On a need to know basis? How would you approach such situation?

[rksgray13]

So I was just thinking. I have seen this and witnessed a "mum" kind of speak. Personally, I acknowledge and education when faced with such incidents, be that as it may. When face with, for instance, any type of IV drg change that it LONG overdue, would you let your patient in on it? I have seen wound drgs, IV dsgs, and many other "boo boos" that have been more or less neglected from previous shift duties. I am quite emotional with my facial expressions and get pretty pi$$y with a potential for nosocomial issues. Nasty PICC lines drgs with dried blood and tape coming off. I tend to put an "attorney hat" on. Question after question to figure of the reason behind incidents and I will say to my patients, "this should not look this way or could you help make your caretakers aware when your drgs looks like... such and such?" And I chart everything pertinent. I'm not trying to blame or point fingers but these things are avoidable. I would want someone to call me out if it overlooked any part of assessment because any good attorney will if needed. The last thing I want is a patient with a nurse badmouthing their colleages or facility over this but rather that than a lawsuit for neglect or wrongful death from nosocomial infections or whatever. So are you "MUM" and just do the duty or do you speak up?

[Altra, BSN, RN]

I wouldn't wave my arms around and go ballistic or say the day nurse had responsibility for this. That's harsh.

I'd say the "pi$$y facial expressions" you mentioned earlier were pretty harsh too.

I'm sorry -- this smacks of the "I'm SuperNurse, here to save all the patients" mentality. And I'm not buying it. Encounter what you feel is poor care? Fine. Strap on a pair and address it unemotionally and professionally with the appropriate party, whether that is another staff nurse or someone further up the chain of command.

[akulahawkRN, ADN, RN, EMT-P]

In situations like this, I would expect that the patient would at least understand that dressings need to be changed and that dressings occasionally to being needs to be changed out, and the like, to maintain a handle on infection control. I probably would not go any farther than that in less they asked.

When it comes time to change dressings, IV tubing, IV sites, that sort of thing, especially if they are out of date, I would just simply change the item the way it is supposed to be changed out, do the education that I would do every time I change dressings or IVs or what have you, go about my business (as far as the patient is concerned), bring it up to my supervisor, and somewhere along the way, chart the fact that something got changed out. Just don't let the patient know that something is off, because that could lead the patient to going on their own witchhunt, when nothing truly has gone wrong, and you might be caught in the crossfire.

When something has not been changed in several days, and is overdue for it, a bunch of people need to be held accountable for it, but it is far better to hold him accountable and remind them that things need to be changed out than it is to go on a witchhunt and smack everyone with a stick unnecessarily.

[rksgray13]

Thanks for replyng everyone. Just curious

[BrandonLPN, LPN]

"I'm sure glad that nurse pointed out the other shift's shortcomings."

- said no patient, ever.

[tewdles, RN]

As a manager I am not friendly when staff make a point to cause a patient to have concern about a co-worker. Trust is important for patients when they are under our care. In my workplace, if you throw a team member under the bus you will find yourself in the cross hairs of my scrutiny.

While it is true that we want patients to be engaged in their own care, we don't want to make them responsible for us doing our jobs.

If you have co-workers who are not doing their work as expected, speak to them about it...discover what is happening. If that is not fruitful, take it to management.

off my soap box

[NRSKarenRN, BSN, RN]

Closed per request.