NOC nurse vent

[SunnyAndrsn]

I'm the NOC nurse in a 27 bed TCU. I just have a vent for the the day and evening nurses. If each of my PM co-workers "passes through" work for me to do, "because it's quiet at night" that's a lot of work you're all throwing my way.

In theory, everyone is asleep on NOC shift. In reality, at least a few people are awake. We have less staff, and while my day coworkers have 6-9 patients to do MDS paperwork for, I have 22-27.

When I walk in and the desk is covered with paperwork because each nurse had an admit, that means I have charting, vitals, and assessments to do on three patients. That's in addition to:

-cleaning the med rooms

-doind a "chart check" on all the day's orders to make sure they were properly entered

-Spending the first 45min-hour getting report (I've asked management for a taped report, as the nurses usually don't start giving report until 10:15-10:20)

-sending d/c meds back to pharmacy, along with getting all the paperwork ready

-stocking the med rooms

-Monitoring sleep patterns on 8 patients

-IV abx at 10pm and 5am

-scheduled 11pm meds for one pt.

-two tube feedings--checking placement, flushing

-PVR's on two patients

-8 scheduled meds between 5-6am

-three times a week, getting a dialysis pt. ready by 6am including early meds, breakfast, getting dressed in the morning

-three pts. have catheters, all three have "issues" including frequent clogs, blood in cath d/t CA dx, etc

-BP monitoring and O2 monitoring on approximately 6 pts. Oh, and one is a "check O2 every 2 hours during the night"

There is more of course, like I said this is TCU so everyone has PRN pain meds throughout the night.

I've worked ALL three shifts during the last two years, and it seems to me that NOC shift gets a lot of disrespect. I have one co-worker who frequently gets irritated with me when I pass things through in report from PM shift. If I get a "can you have day shift contact the MD", I catch grief from this particular co-worker. I get asked why didn't I call the MD at 10pm last night? If it was critical, I would have called an on-call!

This morning she was mad at me because I had a guy bypassing his catheter. We can't change it in the facility d/t his prostate issues, his orders state it must be changed by the urologist. So I pass it through that he'd been bypassing, what I tried to do to adjust it (balloon deflating/inflating, flushing, etc) how much was in the bag vs. his pad. She freaked out on me--I feel bad, but I did bladder scan the guy and he wasn't retaining, and I couldn't send him to the urologist at 2am! It wasn't an emergency--had he been retaining urine, I would have called an on-call and tried to get him sent in.

Do I feel bad for passing problems through in report? Of course, but it's not like I can call the clinic in the middle of the night. On-call MD's do not appreciate those calls unless it's an emergency.

[caliotter3]

Lots of people like to forget that it is a 24 hour job when it comes to what needs to get done on their own shift. They like to pass things on to others, but get miffed when someone passes something on to them. It is always supposed to be a one-way street in the direction away from them because they are privileged, or so they think.

[Rabid Response]

I don't usually have problems with the nurses on other shifts. There are a few who always pass a lot of work on (overdue meds, dressing changes, iv starts, etc...) but they would do that stuff no matter what shift they worked. There are certain things that I just can't take care of on night shift because the folks I need to call aren't around at night. One time a day shift nurse chewed me out because I hadn't called the MDs in the middle of the night to advance the patient's diet. The last diet order in the chart was from the attending at 3pm and stated, "Do not advance diet." Did she really think the resident would write me a new diet order at 0300 when the whole team was going to round on the patient anyway before breakfast? Once again, though, this is a nurse who is going to be a witch to you whatever shift she is working.

[AmazingGracie]

It is a better world when we support each other. And it can be done. Sounds like management needs to de-witch some nurses. I'm sure they know who they are.