Published Aug 10, 2015
ixchel
4,547 Posts
Does this happen at your hospital?
Recent examples:
#1:
Radiology tech: "this patient has q0600 portable chest X-rays part of his old ICU order set. They normally DC these but they didn't DC his. Do I really need to do this?"
#2:
Me, to a different radiology tech: "we just discovered he might have foot fractures and I'm putting in orders right this exact second. Do you mind grabbing images of his feet while you're here?"
Rad tech: "the order wasn't already in so your, have to get that later."
Me: "the order is in right now."
Rad tech: "no."
Two seconds later, does the images anyway, because she realized it meant she'd have to come all the way upstairs again.
#3:
Respiratory: "Earlier MD asked for a different patient to have ABGs done at 0800" (after RT's shift would be over) "so we can just do this patient's in a few hours, too, right?"
#4:
Lab, after walking the whole unit to find me: "that patient has a PICC, why can't you draw her?"
Me: "I don't have orders saying I can."
Lab: "I saw her get drawn off that line last week, you need to draw her."
Me: "her line isn't being used for labs. I don't have an order saying it can be. I CAN'T use it. You need to draw her."
If it weren't the same people trying to get out of their orders every time, I'd figure they were just confirming things, but I am absolutely convinced they're trying to get out of doing their job, and they're trying to get the RN's "okay" so they can pass the buck to us, I am so done with this! If they want to questions orders, they should call the people writing them. :\
vanilla bean
861 Posts
Why not make that your "stock" response? As in, "let me know what the provider says after you call." Or, "that's an excellent question. Tell me what the doctor decides once you've clarified with him/her."
KatieMI, BSN, MSN, RN
1 Article; 2,675 Posts
Yeah, happens all the time and if nursing, God forbid, stops to control it, the famous stuff of "but we ALWAYS do it this way here" and blah about teamwork, cooperation and "we're all one family here" will grow up like weed in no time. And there will be claims that "we never call providers, it's nursing job!"
I saw a rad tech calling me in a room, hanging me an X-ray cassette and saying that he's all ready, just please position that right under the patient and let him know where to push the button. When I told him in his face that I am not going to do his job, he scowled something about me being so nice that he was just 100% sure that I wanted to "help". Nope, cookie, it's yours. Likewise responce for a lab girl who was so nice as to leave empty blood culture bottles in the patient's room thinking that I will be a sweetie and draw them... later on she made a point that she EVEN labeled them!
Nice and polite but absolute refusal to do one's job usually works as a miracle... but meanwhile I know that patient is suffering and that d*** thing just got to be done. We are blessed by having a nursing leader who will not hesitate to call that department and get a little chat with their NM. This solves the problem for a while.
ScrappytheCoco
288 Posts
Last winter we were boarding all the admitted patients in the ED, so technically I had 3 med/surg patients I was doing all the cares/meds/floor stuff for plus an ED bed I turned over 5 times in a 12 hour shift. Lab is supposed to draw patients once they're admitted. So I call. "Is Mr. Rm ED4 going to have his am labs drawn today?" Lab: "Well, he's in your department, so you should draw him." Me: "Uh no, he's admitted, there's just not a bed for him upstairs." "Well, sorry, he's in your department."
VANurse2010
1,526 Posts
Response: Read the hospital policy - if you don't get down here and draw these I'm calling the nursing supervisor and filing an incident report.
This usually gets people to cooperate.
Pangea Reunited, ASN, RN
1,547 Posts
These are a few of my favorites:
Stat blood culture order entered. Patient also has routine CBC, BMP, etc. ordered in the AM. Lab tech asks the patient if they want to be stuck two times, or just one time in the morning. Of course they're going to say once when they don't understand the importance of the "now" order. And after I talk to the patient, the tech has to come back to the floor again and draw the "refused" lab. It's a waste of my time and of theirs.
Lab tech: Why does the patient have to have blood drawn for a pregnancy test tonight?
