New nurse, opinion?

pmabraham, BSN, RN · Nov 21, 2017

Personally, I would have told the oncoming nurse I have x other reports to give, let me go give those quickly and come back to that nurse to see if that nurse still needed help and potentially get the charge nurse involved. You did your part, the system is 24x7, and your shift is over.

3ringnursing, BSN · Nov 27, 2017

You did everything you could possibly do to get this done before day shift arrived for report, and before the bolus was late (potentially leaving the patient in pain) except for attempting to hold the intern hostage and threaten bodily harm. :bored: :blackeye:

I can't really see how this could have played out with a different outcome considering this particular intern was involved. You had to give him or her an opportunity to try to enter the order - and since you don't have a crystal ball, or mad precognitive/psychic abilities to predict difficulties ahead, how would you have known to get the charge nurse or pharmacy involved before things went sideways? :down:

I agree with pmabraham about shifts being 24/7 and your shift was now over. Not allowing you to hand off was a bit extreme, and also a bit selfish on the receiving RN's part toward someone whom has already been there for over 12 hours (factoring in lunch) and is likely dead on their feet tired. :dead:

About 20 years ago I worked at a facility that was part SNF, part ICU (we were a long term care facility that specialized in patients that were predicted to have extended stays due to difficulty weaning from ventilators, as well as prolonged ICU status type patient's with all the expected tubes, drains and lines whose DRG days had run out at an acute care ICU setting). Nearly all were in isolation due to MRSA, TB, or VRE, and nearly all were train wreaks. Our patients stayed long term, so it was not typical that we had admits or discharges on a routine basis.

One day I got a late admit patient from a tiny hospital located in a smaller neighboring community after receiving a telephone report (and a crappy one at that). The patient arrived via EMS transport with vasopressors infusing into a triple lumen central line, and their A-line clotted off - you'll love the reason: instead of a pressure bag on the TKO heparin infusion bag, the bag was tied with a tourniquet (when I called the discharging nurse about this curious improvisation her response was, "We reuse our pressure bags, so I didn't couldn't give it to you". :cautious:

Wait ... Isn't this a disposable item billable to the patient? :nono:

Anyway, settling this late admit was not simple: the main ICU room which held 4 beds had it's own telemetry station and was having difficulty synching correctly (was likely broken), as was the swan (ditto). The pressor bags were nearly dry, and of course we had to get another A-line in pronto.

The night nurse arrived to discover during the 45 minutes this patient was under my loving tutelage that all admission orders wasn't finished. She hit the roof, demanding I stay until every last item was completed to her satisfaction. Every. Last. Thing. :grumpy:

I was dog tired :sleep: - and bit cranky :sniff: but relented. Thankfully the charge nurse noticed me still working on settling this patient 45 minutes after I should have skedaddled.

Saved! :laugh:

She let the night shift nurse know that on no uncertain terms that her expectations were unacceptable, and she was unimpressed with her attitude/behavior. She also echoed pmabraham's above sediments about we were a 24/7 facility - that one shift had ended and another had begun. She said it was unreasonable to expect me to stay to finish all the admission needs when my shift was over.

The night nurse had no choice but to relent and apologize - likely while grinding her teeth to powder. :mad:

When I still worked doing bedside care I always tried to keep in mind while taking report that there will be shifts that the road apples hit the fan, and more often than not they're isn't a damned thing you can do about it. Sometimes you just have to fly by the seat of your pants and roll with it. It happens to us all eventually - if it happened to me, I had to concede that it happened to others too, and tried my best cut my coworkers some slack.