Ignorance or just not caring?

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Specializes in Cardiology, Psychiatry.

this has been an extremely frustrating weekend for me. i work nights, and this weekend it seemed as though i was being punished, not by the patients that i had, but by the nurses i gave report to. on my first night i had a pt with bs >200 at every accucheck. now, hospital protocol is that if there are two blood sugars >200 then the md must be called to be informed and see if any adjustments could be made. now granted, pt was on solumedrol and they had adjusted her pills during the day, but come 2100 accucheck, she's still greater than 200. call md, follow protocol and we will follow up tomorrow. now our protocol is to recheck the bs every 2 hours until under 200. needless to say it wasn't until 3am when pt was finally 194. come time for breakfast... 231. i explained this to the rn i gave report to and asked her to follow up on it since it's been a problem. when i came back that night, the pts bs were still >200 all day. when i asked her if she called the md, she said no. so yet again, i'm calling at 2100 because yet again she's >200. this annoyed me to no end because i had flat out asked her to follow up, and she simply didn't. her response was, "well i didn't see md when he rounded" well, guess what, i don't see him either at night but i certainly know how to pick up a phone.

then to make matters worse, had a pt who was from texas and was a truck driver. ended up coming in for chest pain, got 2 cardiac caths and then a pacemaker. pt was going to have to make his own flight arrangements back to texas when he was discharged. now, i had called sw the first night with him trying to address the situation. really, all the pt needed was a definite dc date so he could book a flight. again, i'm explaining this whole situation to the same nurse. "he needs to know when he's being discharged so he can make a flight". when i came back last night, the pt had dc orders written. he, and his family, were extremely upset, as was i. i couldn't believe they blindsided him by discharging him. sw response, get a hotel or go to the salvation army. really? i mean really? you've known for days he needs to take a flight and then you just come in and discharge the man. then the nurse gets offended when the patient refused to sign the discharge instructions. well, heck, good for him! i just can't believe that after i went through a 20min ordeal explaining how he needs to make arrangements for a flight, she thought it was ok to kick the guy out on the curb. i just don't get it! i mean, where was the pt advocacy on that one. i left notes in the chart for the mds saying he needs to know when he's being dced cause he has to make a flight... and it's like no one cared. and what really ticked me off is that the day nurse didn't stop and think twice that hey there are issues here! yet again, i was left cleaning up the mess. i am just so frustrated! can she really be that dumb or did she just not care enough to stop and think?!?!?

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Well if shes not getting it, maybe shes really busy on days and it just slipped by. Let the manager know that shes not doing these things.

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Specializes in Emergency.

Honestly, it sounds like an issue of not caring. I experience the same BS where I work. I work nights, very often have 8-9 sometimes even 10 pts if I get admissions, and then I give report with specific requests to the day nurse (who BTW has 5-6 pts on a bad day). When I come back that night, guess what? None of the things I specifically pointed out have been addressed. Then to add insult to injury, I make rounds only to find IV bags with 50 cc LIB, no IV tubing labeled, hep locks that needed to be changed earlier in the day, etc., etc., etc. This is not all the day nurses, of course, just 1 or 2 who consistently do. Not to mention orders signed off on that were really never picked up and med admin times changed on the MAR to be given at 2200 instead of 1800. And I'm not talking about time-sensitive meds like antibitocs where the times have to be changed. I'm talking about colace and iron. I understand your frustration. I really believe it is a combination of a lack of caring and just plain laziness. If I were you I would discuss it with your nurse manager.

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Specializes in Cardiac, Skilled, Medical.

I understand the MD not being able to give a pt a DEFINITE discharge date in advance, BUT the SW could have called for info re: motels and communicated this info to the patient.

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Specializes in Med-Surg.

I totally understand your frustration and where it's coming from, it seems as though some people are just there to do the basics of their job and that's it. I feel that I'm a strong patient advocate, I tell my patients to not settle for BS answers and what to do or say in specific situations when approached by ancillary staff. Let me tell you, they really appreciate it because they know that someone is looking out for them and their needs. Don't stop what your doing, you sound like a great nurse and excellent patient advocate. It gets very frustrating when you try so hard during your entire shift and it all goes down the drain when the next nurse brushes everything off. Welcome to the life of nursing! Just keep doing what your doing and don't give up on yourself or your patients!

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Specializes in Cardiac Telemetry, ED.

I feel your pain. Seriously. Every single day, when I come on, I'd better check my charts, because there WILL be something that was missed or not addressed by the previous shift. Orders not put in correctly, yet still noted off by the nurse, orders missed completely, orders for follow up with MD and no mention of it in report, and so on. It's not all of them, but I can think of three nurses off the top of my head that I absolutely hate to follow because of this. The thing is, they are not new nurses (if they were, I'd be more forgiving), but they are *experienced*.

I'm about ready to start writing an IR every time these things happen from now on.

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Specializes in Cardiology, Psychiatry.
Well if shes not getting it, maybe shes really busy on days and it just slipped by. Let the manager know that shes not doing these things.

Is being busy a valid excuse for not looking after your patients? Being busy means you can't think about what a constantly high blood sugar can do to a patient, or being too busy means she didn't have time to think that a man from Texas might not have anywhere to go on a Sunday at 5pm?

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Specializes in ICU/Critical Care.

Same thing happened to me last week. Had to supplement a patients potassium level 3.3. Well, had another patient crash so I didn't get a chance to recheck the k level before I left. I TOLD the oncoming RN to PLEASE, PLEASE check the potassium level. So when I come in that night, sure enough no potassium was drawn and when I checked it that night it was 2.8. I wrote her up. It's a safety issue also. Gees, the lady was having PACs/PVCs all day with runs of SVT. Did you think maybe her lytes needed to be checked?

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