I'm disappointed tonight.

Published

Specializes in Forensic Psychiatric Nursing.

A very basic aspect of care was very callously ignored by a bunch of nurses. I would like to vent about the case, but I don't want to say anything that could be identified.

Let's just say that more than five RNs and more than three CNAs signed off on the care for this patient. At the end of my shift, I assessed the patient and found that the patient had not been cleaned in several days. The stench hit me like a fist.

I had foolishly assumed that the charting I had seen and the report I'd taken earlier in the day meant that the problem had been resolved. It hadn't. I was at least the tenth nurse who signed off on the care for this patient, and this person was in a condition that could only be described as shameful.

It was a very busy shift, and I was more than an hour late in punching out tonight. That's still no excuse for missing (skipping) an assessment I should have done hours and hours before.

I'm disappointed in my own lack of professionalism more than anything else. It's easy to point the finger at the nurses who came before me with this patient, but I should have caught the situation and fixed it on my shift.

There's no doubt in my mind that I should have done more. I was a little unsure about rocking the boat, or that I'm not perfect at this so who am I to tell somebody else what to do, etc. In the end, the responsibility for taking care of this patient was on me and it didn't get done.

Not a good day today.

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Specializes in ICU/ER.

Just out of curiosity, did you end up doing what needed done then? I was confused in your post, did you chart you did a task you did not do?

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Specializes in ED.

Stop beating yourself up! No one is perfect, we all miss things. It was a bad night, you were busy, distracted, whatever. It's done, you're home. The important thing is that you learn from your mistakes so you don't repeat them. Mistakes and omissions are gonna happen, we are only human. It only makes you a bad nurse if you don't care that you made a mistake. Obviously, you care and will learn from this episode. In my book that is the best kind of nurse (or anybody)!

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Specializes in Med/Surge, Psych, LTC, Home Health.
Just out of curiosity, did you end up doing what needed done then? I was confused in your post, did you chart you did a task you did not do?

Well, let me tell you... at this hospital that I used to work, we nurses used to sign off on the charts at the end of the shift, basically that all necessary care had been carried out on this patient. I never necessarily charted myself, that a patient had been bathed/cleaned up; the techs usually did that. Still, it fell on me that it didn't get done, especially if my tech charted that it did. I didn't chart something that I didn't do, but my tech did. (speaking hypothetically of course :))

So I take it that that, is basically where the OP is coming from.

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Specializes in Forensic Psychiatric Nursing.
Well, let me tell you... at this hospital that I used to work, we nurses used to sign off on the charts at the end of the shift, basically that all necessary care had been carried out on this patient. I never necessarily charted myself, that a patient had been bathed/cleaned up; the techs usually did that. Still, it fell on me that it didn't get done, especially if my tech charted that it did. I didn't chart something that I didn't do, but my tech did. (speaking hypothetically of course :))

So I take it that that, is basically where the OP is coming from.

To give a little more detail, this patient went through at least four days of care in two different facilities. The report I was given and the charting that I saw led me to believe that she was clean. Who would chart that the pt was dirty and then not clean them? So, I assumed the pt was clean.

I didn't think that the pt needed more of an assessment than what I gave, pt was admitted the shift before me. You do a full body exam on intake, the pt was in a clean gown with clean socks...

And, the pt had been taken care of by 10+ nurses before me in the last few days. It was just not anything I could imagine. How could a dirty patient stay in that condition day after day and go through so many hands, and nobody saw to it that she got cleaned up?

I did take care of the problem at the end of my shift. The patient was clean when I was done for the night.

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Specializes in Breast Cancer, Arterial, General Surgery.
I did take care of the problem at the end of my shift. The patient was clean when I was done for the night.

You took the professionalism of your colleagues seriously and did not disbelieve their reports.

When the the true state of the patient was ascertained, you did something about it - strikes me that you have nothing to be ashamed of.

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Specializes in ICU/ER.
I did take care of the problem at the end of my shift. The patient was clean when I was done for the night.

So why are you disappointed? Or is it just that you are dispapointed in the rest of the nursing staff??

Take it easy on yourself, you did the absolute best you could given the circumstances. I am positive if you were told in report "hey Mrs Stanly needs some major peri care--I meant to get to it today and just couldnt" You would have said "Oh ok, I will make sure that gets done" and made a point early in your shift to make sure Mrs Stanly was taken care of.

I have not been able to get to certain tasks because given the night other tasks were more critical or demanding of my time, I just report off, and chart that I did report off....Sometimes no matter how hard you want, you just cant get it all done during your shift!!! That is the great thing about hospitals, we never close.

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Specializes in Community Health, Med-Surg, Home Health.

This is not the first, nor will it be the last that you will see CNAs, nurses and physicians lie about care that was done. We want to trust, in fact, many cases, we have to because we are too distracted with our own work. It is true that the RN has the ultimate responsibility to ensure that care is done, but the system provided extensions of the RN via LPNs and UAPs because the registered nurse cannot be everywhere at once. It is your ultimate responsibility, but it is their jobs, otherwise, why even work?

You did the right thing and now, you know to watch these people to protect yourself. Don't beat yourself up, unless you KNEW about it and then, intentionally left without intervening.

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Specializes in Med-Surg, Psych.
I didn't think that the pt needed more of an assessment than what I gave, pt was admitted the shift before me. You do a full body exam on intake, the pt was in a clean gown with clean socks...

Although the admitting nurse is expected to do a complete skin assessment, I never assume that was done on a recent admit as many nurses do not do that thorough a job. So I do a pretty thorough skin check on any admit done during the prior shift to make sure nothing was missed. As far as being clean, it's unclear to me what you mean. A filthy patient may not have been that way for the length of time you seem to think it was. Every shift needs to ensure that incontinent/unclean patients are cleaned during their shifts, which it sounds like you did.

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Kuddo's to you.... I'm so proud of you for taking care of the situation. You truly are an amazing nurse. Don't beat yourself up. You can go to sleep knowing that you did what you needed to do. Good job, I would have a very nice talk with the rest of your staff though. let us know how your feeling after your next shift.

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Specializes in ICU, CCU, ED.

I would just like to say congratulations for finally taking care of a problem that was obviously lied about not only verbally but in charting. In the past 20 years I have also followed nurses who stated that something was done and it was not, found patients in dried feces and foul stale urine that had obviously been there for some time, patients who had not been turned and where developing bed sores. It is terrible. I would have done as you did with one great exception, I would have brought it to the attention of the charge nurse of what the situation was and is. Most of the time this is the only way you will be able to correct poor care. Just because someone becomes a nurse doesn't necessarialy mean that they care about their patients. Like anything people like these give the good nurses a bad name and they also give the hospital or facility a bad name, needless to mention of the injustice they are doing to the patient themselves. I have stayed many extra hours after long hard shifts to finish doing exactly what you did as I would not be able to rest well knowing I left someone in poor shape...we do the best we can but we also must make sure the patient is not mistreated...I am assuming that you didn't want to be the "bad guy" and report this incident for some reason. Please dont consider reporting something like this a bad thing, it is something that needs to be corrected, what happens if you leave the facility? Who will take care of things? Will the patients just lay there dirty all the time then? At least you were able to put a bandaid on the situation....good job...next time fix the wound my friend...the good nurses will repect you for it and the bad ones...well they probably should be in another profession...Good luck in your career and keep up the good work!

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