New Rule on My Unit......

Beary-nice · Apr 25, 2006

We have been having some teamwork issues on evening shift, so yesterday our nurse manager implemented a rule that we are to "try for a week." We are not to leave at the end of the shift until everyone else is finished and able to leave too. She did put a limit on it, so it's no ridiculous. The shift ends at 2330, but she said if you've done all you can to help and someone is still charting at 0030, then you can go home.
I'm not sure exactly what I think about this. I usually get out on time, or 20-30 minutes late. It does make me nervous though, that I will have a bad night and hold everyone else up. We do have a couple of people though that don't help others much and ALWAYS get out on time, so maybe this will encourage them to help more.
The NM also mentioned that on nights when we have four nurses on the floor, instead of five, which is our full staff for 28 pts, that we may be trying out team nursing. We would have the same number of nurses and aides on the unit, we would just divide the work differently. I'm not sure how I feel about this either. I've gotten quite settled into my routine and the way I do things during a shift, and I know the other nurses have too. I wonder how much conflict it will cause when trying to intermesh seperate work styles? I guess I'll have to wait and see how it works out.

Wow! This is soooo Twilight Zonish!

We are supposed to be implementing the same thing on our unit. I wondered how the charting thing would work because I am occasionally behind in that myself on a bad shift but there are some who are chronically late charters. Here I thought we were the only ones with teamwork issues.

Thanks for the post! You'll have to let me know how it works!

OC_An Khe · Apr 25, 2006

Don't forget that you are required to be paid for all that extra time (if you are paid hourly as opposed to salary). If everyone one is there 30 to 60 min utes extra and paid for it it will not last long. As for short staffing you and changing to team, ask why are they staffing you short?

Jolie, BSN · Apr 25, 2006

As far as the new rule about everyone staying to help out: The key to making that work without holding up your co-workers while you chart is to keep up with your charting all shift long. That way, come the end of shift, your co-workers can help you complete "tasks" such as passing the last few meds, doing I&O, checking on orders, etc. If you are late in leaving because you've completed every task, but not charted a word all shift, no one can help you!

I can't comment on team nursing because I haven't done it since nursing school over 20 years ago. I'm not sure how you would do primary nursing one night and team nursing the next because you are short. I'll leave those comments to someone else :).

Natkat, BSN, MSN, RN · Apr 25, 2006

I'm not a nurse, but in places where "teamwork" kinds of situations have been implemented, there are always those who abuse the system. I've seen folks work slowly on purpose because they know they'll get help at the end of the day.

Personally I'm a control freak and like things a certain way. If someone comes in in the middle of something I'm doing I feel like they "mess things up". I don't know how else to say it. Anyway, I feel they wouldn't give it the attention I would, and then I wind up getting dinged for someone else's mistake.

FroggysMom · Apr 25, 2006

Don't forget that you are required to be paid for all that extra time (if you are paid hourly as opposed to salary). If everyone one is there 30 to 60 min utes extra and paid for it it will not last long. As for short staffing you and changing to team, ask why are they staffing you short?

Agree. I wonder how long this might last if they find they are paying 4 or 5 people overtime instead of one?

Pepper The Cat, BSN, RN · Apr 25, 2006

We have one nurse who never gets outs on time because she spends sooo much time talking she never gets her work done. I would not like staying late to help her because she spent all her time talking. I have days where I'm done all my meds and starting my first bath before she even comes out of the report room because she is talking. If everyone had to stay until she was done, she would spend all her time talking and everyone else would do her work!

GooeyRN, ADN, BSN, CNA, LPN, RN · Apr 25, 2006

The last place I worked was similar. But it was out of respect for each other, not mandated. No one left until everything was done, unless someone had just charting left to do then we would leave. However, the last hour of the shift we always asked each other how things were going and if we could be of any help to each other. We would never let one person get swamped and 2 sitting chit chatting. If someone didn't get a chance to start their notes all night and the other nurse was finished w/ am rounds, the finished nurse would do the other nurses med pass for her while she charted. No one did an admission alone. One would do the assessment and nurses notes, another would transcribe the orders, get out pre-made care plans and get the chart put together. the aide would set up the room and get vitals, etc. No one abused our system. We all wanted to get out of there on time and go to bed! (night shift) Sounds like utopia, huh? I sure did have a great set of co-workers. Too bad everything else about the place sucked.

Antikigirl, ASN, RN · Apr 26, 2006

Oh wow...I use to do that till I had team members that were ALWAYS 1/2 to an hour late! Sorry, but I am not sitting around for someone to complete charting...that I can't help with! Sure I will always stay if someone needs help, but most times it is a charting issue..and I get my charting done, and the rare times it doesn't go on time, I don't expect to keep everyone waiting....that will rush my charting and I will forget something in attempts to get everyone home!

Nope, if it is a charting issue...I am done and I go home! Not only that...I make sure the next nurse has a chance to talk face to face with me in case they have questions...if they don't...I am going home! (unless I remembered something I need to do....I always stay till MY job is done!).

That rule puts too much pressure on nurses...end of shift means just that...end of shift. I make sure all runs well after I am done, and when it does out I go...sometimes screaming..LOL!

ilovecamping · Apr 26, 2006

sounds like this is more of management issue - i remember working with nurses like this, these were the same ones who time after time, night after night just couldn't stay to any time management schedule, it didn't matter if the shift was quiet or stupid busy.

the rest of the staff shouldn't be punished for the chronic slow pokes, the manager should be finding out why the same certain staff members are chronically late.

needless to say, after 13 years of bedside nursing, i only ran into a very small number of nurses who wouldn't help in time of "crisis" at the end of a shift. but it's easy to get bitter about the ones who ALWAYS have the end of shift crisis.

SmilingBluEyes · Apr 26, 2006

I predict this will indeed blow up in the manager's face, for many reasons.

shannonleighann · Apr 26, 2006

I think the rule should be "no one leaves until everyone is caught up on the floor" meaning if someone has charting to do they will have to stay longer than those that are caught up. I work nights and we always offer to help each other if one is having a bad morning, we will do accuchecks for each other or pass meds or the simple things. On days they have problems with a couple of nurses that seclude themselves all day, refuse to take new admits and never offer assistance. They give report and run off leaving others with a heap of unfinished business. I can think of a million times that a dayshift nurse has had to finish their floor work, give report then stay until 2100 charting. It's a mess. I think this rule could potentially help at my worksite, just needs a little modification.