lunch break handoffs

Specialties Critical

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Anyone here have a facility that uses a hand off note for lunches and breaks that requires the nurse taking report state or sign off in some way showing they have agreed to watch the patient while the primary nurse is on lunch or off unit?

We recently had a nurse on lunch break give report to another nurse. Unfortunately the patient had a sentinel event while the primary nurse was on lunch. The nurse who took report and agreed to care for the patient isn't owning up to being in care of the patient. We need a way to hold each other accountable in situations like this.

Specializes in Med-surgical; telemetry; STROKE.
On our floor we cannot prove that you were on you meal brake except clock in and out procedure, which works for your first half-hour; for the second half-hour, your word against the meal brake nurse. I would expect one to be honest-- we own it to one another.

But I also expect you to give a good report to the nurse who will keep an eye on your patients. I want you to tell me: any concerns about any of your patients: "watch this one-- can be restless; can pull IV, etc, can get up and fall; this one can desaturate without NC; low BP in room 200 and doctor knows; etc"

One time, I was helping on the floor. One nurse left for the meal brake and didn't tell me about low BP in one of his patients. Doctor called in 5 minutes asking about the patient. I was embarrassed, angry. How can you leave for your brake without telling me about low BP! Nothing bad happened, but could...

sorry for my writing. I read the first sentence and realized that it makes very little sense :)

I wanted to say that we don't have much of a proof.

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Specializes in SICU, trauma, neuro.

We don't have anything like that...but none of us would lie about having relieved the primary nurse either. What a fecal thing to do. :madface:

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Specializes in Critical Care.
On our floor we don't have anything to prove that you were on you brake except clock in and out, which works for your first half-hour; for the second half-hour, your word against the meal brake nurse. I would expect one to be honest-- we own it to one another.

But I also expect you to give a good report to the nurse who will keep an eye on your patients. I want you to tell me: any concerns about any of your patients: "watch this one-- can be restless; can pull IV, etc, can get up and fall; this one can desaturate without NC; low BP in room 200 and doctor knows; etc"

One time, I was helping on the floor. One nurse left for the meal brake and didn't tell me about low BP in one of his patients. Doctor called in 5 minutes asking about the patient. I was embarrassed, angry. How can you leave for your brake without telling me about low BP! Nothing bad happened, but could...

*Break. Brakes are on cars

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We trade off and let the other nurses on our unit know who we are trading off with. So say there are 3 or 4 nurses in our little pod, we all discuss who is taking report for who. There would be no way anybody could deny taking report for another nurse.

Thats a really crappy thing to do, by the way. Stuff happens in nursing. When we hand off report, we give code status, if the patient will need anything, their current Neuro status, BP parameters, and if there is anything special, like gtts, heart issues, anything major that could possibly need taken care of while we are gone. The off going nurse though, should try to make sure their patient is all settled and not need much, so the only reason the other nurse should need to go in the room is if they start tanking.

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Specializes in Med-surgical; telemetry; STROKE.
*Break. Brakes are on cars

Agree! Meal break :)

However, if you think about the word and its meaning, meal brake sounds more appropriate, since "brake" means to stop, while "break" means to smash, to hit...

I am a second language speaker... so I think about this stuff sometimes...

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When I worked ICU there were many times I just said, "hey watch out for my patients while I go _______". If there was anything significant I would let the covering nurse know. To be honest any competent ICU nurse should be able to walk into a patient care situation a respond accordingly. the patients are monitored and there are protocols in place.

I did have one instance where I went to the bathroom and had the nurse next to me keep an ear out. I returned to find my patient was out of bed and he had removed all his leads. She and I got him back to bed and then he flipped himself over on his stomach (he was a 380 pound + guy). We thought (crap now we have to flip him back over). My friend looked at me and said, "he isnt breathing". We coded him and he didnt make it, but nothing would have changed no matter who was covering.

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I find myself angry at this post..not angry at someone or any one comment just angry that hospitals are so cheap that they can't provide anything to help the nurses out. We just ask our neighbors to watch out patients while we quickly eat in the breakroom, tell them the drips etc they are on. We also have amazing charge nurses and everyone is willing to come run and help if there is an issue with a pt, so something like has never been an issue on my floor.

If a hospital requires that a nurse be responsible for a patient every second of the 12 hour shift, without allowing for bathroom breaks or lunch breaks than they can take that up with the Dept of Labor. It was pretty crappy for the other nurse to deny she was watching the pt but why did it even come to that? Does this hospital have ratios for ICU patients? There was a lawsuit against a hospital in Washington brought on by the nurses because they said that this was practice of "Will you watch my patients while I am gone" violates the states mandated ratios...and they won. Technically that ICU nurse now has 4 critical patients to watch. The liability falls on the nurse who wasn't there but it is absolutley ridiculous if someone tanks and they are off the floor momentarily (which is most of the time out of their control) than they are in trouble for it. At least once or twice per shift, we are off the floor with pts at scans for well over an hour. Not sure how they would stick it to us if someone had a sentinel event since we are required to go with them.

Maybe we should all start eating at pods and using our patients bathrooms, just to avoid any issue. (HUGE EYE ROLL)

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