Me: The patient might be having surgery within the next hour. The MD wants it drawn now, please.
Lab tech: But why? If she's pregnant, then she's pregnant.
Me: *tries hard to continue to be polite*
Lab: The patient in room 102B has labs ordered, but she's downstairs having an MRI done. Can you cancel them?
Me: *tries very hard to give a polite answer to the stupid question*
TheCommuter, BSN, RN
102 Articles; 27,612 Posts
Hmmm...at the hospital where I work, most of my issues revolve around lazy ancillary staff (cooks, EVS, dietary aides, etc). They turf tasks off onto nursing staff, even ones they could have easily resolved themselves.
Dietary aide, to a patient: "You don't like your food? I'll tell your nurse."
Housekeeper, to a patient: "Your trash is full? I'll tell your nurse."
Cook, to a patient: "Your eggs are watery? Let me tell your nurse."
Dietary aide, to me: "You need styrofoam cups for the nutrition room? Well, I'm the only one in the kitchen. You need to come to the kitchen to get them."
Hmmm...at the hospital where I work, most of my issues revolve around lazy ancillary staff (cooks, EVS, dietary aides, etc). They turf tasks off onto nursing staff, even ones they could have easily resolved themselves.Dietary aide, to a patient: "You don't like your food? I'll tell your nurse."Housekeeper, to a patient: "Your trash is full? I'll tell your nurse."Cook, to a patient: "Your eggs are watery? Let me tell your nurse."Dietary aide, to me: "You need styrofoam cups for the nutrition room? Well, I'm the only one in the kitchen. You need to come to the kitchen to get them."
and yet...
a poor soul with very, very chronic pancreatitis just agreed to eat "just a piece of something" after me talking him into it for a good half an hour. He is on low-fat diet, has to be taken from TPN, has no appetite whatsoever.
Dietary aide: - what would you like?
Patient: - what good do they got today?
Aide: - hamburgers and fries are really good... and cheeseburger is what I like (stops in horror as patient begins to vomit profusely)
Me (after getting situation under some control), to aide: - what did you suggest for the patient who can't have any fat?
Aide, sheepishly: - I do not know... yes, it is in my computer BUT I AM JUST AN AIDE! How can I know.... it is not my fault.... it is what I like to eat.... next time, just do it yourself!
icuRNmaggie, BSN, RN
1,970 Posts
There is always going to be that one employee who tests the nurse saying:
"You don't really want this ABG do you?" - ------- yes I do
"Can't we just do the ABG after the wean?" - ------------- no. It is ordered for now.
" He doesn't need daily PCXRs anymore does he?"(pt with chest tubes) --------- yes he does.
" Are these labs really necessary?" ----------- yes they are
"Why can't you draw these labs from the line?" ---Because if I stop the IV meds it might kill him.
" He already had an EKG in the ER so you need to cancel this one." ---------- No you need to do it.
and my alltime favorite:
"Can this CT of the head wait until dayshift?" --------- It's a stat so no it can't wait.
I do not waste my time and energy discussing the rationale in depth with people who clearly don't care and want to get out of doing their jobs.
... and my all time favorite:
- I need to do (task), would you like to help me?
- no, sorry, I actually don't.
One needs to see the shock this innocent phrase causes.
Here.I.Stand, BSN, RN
5,047 Posts
I've actually had lab staff cancel orders without asking the "does the pt really need this?" Nothing gets a no-attempt-to-be-polite "You need to stop practicing medicine w/o a license, get your self up here, and do your **** job" -- and a write-up -- faster than a lab tech who cancels my labs.
ThePrincessBride, MSN, RN, NP
1 Article; 2,594 Posts
Yup. Happens all the time. And they have the nerve to be ticked off that nurses make more money and have more opportunities.
I also can't stand this rule that insists that housekeeping can't clean up any body fluids. Nursing staff has to scrub everything off before they will come into the room.
Stupid.