I have a situation at work that is very frustrating and turning my insides out. I work the night shift along with 3 other RNs on an 11 bed PCU. One of the day shift RNs is very angry because she feels that there is too much work "left over" for her to do when she starts her shift. One of things she has c/o is that she would wants things on the over the bed tables, like pitcher of H2O, tissues etc. pushed to one side because if there isn't any room, when the kitchen aides come to deliver the breakfast trays they leave the trays on chairs and the pt's don't get their meal until she walks in and gives it to them. Alright, that's reasonable enough and I do do this. I can't stand stuff scattered all over either. She also feels that she shouldn't have to pull pts. up in bed when she enters a room, or fix their blankets etc. This should already be done. We have tried to explain to her that pts. do move around on their own. I mean how many times have you just done up a pt. and you go back to the room 15 or 20 minutes later and the bed is wet and it looks like no one has ever been near the person? The other night my co-worker was having difficulty with a confused pt. He was grabbing her and scratched her, so I and the clinical co-ordinator were in the room helping restart an IV and genarally fixing him up. A little later I assisted her in straight cathing him and we fixed him up again. We both proceeded to continue with the rest of our pts. as it was near the end of the shift and we still had meds to pass and finish charting. When she went into the room she was very angry because he had slid down in the bed so that the pads underneath him were now under his neck and because he had squirmed around, a corner of his sheet was hanging down. She paged the vice president of nursing and my clinical co-ordinator as well as the day shift one. Fortunately my clinical co-ordinator was able to verify the problems we had with this pt. as she had helped us out. The day RN had said that no one had touched this man at all. We then thought that if we did pt. rounds when the next shift comes on we could rectify any of the things that are aggravating her. She refused to do this asking what that was supposed to accomplish and feels that it's the job of the clinical co-ordinators. ("I told them the problem now it's up to them to do their jobs"). When asked point blank, she said that none of the 4 of us night RNs are doing our jobs well and we need to learn to manage our time more effectively. She knows there is a lot of down time on nights (which we acknowledge) and plenty of time for "chit-chat". She doesn't feel she should have to do orthostatics, wgts, all transfer sheets should be done, whether pt. going to another facility or to the med-surg floor, (we should be able to anticipate this). We do these things but sometimes it's not done because we've had heavy pts. or emergent situations. (pt. transfered from floor with profuse nasal bleeding, tachycardia, needed few units of FFP/blood given and pt. vomiting and frightened. No, I didn't get a chance to do the transfer sheet on someone going to the floor probabaly that day because I spent all my time with this pt. and MD phone calls etc. BTW we have electronic charting so when doing the transfer sheets most info. is re-called from other assessment sheets. The only thing needed is a brief pt. summary). Plus most of the transfers to another facility for cardiac caths. occur on my shift. Pts. usually leave around 5 or 6 am. It's very difficult to talk with her. She doesn't acknowledge anything we say or respond to our explainations. She has made it quite clear that she is the best nurse on the floor and always does her job well. We all know what the day shift entails, docs coming in, dx. tests, two meals, families etc. I understand that and empathise. But exactly when are my pts. supposed to sleep? When I go into my pt. rooms, I do their assessments, straighten out furniture (basically because you can't get to the pt.), untangle IV lines from the phone cords and call bell, get fresh ice water, clean off tray tables etc. I'm not perfect and I don't pretend to be. But how do we deal with this person? My clinical co-ordinator is bringing this to our manager because she doesn't know what to do with it anymore. We come in to messy rooms etc. but I know that the evening shift is busy with tx., d/c, adm. etc. so I just do it. If they leave something left over like an IV start or late meds on an admit, I don't care I just do it. I know they are busy. Mnagement has acknowledged that the day shift probably could use an aide for the whole shift. Right now they have one that works from 8am to 5pm to cover a little of both shifts, and thay have been trying to float one down from one of the floors but this isn't always possible. Any suggestions? Has anyone had similar situation? Whew!! Long winded I know but had to vent.
