How much do you do for the next shift . .

whipping girl in 07, RN · Jan 10, 2008

Just because they called and said the blood was ready, you didn't have to necessarily start it then. The day nurse could have given the IV med, then given the blood (unless the pt was symptomatic from need of a transfusion). The fact that you stayed late when you had to be back early was over and above what's expected. It's a 24/7 job...and sometimes you have to hit the ground running. At least you didn't try to hide the fact that some things weren't done. As long as I know I have to do something, I don't mind doing it. It's when you get report and find an hour later an infiltrated IV, 6 AM meds not given, and half a page of orders not signed off that's frustrating! :devil:

Sounds to me like you did more than enough, and if the nurses that I work with would do half as much, I wouldn't be looking for another job...

snowfreeze, BSN, RN · Jan 10, 2008

Widi96 you can work with me anytime! I probably would have prioritized things just as you did.

I usually don't mind the prior shift leaving things that still need to be done, what I don't like is finding out 2 or 3 hours after report that these things did not get done. Tell me in report what still needs to be done please so I can properly plan my shift. If you want to stay and help me get things started on an admission, blood started, orders taken off, IVs restarted I really appreciate it but I don't expect it.

**SKM-NURSIEPOOH, BSN, RN** · Jan 10, 2008

okay, so had a little bit of a rough morning and was wondering some other's opinions on it. i had 5 pts last night, two of which needed q2 vitals. one was seriously ill, the other was not. 5 minutes before the change of shift the ill patients labs came back, i had to call them to the dr and he wanted 2 units to be infused immediately. i called and got consent from poa, got the blood ordered, etc. so, the day nurse got both of these patients, plus two more and was quite overwhelmed. i stayed forty minutes over my shift to go down and get the blood (they called stating it was ready 5 minutes after i was suppose to leave), stayed to verify everything, get vitals and get it initiated. well, this patient had an iv med due at 6am that when we went to check the blood i realized it hadn't infused (yes, my error and i still don't know what happened). so the day nurse acts like i'm just completely dumping on them (their float nurse even refused to help the day nurse) to start a new iv on the patient so that she could get her iv med and her blood, rather than pushing the iv med off even further. (pt had one iv site) so, in general opinion, was i out of line to leave the iv for the day shift to start - i was already 40 minutes past when i was suppose to go home because i stayed to help her with the blood. the float nurse even gave me the third degree stating that i should stay and do that.
(i think it didn't help the situation that they had called and begged me to work extra this week, which i did and i have to be back at 5pm this evening (so 2 hrs less sleep) for a mandatory staff meeting before working another 12 tonight. i just really didn't want to be there anymore).
in general, do you all think i was out of line to leave that? (and i will gladly take constructive criticism, please don't completely jump me if you do not agree with my decision) i guess i just thought the blood was the priority and beyond that, they could get the rest done.

here's the problem...you've stated that the ill patient's lab results came in literally five minutes before your shift ended. i personally would have simply given those results to the on coming nurse & she would have then called the md on duty. the results would have been the same except that she would have the time to do the transfusion with the float nurse to co-check/sign. i then would have asked the on coming nurse if she wanted me to still hang the antibiotic before leaving. it would have taken her at least five to ten minutes to call & get the orders from the md & then it would have taken at least another 15 to 20 for the blood bank to prepare the blood. most antibiotics take 1/2 hr to run. it would've been completed (or very close) by the time the blood arrived. there was no reason to stick this patient again. it's a shame all the way around...but that would have been better for you & the patient. as a result, you stayed 40 mins over & the patient got a secondary iv line (hopefully on the first try). my question is: what time is you routine lab draw & who does them? is this a m/s floor or unit? i'm having a hard time understanding the timing of the lab results. if they came, say, 1/2 - 45 mins before your shift ended...then i can see where you'd want to stay to give the blood. again, in my experience with the blood banks, it can take as little as 15 mins to get stat blood. i'm just trying to get a handle on the time frame is all. if your shift ends at 7:30am to include report time, then if the lab results came in at say 6:55am, again, i would've pass that onto the on coming nurse. but if the result came in more like 6 to 6:30am, then i could see how you would've missed the 6am iv med administration (if not other things as well). you then would've been concentrating on getting the blood transfusion & dropped everything else.

no...i would not have stayed any longer than to run that iv med. i guess you felt badly about leaving the iv med; therefore, you stayed long beyond necessary (these things happen all the time...don't worry about that...antibiotics can get rescheduled if/when necessary). next time, try prioritizing & consult another nurse colleague (perhaps the charge nurse) on your current shift for their thoughts...if you're not sure.

hope this helps ~ cheers :cheers:,

moe

brissie · Jan 10, 2008

I applaud you for your efforts to help the next shift. You went above and beyond to provide assistance. Nursing is all about having unexpected things happen at inconvenient times, that is what we are paid to deal with. It has also been my observation that the nurses who gripe and whine about having to take over procedures you are halfway through are the exact same nurses who always leave on time themselves and never stick around to help and almost always have things left over from their shift for you too do. I remember on one grand occasion that I had a pt code at around 0645, when I would usually have been putting labs and new MARs in charts, well the oncoming nurse was miffed that her MAR hadn't been printed for the day and proceeded to walk into the room while I was doing chest compressions and berate me for not having the chart ready!

cloister · Jan 10, 2008

Hey, you did your best. The job is 24/7.

I'm not sure I understand where your float nurse is coming from. Where I work, the resource nurse fetches blood, helps turn patients, etc. Looks like she should have been the one to assist the day nurse. How in the heck could she refuse to help her?