Passing things on

This is a gray area for me right now. I'm a new nurse on nights and just yesterday I had one of the busiest shifts because of stuff done/not done by day shift. One or two things here and there are okay, but I'm still a noob so I can only handle so much! I admit that my skills are still growing and this was a factor in making my night busy, but a new nurse receiving an assignment (from another new nurse) that needs much more than everyday catchup can be overwhelming. My patients were stable, but the remaining tasks from the previous night + my own got to be too much.

The one patient I got seemed to have been harmed more than helped. I walked into the room to see that I had maybe 20 minutes of levophed left with no backup in the med room (I always make sure there's a new or extra vaso gtt bag for the next nurse, this is just common courtesy) so that's a trip to pharmacy. She fell at the beginning of the day (while the day team was shorthanded) and had a couple of scrapes and bruises nothing serious, but quite noticeable and definitely document-worthy. They were neither treated nor documented. This is a liver patient we're talking about here with a PTT in the 50s and an INR above 2.0 c'mon man! I had to take her down for the X-ray of her LS spine that was still pending to r/o injury (the fall was at ~0900 and I was taking her at 2100). There was a unit of blood pending to be transfused from 0838 for a Hb of 6.6 (pt. wasn't symptomatic, but I would still prioritize blood transfusions pretty highly). Her NGT was clotted and they didn't want to replace it 2/2 her coags being elevated, so I had to embark on the next to impossible task of "bribing" a very confused/picky patient to take her medication PO.

My current impression of nursing: it really is an unpredictable job. I feel like you'd be making a mistake to expect your day to go any certain way. Anything can change at any time and you really have to stay on your toes at all times.

I have to say... it looks to me like you got dumped on because you're a newbie. If I were you I would have (and you should have) written up the nurse on the shift before you. Not hanging blood from 0830? Write up. Not documenting injuries from a fall? Write up. Both of these things could have meant great harm to the patient. I'm sorry they did that to you!! What you're describing though is not a typical situation of passing things on... if that kind of thing is routine in your facility, you might want to think about getting out sooner than later.

You'll always encounter eye-rollers who will take exception to anything that is left for them. There are a few in EVERY workplace. However, the general consensus is that if you've made an honest effort to get all your work done and have to pass something on, I'm happy to take care of it. If, however, the work didn't get done because you were playing on the internet or gossiping all night and/or just didn't feel like doing it, I'm not happy.

We rarely do enemas in my ICU, and when I came in on the night shift, the relatively new nurse who had the patient on days told me that he wasn't able to take care of the enema "because CS didn't send up the supplies." My charge nurse happened to hear this in passing, and moved off without saying a word. But when he was done giving me report, the new grad was confronted with an irritated charge nurse who said, "The order was written five hours ago, and all the supplies are in stock. Ruby and I will be happy to teach you how to do the enema right now, but you're not passing this on because you didn't know how to do it and didn't feel like learning." He learned two things right then -- how to give an enema and not to pull anything like that again. It's been about ten years now, and I've never seen him try anything like this again.

The experienced nurses on your unit figure out real quickly who is leaving things for the next shift for a legitimate reason and who is just shirking. You'll see eye rolls for the latter, but a friendly "Don't worry -- I'll have lots of time to take care of that" for the former.

I'm night shift and this is definitely not exclusive to our shift. Day shift is actually the worst at my place for eye rolling. If I get a laundry list of things not done(labs, TPN not hung, dressing not done and on and on), yeah I'm gonna roll my eyes a little(inside, not literally.) We all have flat out shifts where we can't complete every thing. But if it's a constant thing, it might be a time management/organization issue. Some people are a nightmare to follow with lots of mistakes and undone things in their wake and that makes for a very unpleasant shift for the one following.

You'll always encounter eye-rollers who will take exception to anything that is left for them. There are a few in EVERY workplace. However, the general consensus is that if you've made an honest effort to get all your work done and have to pass something on, I'm happy to take care of it. If, however, the work didn't get done because you were playing on the internet or gossiping all night and/or just didn't feel like doing it, I'm not happy.

We rarely do enemas in my ICU, and when I came in on the night shift, the relatively new nurse who had the patient on days told me that he wasn't able to take care of the enema "because CS didn't send up the supplies." My charge nurse happened to hear this in passing, and moved off without saying a word. But when he was done giving me report, the new grad was confronted with an irritated charge nurse who said, "The order was written five hours ago, and all the supplies are in stock. Ruby and I will be happy to teach you how to do the enema right now, but you're not passing this on because you didn't know how to do it and didn't feel like learning." He learned two things right then -- how to give an enema and not to pull anything like that again. It's been about ten years now, and I've never seen him try anything like this again.

