Nursing is a 24 hour job, right?

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I work in LTC as the weekend treatment nurse. Im responsible for all dressing changes,catheters,lab collections,etc as well as managing the 2-3 wound vacs we have. This weekend one of my residents had a new vac system that I had never dealt with before.I was left no instruction booklet, no demonstration,no support contact number, not even a drawing of how this thing is supposed to work, it was like a forigne language to me. Well naturally it goes on the fritz and I change the dressing,seal and canister to the best of my ability considering I had no idea how to work this thing.It seemed appeased for a while but as the day wore on the machine kept giving me error msgs. I was able to hit the reset button each time and it would be happy for a while. At the end of my 13 hour shift I checked the machine to make sure it was ok for the time being, clocked out and headed for the door. Well before I could successfully make it to the parking lot the supervisor was chasing me down to come back in and fix it as it was 'beeping' again. I came back into the building explained the situation to the oncoming night nurse and told her if it gave her much problem to unhook the entire thing and just cover the wound with a clean dry dressing until the expert wound care nurse came in the next day.The supervisor insisted I clock back in to resolve the situation, I politely explained I had to go and walked out. Am I wrong to assume that nursing is a 24 hour job and whatever cant be done on the day shift can be passed on to the next? This wasnt a life/death situation and any licensed nurse should know how to apply a clean dressing. I was very frustrated with the whole situation. Any ideas how I could have handled it better?

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Specializes in CCU, SICU, CVSICU, Precepting & Teaching.

i work in icu, so my situation is a lot different. we deal with unfamiliar equipment a lot of the time. our hospital is always trialing some new gadget and often we're only inserviced on it after the fact. (ventricular assist devices pop up and we get the inservice after we get the patient.)

i know you're busy, but if you have access to the internet, most companies have information for clinicians on-line. some companies have full user manuals on-line. many require that you log in, so create an account -- you have a legitimate reason for wanting the information. you can download full user manuals, you can go to their faqs page, you can submit a question that the company answer at their leisure -- some companies answer immediately, some not. if there isn't a contact number etched into the machine somewhere, you might find it on the company's website. most have a 24 hour customer service line. so call the rep and ask them to help you trouble shoot the machine.

nursing is a 24 hour job. i'm not going to comment on the conduct of you or your co-workers. someone has to trouble shoot the machine sometime. maybe it isn't your job to do so, but if it is, contact the company and ask for help. or if you have sister-facilities call one of them and ask if anyone is familiar with the equipment and can talk you through troubleshooting it. pressing the reset button over and over may silence the beeping for awhile, but it isn't a solution to the problem. i've gotten phone calls from ltc facilities to ask about how to care for some of the vad patients we've sent out -- i'm happy to troubleshoot over the phone with them. so maybe calling the sicu of your local hospital might get you a nurse willing to troubleshoot over the phone.

the company, though, is the best bet. they want to sell machines so they don't want unhappy nurses. good luck!

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Specializes in M/S, ICU, ICP.

ruby gave superb advice. there are so many ways to obtain information now when you run into unfamiliar equipment or procedures. nursing is a 24/7 job and because of that when i am left having to monitor a piece of equipment i am not familiar with i have the nurse leaving give me a quick inservice on it. the next thing i do is hunt for my facilities policy concerning the device. at the very least i ask for a phone number or contact person just in case something were to go wrong.

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Both posters have great ideas, advice. But I do understand your basic frustration. I hate giving report, trying to end my shift, and I am asked to deal with, questions about "things" that the nurse, the "next shift" should take care of. It is a 24 hour job. You CANNOT get every i dotted and every t crossed during your shift, that is why there is a next shift!

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Specializes in Trauma Surgical ICU.

If it gave you problems all day, why didn't you take it off and put on the dressing? That would have solved everything until wound care or whom ever could come and fix it..

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If it gave you problems all day, why didn't you take it off and put on the dressing? That would have solved everything until wound care or whom ever could come and fix it..

It wouldn't have solved the whole thing "until wound care or whom ever could come and fix it." My experience with VADs is that there is a company name and phone number on it or its case somewhere, and they have support people who will come out and trouble shoot the machine and teach you how to use it. The machines differ only marginally from each other. The company that supplied the VAD should have been contacted. THAT might have solved the whole thing.

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Specializes in ER, ICU.

There is some debate about how you should have handled the device but I'm with you about leaving. When work is done, you clock out and go home. One poster said nursing is a 24 hour job and that's why we work in shifts. Your boss should not have put you in that position in the first place.

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Specializes in Critical Care/Coronary Care Unit,.

The previous posters gave some good advice on how to get some resources in the future. As far as the behavior of your co-workers, it was inappropriate. You were not wrong to leave once you were clocked since it wasn't life or death..especially if you told the nurse about it during report. I really don't see what's so hard about putting a clean dressing on it til the wound nurse comes in the next day. You were well within your rights. Don't they have a night charge nurse?!

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Specializes in Professional Development Specialist.

Okay you probably won't like my answer. But you didn't take care of the problem during your shift. You hit reset, which basically means you hit the silent button until the next time the message popped up. For all intents and purposes the vac wasn't functioning correctly during your 12 hour shift at all. Some nurses in my facility do this as well, or they just turn the wound vac off so it doesn't give beep anymore while they are on shift. But it's not fixing the problem, it's just delaying it until it becomes someone else's problem. If you can't fix it on your shift then at least leave a good report that the device is not functioning and you don't know how to fix it. Maybe someone else will take the initiative and research it online or ask around the facility or find a number for the manufacturer and call. But just checking to be sure it won't beep until you are gone isn't taking care of the problem. Nursing is a 24 hour job, but you still have to do your part.

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Specializes in LTC, med/surg, hospice.

I would have taken the vac off and put the dressing on already as you advised the night shift nurse before I left my shift.

I agree you can't do every single thing on your shift but I don't like to leave a mess for someone else if it is possible for me to handle.

Once I've clocked out, I generally don't stick around to troubleshoot..only if I just want to help.

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Specializes in Nursing Professional Development.

I agree with JenniferSews. You should not have allowed the problem to go unsolved for your whole shift. Simply hitting the reset button is not solving the problem. Alarms go off for a reason -- and if you don't address the underlying problem triggering the alarm, the patient might get hurt.

If it was alarming because the machine was not working properly, then you have an obligation to protect the patient from a malfunctioning piece of equipment.

You should have called your supervisor (or whoever) and reported the problem early in your shift. Your job that day was to fix that problem. All you did was pass the problem on to the next person.

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Specializes in Trauma Surgical ICU.
It wouldn't have solved the whole thing "until wound care or whom ever could come and fix it." My experience with VADs is that there is a company name and phone number on it or its case somewhere, and they have support people who will come out and trouble shoot the machine and teach you how to use it. The machines differ only marginally from each other. The company that supplied the VAD should have been contacted. THAT might have solved the whole thing.

Yes, I understand that.. The point was, OP just kept hitting the reset button to keep the machine quiet. The OP stated that any nurse should know how to put on a dressing, but the OP did not do that. She/he passed the buck. This was an issue all day. So taking off the equipment and putting on the dressing would have solved the problem UNTIL wound care could come.

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