Physicians orders

[remched]

I have been working at a LTC facility for two months after graduating in August. I feel somewhat comfortable (although not as fast as I would like to be) with the med passes and treatments. The paperwork is a different story. I can get my basic paperwork done during my shift, but if physician's orders come in, it really throws my night off. Do P.O. have to be done by the shift in which they are faxed, or can you try to complete what you need to do, and pass the remaining ones onto the next shift? The next shift is night, and I know they will have time to complete the orders.

Thanks. I really do like the work, but I don't have time to do the unit clerks job, and we don't have one 3-11.

[TheCommuter, BSN, RN]

I once worked the 3-11pm shift at an LTCF. While it would be nice to pass the orders onto the next shift, I am always rather leery of passing any task onto any other nurse. Here's why.

You know that you have worked hard and had a whole lot of things to do during your shift. During change-of-shift report, you pass on the unfinished portion of the physician orders. The oncoming nurse smiles and says, "Sure! I'll finish them up for you!"

However, I have encountered nothing but problems when passing tasks on to other shifts. These passive-aggressive nurses will smile at you and pretend to want to help you with the physician orders, but they go around and complain to other people, "This particular nurse had the nerve to ask me to do something for her!"

I virtually never pass anything on to the next shift because:

1. I can never be sure that they will follow through with the orders; in that case, you will get in trouble if the other person does not do whatever it was that you asked them. After all, the P.O. came in on your shift, so you are liable if the oncoming nurse doesn't follow up.

2. As mentioned previously, passive-aggressive nurses will smile and claim that they will happily finish the orders, but they will complain behind your back that you dumped some work on them.

[remched]

Thanks for answering so quickly. The problem here is, the facility won't pay overtime. We had over 20 P.O.'s come in the other night. If another nurse had not come from another floor, I would have been there until 4am. I don't mind putting in a extra hour (after clocking out first) to finish my work, but I couldn't possibly have finished it. Maybe this facility is asking too much. I'm already in charge of 24 residents.

[soulfullady]

I agree with you 100% commuter. I have recently experienced this situation exactly and have learned my lesson the hard way. Especially if you're coming on shift right after them, after asking if those things can be done. Not to mention the workload it puts on you during your shift. And the frustration, which doesn't help your day in the least. If I have to stay late to finish, I will. CYA....(cover your a..)

[soulfullady]

Maybe the facility needs to have other employees help. Like an hour here, an hour there, so that the P.O.s can be followed in a timely manner, since they are not willing to pay overtime. Thats frustrating, I would imagine!!

[TheCommuter, BSN, RN]

The problem here is, the facility won't pay overtime.

This is terrible. Perhaps you might want to transfer to a 'quieter' shift (such as graveyards), or find a job at another facility that will pay you for all hours that you have worked.

[withasmilelpn]

If I have to stay over, I stay on the clock. They want to fire me for finishing my work, fine. I will never work off the clock. It is against the law!

[Wile E Coyote, ASN, RN]

NEVER work off the clock, as just posted. I won't go TOO FAR (hehe) off on a tangent here, but I will say that facilities count on and exploit that common thread we nurses have. You are a professional, should be treated as such. The docs don't round for free, and you're not gonna work for free, either.

[Nascar nurse, ASN, RN]

NEVER work off the clock, as just posted.

AMEN. No way - no how!