Just looking for some advice on a situation and whether to report or not or even how high to escalate it.
I work in a neuro ICU as a charge nurse and return to work one day to find that the day shift charge (L) had left early due to an emergency; apparently there was a death in the family. Another nurse took over charge and gave me report, but clearly didn't know very much about any of the patients except his own. I had questions about the final patient that the previous charge, L, had been assigned to that day. This was a fairly stable patient, hence why the patient was assigned to a charge nurse for the day, but nonetheless, this is a neuro ICU and the patient had had brain surgery, was wheezing, and retaining urine. Relief charge had no idea what was going on with the patient and all other day nurses stated they did not assume care of this patient. Relief charge then told me, "I guess the patient didn't have a nurse for the past hour."
I texted the previous charge, L, and apologized for bugging her during her family emergency but just wanted to know who she gave report to since charge report is vague without the fine details. No response. I was left with no other option than to give report on this patient to my night shift nurse based on my limited charge report for this patient.
My director showed up not long after and I explained the situation to him. He tells me, "Yeah, she's (L) not going to text you back. Under the circumstances, just have your night nurse read the patient notes." He leaves. I suddenly get a call from my clinical coordinator, my director's #2, and she tells me that she "heard" I had questions about a patient. I told her I spoke to my director already, to which she had no idea. This leaves me to conclude that L had completely disregarded my text and went straight to our bosses to let them know I was texting her.
This situation frustrates me in several ways. First off, to me, this nurse essentially abandoned her patient because she did not properly transfer care of her patient. Secondly, this patient had no nurse for an entire hour and considering her current state, a number of things could have happened and there would have been no nurse to take accountability for the patient. Patient safety was severely jeopardized here. It also put me in a position where I had to give report on a patient that I was not assigned to, did not care for, and had limited information on. Lastly, this nurse should have been a professional and responded when I texted considering she was the last known nurse for the patient, but for her to go over my head and straight to the coordinator was uncalled for. In the time it took for her to contact the coordinator, she could have replied back to me with a quick text.
I'm stuck with the decision now whether to report this or not because I truly think that it was wrong what this nurse did and that the patient's safety was jeopardized. I completely understand that emergencies happen, but proper handoff of this patient should have taken place. My reservations in reporting it though, are that for one, my administration is incredibly corrupt and they will throw anyone under the bus to get what they want, and will retaliate like they have with several of my colleagues. My admins are also very friendly with the day shift staff, as is how it usually is when night shifters are treated like the orphan children. So I know for a fact that if I reported this day nurse, that they would do everything in their power to protect her. Even my CNO and my director are very tight with each other, so that puts me in the line of fire with my entire chain of command.
