4-hour Floating and Assessments

[AWanderingMinstral]

As a travel nurse, I am prepared to float at any point. Whenever I work a 12-hour daylight shift (7a-7p), I don't usually float (unless the majority of staff works an 8-hour shift). I recently floated from 3-7p and, having already assessed and charted on 6 patients for 8 hours on another unit, I did not assess the patients. I received a thorough report and I knew what issues I MAY have with each patient. Instead, I did their vital signs (this was total care of 4 patients), administered any medications that were due, completed blood sugars (and administered insulin coverage as ordered), and ultimately wrote a 2-4 sentence summary at 630p or so of anything that occurred during the 4 hours. I had a manageable group of individuals, but it's NOT always like that. I'm SURE someone will tell me that I'm a "bad" nurse because I didn't assess the patients, but I do NOT feel that 4 hours with them should trump a nurse coming in for 12 hours at 7p. What do YOU do?

[NedRN]

Why do you ask? Did management have an issue? Why does what happens four hours later affect basic nursing practices? Or what you did with other patients 8 hours earlier?

[calivianya, BSN, RN]

The policy at the hospital I worked at was that if you were a float and only worked with the patient for four hours an assessment was not necessary on a med/surg floor unless there was a change in condition. If it was a more acute floor like stepdown/ICU, I'd imagine you'd still need to do an assessment. I'd look up your hospital policy on this one.

[AWanderingMinstral]

Why do you ask? Did management have an issue? Why does what happens four hours later affect basic nursing practices? Or what you did with other patients 8 hours earlier?

Just curious, NedRN. The tone of your response speaks volumes.

[NedRN]

Just curious, NedRN. The tone of your response speaks volumes.

As does yours. You have apparently been dinged by administration and are seeking validation here for not doing your job. Good luck with that.

[RNewbie]

I've been floated before after 4 or 8 hours. I always document an assessment regardless. I always felt that working agency, I would be the first to be thrown under the bus or used as a scapegoat if anything went wrong so I'm just paranoid about that kind of thing. I like charting systems that allow you to select "no changes from previous assessment." That will cover you from charting an entirely new assessment. If nothing else in a narrative I would sum up a focused assessment or at least write in "no changes from previous assessment."

[AWanderingMinstral]

Actually, no, NedRN, I haven't been "dinged" by anyone. I was simply curious. I learned that people default to facility policy. That may seem like common sense to you, but, to me, it wasn't. Allnurses is meant to be a supportive environment. Your responses, particularly the second one, were inappropriate. I feel sorry for you.

[AWanderingMinstral]

I've been floated before after 4 or 8 hours. I always document an assessment regardless. I always felt that working agency, I would be the first to be thrown under the bus or used as a scapegoat if anything went wrong so I'm just paranoid about that kind of thing. I like charting systems that allow you to select "no changes from previous assessment." That will cover you from charting an entirely new assessment. If nothing else in a narrative I would sum up a focused assessment or at least write in "no changes from previous assessment."

Thank you for your helpful response, RNewbie.

[miam]

i have only been a RN for 5 years, and traveled for 2 but dont you ALWAYS have to do an assessment on a pt when you take over care, wether it be for 2 hrs or 12 hrs ??? If you dont how can you legally answer in a court of law " yes, i assessed this patient and based on this my nursing interventions were......(x,y,z) if sonething were to go very wrong with them an hour after you assumed care? Legally you cant say that you based your nursibg care based on the assessment of another nurse.

[miam]

just curious, why were you "feeling sorry" for NedRn for just asking you a question in response to a question you posted? It sounded as if you were very unsure about what the appropriate nursing care might be, and usually when that is the case the nurse may not know enough to question it unless it is brought to her attention by someone else, usually a charge nurse or higher up. I find most people on here are only trying to give support regarding questions from people who have less experience then themselves.

[AWanderingMinstral]

i have only been a RN for 5 years, and traveled for 2 but dont you ALWAYS have to do an assessment on a pt when you take over care, wether it be for 2 hrs or 12 hrs ??? If you dont how can you legally answer in a court of law " yes, i assessed this patient and based on this my nursing interventions were......(x,y,z) if sonething were to go very wrong with them an hour after you assumed care? Legally you cant say that you based your nursibg care based on the assessment of another nurse.

Well, miam, a lot of nurses, travelers or otherwise, I have spoken with do not feel that a full assessment is necessary under the circumstances. Therefore, I was simply wondering what other nurses do. NedRN's response insinuated that I wasn't fulfilling my job responsibilities. Would you appreciate someone insinuating that? Probably not.

[miam]

O.k. i guess then you would have to base it on your own comfort level and not on how other nurses think about it, since when push comes to shove you would have to legally defend your position in a court room if that patient should have something go wrong during your 4 hrs and wind up coding. I guess i just think it makes sense to go ahead and assess each patient since i dont want to give a board of nursing any reason to take away my license or god forbid a judge/jury decide i am guilty of negligence if that patient happen to die. We all make our own decisions though. :