Holding each other accountable..

suni, BSN, RN · Jan 19, 2009

This is a hugh issue everywhere but if we do not hold our co-workers accountable and advocate for the safe care of all patients on our unit that we are remiss.

This is a difficult situation but the suggestions here are right on the mark

angel337, MSN, RN · Jan 19, 2009

i am not a beat around the bush nurse. the fact that this nurse has a history of leaving a mess is enough reason for someone to be up front with her. she is sliding by and being allowed to because no one will confront her. its nothing personal, its about what is best for the patient. if she was busy and could not get to it, fine, but she needs to know that the quality of patient care is the number one priority. if she leaves 10 minutes late to clean up her mess then she probably should. nursing is 24/7, but that does not mean that you continuously dump on your coworkers. i have confronted nurses in the past about similar situations, and you will be surprised how people try to clean up their act. again, its nothing personal, its all about the patient.

FLmomof5 · Jan 19, 2009

WRT the manager....I would glibly say, "I have no problem performing tasks that are normally that of the manager as long as that is recognized at appraisal time."

There was a time in my smart orifice days that I would have said, "I have no problem doing your job for you as soon as I get the matching paycheck! So, since you are the one being paid the big bucks....you get the joy of handling this!" (Hmmmm, that's when someone suggested I read, how to win friends and influence people...) :wink2:

whodunit · Jan 19, 2009

Yeah, and don't you just love how managers tell you how we are to hold co-workers accountable? We were having a problem with several nurses being chronically late , which in turn made off-going shift late clocking out,so manager sends me and others a copy of our time sheets as a reminder we are "costing them money that could be used as an extra nurse when needed".I told the manager it was the nurses coming in late that caused it, {after bringing it to their attention numerous times} only to be told to hold them accountable. It got sooo bad that both on coming nurses{unbeknowest to each other }, were calling to say they were running late just start report without them,. The problem was solved when I started sending the manager an e -mail every time they were late with the time they arrived and the time shift report ended !

truern · Jan 19, 2009

There's really no way to get your point across without her perceiving it as confrontational, therefore her first instinct will probably be to go on the defensive.

Unlesssss....you approach it as "how can we, as a team, provide better care for this patient?"

I really like how your manager has your back...not.

RN1982 · Jan 19, 2009

Personally, the idea of holding each other accountable is a good one. But it's not as if this girl has never been confronted about her care. She has and has the same blank look and response every time. I'll let you all know what happens when I go to work tonight.

nrsang97, BSN, RN · Jan 19, 2009

Trauma,

I emailed the ANAM and educator and they forwarded it to our new manager. Our NM told me it would be taken care of.

The nurse before me received a transfer from the floor at 1730 MD up at 1745 to give orders. The pt was placed on Bipap so she could hopefully not be intubated. Pt RR was 55. She didn't do the stat ABG's or blood cultures. The pt had a ton of labs ordered that could have waited, but she didn't do the cultures and ABG's. I was told she would be spoken to. I understand we cannot get EVERYthing done, but at least do the important stuff. RR 55 warrants a stat ABG. I would have understood that she couldn't get them, but all I ask is that she try. I had a hard time , and finally the resident decided (with my persuasion) to place a line so I could do serial ABG's. We ended up intubating this pt.

The problem with this newer nurse is that she wont let you get all the info out in report and you have to remind her that if she didn't interrupt it would go alot faster.

Batman24 · Jan 19, 2009

Your manager should be involved if there is an ongoing problem with patient care. I would try talking to her one more time and if that doesn't work start a paper trail to cover your own heinie. Once the complaints are in writing management will prob take action to cover their heinies in the event of a lawsuit.

Also, next time a patient/family complains bring them right to your supervisor to let them make the complaint in person. They won't be able to brush them off like they brush you off.

RN1982 · Jan 19, 2009

Your manager should be involved if there is an ongoing problem with patient care. I would try talking to her one more time and if that doesn't work start a paper trail to cover your own heinie. Once the complaints are in writing management will prob take action to cover their heinies in the event of a lawsuit.
Also, next time a patient/family complains bring them right to your supervisor to let them make the complaint in person. They won't be able to brush them off like they brush you off.

When I talked to the patient's mother on the phone, I gave her the names of both of my managers and then in the morning, I pulled my manager aside and said "Hey, family has complaints about the day shift nurse, thought you should know that they will want to speak with you."...I don't think the patient's mom ever spoke with my manager.

kmoonshine, RN · Jan 19, 2009

Next time you get report from this nurse, ask them for 2 minutes of their time to pop into each room with you for a quick "bedside" report. That way, you can address these issues right away.

Management won't care until a patient has something bad happen to them (whether it be bedsores, infection, etc). When you hit this point, too much time has elapsed and this behavior has gone on for way too long.

As someone else said, we also all need to praise one another for the things that we do right - positive reinforcement does go a long way.

If the problem is severe, you could always fill out incident reports citing that an adverse event could have occured had you not remedied the situation. And be sure to chart what you find at your start of shift - this is one way of holding each other accountable.

RN1982 · Jan 19, 2009

You are right. We are suppose to get report at bedside. I slipped up and let her give me report at the front desk instead that night. I want to take her by the shoulders, shake her and say "you are better than this."

leslie :-D · Jan 19, 2009

managers always prefer we try and handle this between ea other first.

that said, after you speak with this nurse, you should f/u in writing to your mgr, stating you acted, AS ADVISED, with the nurse's response.

end the letter with, "i will keep you updated".

i'm an avid believer in putting stuff in writing.

that way, the mgr can never deny that you came to her with this problem, should it escalate.

btw, you can 'confront' w/o being confrontational.

starting out conversation with, "i noticed a,b and c...did you have a rough shift?" is usually sufficient to elicit a less defensive response.

definitely let us know what happens.

leslie