Nurses nit-pick & endorse too many things

[cafegoer]

I’ve been a night shift nurse for 4 years on a busy med-surg tele floor. Almost every shift while giving handoff report, an oncoming nurse will nit-pick at something small that I didn't do. Meanwhile, when they give me report, they leave so much for me to do. We’re usually short staffed, with no cna and sometimes no charge. Most days there’s not enough time or help to accomplish everything no matter how hard I try. Some things I have to endorse to the next nurse.

For example, if I have to endorse an IV dressing change (that is not expired yet, but just due to be changed on day shift) they comment “Oh. You didn't change it??” Meanwhile, some of these nurses overlook critical things. I had to report to my manager one nurse that didn't hang a heparin drip all day. Her response was “I didn't get around to it”. Another time a nurse endorsed to me: a blood transfusion which had been ordered hours before, a new admission, and a discharge (the discharge paperwork wasn’t done yet despite being in the computer for hours). Again I reported to the charge nurse who helped me and took down the name of the nurse.

I do my best to prepare the shift for the oncoming RN (hang new bag of fluids, medicate the pts, clean the pt’s). However some nurses leave so much behind and nit-pick at the smallest things that I didn't do.

How do I deal with behavior on my unit? Btw this happens to my other night shift coworkers as well. How do I deal with these nurses?

[caliotter3]

The behavior no doubt is institutionalized. I noted that you said in your post that you reported situations to the manager, yet it seems nothing has changed. Nothing will change. You have to decide how badly you want to keep this job and how much you are going to allow this "to and fro" to affect your job performance and your personal health.

[NotMyProblem MSN, ASN, BSN, MSN, LPN, RN]

This exact same thing happened to me on my last travel assignment. The day nurse reported to her charge that she didn’t give a patient’s meds. The charge told her to “tell the night nurse to give ‘em”. This was a regular occurrence for this nurse. She approached me and I looked her straight in the eyes and told her, “I will NOT give your meds. While you were at the desk reporting this to your charge, you could have been down the hall giving them to your patient instead, and if you still don’t, it is YOUR responsibility to notify the doctor and the pharmacy of the missed dosages on YOUR patients for YOUR shift”.

Even though this is a 24-hour institution, nobody can hold you responsible for what goes on (or didn’t, in this case) when you’re not there.

[TriciaJ, RN]

The same people who are skipping heparin administration are nit- picking IV dressing changes?

Don't be chronically annoyed by this behaviour. Deal with it. Missed meds and heparin, delayed blood transfusions, etc. require an incident report for risk management purposes.

Forget the charge nurse. She probably has no real power in the situation anyway. Develop a reputation for completing your work and call out the nit-picking for what it is.

You'll keep being taken advantage of until you start putting a stop to it.

[JKL33]

A few new ways of thinking about some of this will benefit you.

You are destined to be chronically disappointed if you expect your standards to be others' standards, and if you expect that others will go out of their way for you the way you believe you go out of your way for them. This is not a criticism of you at all; it's just sort of a truth, if you will.

Begin by reframing everything around the patient, not around who did what and who didn't do what and who said something snarky.

1. Utilize your incident reporting system for reporting serious patient care errors such as the delays in care that you mention. This is not as much about taking down anyone's name or reporting a person, but rather approaching the issue from the standpoints of patient safety and risk management. A patient experienced a delay in care. That is a matter for the incident report. So-and-so RN who left x, y, and z for the next nurse is part of the picture, but not the focus you want to portray. Think of incident reports as being a care improvement tool and in the best interest of patient care and safety. Don't think of them as a nurse reporting another nurse.

On 4/14/2020 at 4:28 PM, cafegoer said:

if I have to endorse an IV dressing change (that is not expired yet, but just due to be changed on day shift) they comment “Oh. You didn't change it??”

Ho-hum. That's how you think about this. If they need to get their little comment in who cares. Feel sorry for them for being so petty make sure you are never tempted to act that way when you're getting report from someone else.

On 4/14/2020 at 4:28 PM, cafegoer said:

I do my best to prepare the shift for the oncoming RN (hang new bag of fluids, medicate the pts, clean the pt’s).

This ^ is what compels me to advise you to reframe things. If you are doing all of the above to prepare things for the next RN then that's nice I guess but not really the right intention. Your goal is to do what is best for the patients in your care. When you look at it that way, you don't have to worry so much about whether others reciprocate. Every day when your shift begins your mission is to take care of your patients the best you can; not to appease coworkers who would complain about IV dressings. You aren't cleaning your patient to get ready for the next RN; you're cleaning your patient because your patient deserves to be clean and comfortable as much as humanly possible. Same thing with giving them their medications and caring for their IVs.

You are frustrated and yes, other people are crappy sometimes. You sound like you care about your patients and you will increase your personal sense of peace and well-being immensely if you focus on doing what you can do during your time at work, to the best of your ability, because you want to provide excellent care to your patients. You will only deepen your own frustration and dissatisfaction if you keep your focus on your coworkers' performance (which you are taking personally).

Think about it. Take care ~