The experienced nurses on your unit figure out real quickly who is leaving things for the next shift for a legitimate reason and who is just shirking. You'll see eye rolls for the latter, but a friendly "Don't worry -- I'll have lots of time to take care of that" for the former.

I don't get people who try to pass the ball like that. Yeah you don't know how to do it, so learn!! I'm a relatively new nurse and if I come across something I've never done I grab another nurse and ask for their advice. And then you learn something new!

This is a gray area for me right now. I'm a new nurse on nights and just yesterday I had one of the busiest shifts because of stuff done/not done by day shift. One or two things here and there are okay, but I'm still a noob so I can only handle so much! I admit that my skills are still growing and this was a factor in making my night busy, but a new nurse receiving an assignment (from another new nurse) that needs much more than everyday catchup can be overwhelming. My patients were stable, but the remaining tasks from the previous night + my own got to be too much.

The one patient I got seemed to have been harmed more than helped. I walked into the room to see that I had maybe 20 minutes of levophed left with no backup in the med room (I always make sure there's a new or extra vaso gtt bag for the next nurse, this is just common courtesy) so that's a trip to pharmacy. She fell at the beginning of the day (while the day team was shorthanded) and had a couple of scrapes and bruises nothing serious, but quite noticeable and definitely document-worthy. They were neither treated nor documented. This is a liver patient we're talking about here with a PTT in the 50s and an INR above 2.0 c'mon man! I had to take her down for the X-ray of her LS spine that was still pending to r/o injury (the fall was at ~0900 and I was taking her at 2100). There was a unit of blood pending to be transfused from 0838 for a Hb of 6.6 (pt. wasn't symptomatic, but I would still prioritize blood transfusions pretty highly). Her NGT was clotted and they didn't want to replace it 2/2 her coags being elevated, so I had to embark on the next to impossible task of "bribing" a very confused/picky patient to take her medication PO.

My current impression of nursing: it really is an unpredictable job. I feel like you'd be making a mistake to expect your day to go any certain way. Anything can change at any time and you really have to stay on your toes at all times.

Someone else posted the same, and I agree, this isn't stuff that someone didn't have a chance to do on their shift, these are clinical incidents that should have been dealt with as a matter of priority. Totally different to what we are talking about here. All this being left for you is totally unfair, and if it had been me I would have made a complaint.

My number one pet peeve is people not having a new bag of inotropes ready either for themselves or the next shift. It's just dangerous. This nurse needs a swift kick up the behind!

RNikkiF - it isn't a regular occurrence which is relieving to me. The nurse I got the patient from was a fill-in because somebody called out, so they actually arrived 3 hours into the morning. He is also a new nurse. Gotta say though, the patient who I was assigned to is a pretty difficult patient as far has her behavior goes and I have noticed that she's been getting assigned to the new RNs pretty exclusively. Whatever though, I provided great care and caught her all back up for the next day shift and reflected all of my care in my narrative note and charting.

ausrnurse - I'm worried about complaining because I don't want to appear to my managers and coworkers as disgruntled or that I can't handle my full assignment off orientation. However if somebody says something about why my 2300 meds were late I'm not holding back!!

We have to sign a paper staing why we stayed late and staying past is frowned upon but it's frowned more upon not completing your work. ) it rarely happens to me(once a mth or 2) but sometimes it's inavoidable. This particular instance, 8 nurses clocked out late! It was a crazy, chaotic night for everyone :)

I've finally just cracked and will now clock out and continue to work like everyone else on my unit does. I know it's wrong but I prefer that to having management on my back.

You should be able to call a doctor on your shift - that's why they're paid to be on call. If it's non-urgent (I don't know, rewrite chart if you are using paper charts or something) there's no reason the new shift can't deal with that.

It is never okay to pass on scheduled medications that are late unless pharmacy hasn't sent them up to the floor............regardless of the shift you work on. We have a nurse that when you come at 11 pm still hasn't given her 9 pm medications.........okay to pass on ? nope. she will have to go do that. I am a day shift nurse. i expect the night shift to get their 7am medications but i will gladly give it on occasion if they have had a rough night.

As a day shift nurse over time everything has fallen on day shift. Tubing that needs changed, picc line dressings, iv changes, baths, ostomy changes ect................. I try to never pass those on to pm shift but once in a blue moon it happens and they are clearly annoyed....It is what it is and some of those things are actually 'assigned' to their shift we just tend to do it for them. also if a patient comes back at 3pm and I leave at 3:30 I obviously won't get their admission done.....but it still leaves the next shift frustrated.

I don't get my panties in a bunch anymore when someone rolls their eyes at me or is annoyed with me..........most of the time that response is more to the their stress of their busy day ahead rather than anger. We all have stressful jobs.