specializes in ICU/Critical Care.

Thank you for your replies. I do appreciate your input.

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Specializes in mental health; hangover remedies.

So this is a heap of stuff relating to one nurse?

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Specializes in ICU/Critical Care.
So this is a heap of stuff relating to one nurse?

Unfortunately. Thats why I hate saying anything because I don't want it to look like I'm picking on her.There's some other stuff I haven't mentioned but I have had a family complain to me about her and I relayed that to management.

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Specializes in ICU/Critical Care.

My biggest fear is confrontation and I'm afraid that the way I will come off will be as being confrontational.

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Specializes in mental health; hangover remedies.

No, it sounds more serious than a quiet word.....

I'd put her in headlock and run her forehead across a rough surface.... no, hang on .... that was the previous HR course I went on.... scratch that.

Sounds like your manager is avoiding conflict.

I'd go with rnmi's suggestion - start out positive - and ask her directly if there was a problem with her shift. Then tell her all the issues and ask her again if she's having problems.

Without knowing the nurse concerned it's hard to know if she's struggling, belligerent or incompetent.

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Specializes in private duty/home health, med/surg.
My biggest fear is confrontation and I'm afraid that the way I will come off will be as being confrontational.

I can relate. I hate feeling like I'm being confrontational, even when the situation calls for being up front with your co-worker about the unacceptable conditions the patients are being left in. I think our profession does need to do a better job about giving one another feedback, both positive and negative. Perhaps the lazy nurses would become even a little bit more conscientious if they had to face disapproval from their co-workers when they left the patients lying in their own stool, unmedicated, etc. more so than if they faced anonymous complaints or write-ups.

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Specializes in ICU/Critical Care.

You make a good point. Perhaps, it wouldn't happen so often if someone was being forward with her about it.

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You make a good point. Perhaps, it wouldn't happen so often if someone was being forward with her about it.

it would appear she doesnt have an internal locus of control.....lol, yup she needs to be told, because if no one complains she isnt going to change....and it will prob. take many times, over many things....which really kicks it bck to management......i think the manager needs to stay/come back for, report and do her job....good luck

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