Lately our facility is hiring agency RNs. These RNs are older, not sure how much experience they have though. Anyways every time I receive report from this new agency nurse (not sure on his work experience, but he has been with us for probably 4 months) he never gives a full report, never even tells me why the patient is here, and he never knows labs or tests the patients have gone for. I basically cant trust a deport from him because it always ends up being something else. But when I need to give him report, he questions me regarding the patients head to toe assessment, which I want to yell at him because if you were doing your own head to toe assessment, you wouldnt need to know the nooks and crannies.", youd go based off your findings, so he pretty much copies and pastes the previous shift. He questions many things that are not too relevant in report that he could easily look up on his own. I just dont understand how you ask me a million questions when you dont even give that amount of information to me, let alone it being incorrect. He tapes over leaking IVs (i had to change 4 IVs the other night), my one patients arm was completely swollen from the infiltration. I had no idea my patient had a feeding tube and when I walked in the room the feeding wasnt even connected to the patient, and my one patient wanted to sign out AMA because no one came to speak to her for hours and she got fed up. I just dont know what to do. I know being new can be difficult but finish the work you are intended to do. Dont hide information for me to find out on my own. I rather you tell me hey im not great with ivs so they do not have one. I would appreciate that more than being blindsided. I have had this nurses district several times and it turns into a crappy load and I am on the verge of tears because of what is left behind for my shift. Am I being unreasonable? I was thinking about talking to my manager about it because this isnt the first time and other nurses also know any district taken from this nurse will be a disaster. What do I say to my manager? How can I handle this situation. I am the type of person who tells it how it is but it turns me into a mean person so not sure I should approach this coworker either. Help!
Specializes in Med/Surg/Infection Control/Geriatrics.
Before you go to your manager, address his deficiencies with him. If you don't catch it before he leaves, be sure to talk to him about it the next time you see him. Do it in a non-judgmental way, as if you are merely explaining the expectations of the floor.
Low potassium. Hey, yesterday, one of your patients didn't get her potassium replaced. Be sure to check potassium levels in the future.
IV Infiltration. Hey, yesterday, I noticed that you reinforced an IV that had infiltrated. Please insert a new IV when the old one starts leaking.
NG feeding. Hey, yesterday I noticed that the tubing feeding was shut off. You didn't mention why. Was there a verbal order that never got entered?
If he doesn't improve after calling him out in it, then go to your manager.
I must respectfully disagree with this. This isn't a new grad she's dealing with. Pool nurses are suppose to know their stuff. And, she isn't his manager so he won't take her seriously.
Giving him a free ride for a bit is not what a safe and prudent nurse would do. She needs to protect the patients - now.
If he is demanding all of that info from you in report, it sounds like he just wants to know what to chart without doing the work himself. Don't entertain his nitpicky questions. Just keep your report moving. As for the unsafe patient care part, I agree with the other posters. Document the beans out of it and present this to your supervisor the next time you get burned.
Sorry if I sound crabby, I thought I had breadsticks in the freezer but I don't.
Ugh, we had a traveler like that; not so much with report but with leaving tons of stuff for the next shift. More than one nurse had talked to her about it over a period of a few weeks.
She flat out lied to me in one report stating she had done a dressing change when she hadn't & told me she got an order to keep a foley. No order had been written, so I called about it & probably sounded like an idiot because the MD absolutely didn't want to keep the foley (there was no reason to which I had found odd). When I mentioned all this to her at shift change, she had no answer at all.
The next night, she handed off 5 pts; 4 who did not get their 1600 meds (including insulin), one did not get their first post-op xarelto (marked refused), 1 or 2 missed dressing changes & an IV that "literally just went bad". Every pt had 1 or 2 things she "just couldn't get to". Report for each pt pretty much ended up with her saying "It's been so crazy. Could you take care of that?" I asked her to chart against the missed insulin doses because I would not give those 2-3 hrs late with an HS dose coming up. On the last pt with no IV (new post-op), I asked if she could try to start one before she left & she huffed up & couldn't believe I expected her to stay past 1900. She even got out of that by asking the supervisor to do it who happened to be rounding. And she didn't chart against the insulin in the eMARs, so I had to & attached a note to each one as to why. I ended up having to write an incident report a few hrs later when I discovered she hung an antibiotic that had been discontinued (pharmacy had not yet picked it up) instead of the correct one for a fresh post-op pt. She wasn't scanning her meds which would have caught that she had grabbed the wrong bag from the fridge. I told her about the med error at shift change the next morning & she seemed pretty unconcerned about it. I found myself fuming about the whole thing on the drive home & called my manager (Sunday morning) to let her know what had happened & that there was an issue. She usually left a couple things every shift, but that handover was ridiculous.
She had a couple more med errors after that & was only there a few more weeks before she was let go.
Shifts DO get crazy & some tasks can be left to the next shift occasionally, but if you're scratching your head & wondering "WTH did you do for 12 hrs?!" when things are repeatedly left undone by one person, it's time to say something to them & then to management if it continues.
Specializes in Case manager, float pool, and more.
I am now extra grateful that all the travel nurses I have been fortunate to work with thus far, have been wonderful. I agree this person is putting patient's safety at risk as well as your license by omitting on a continuous basis pertinent information in report to those following him. Leaving work for others goes beyond just letting you pick up slack as evidenced by finding that pt with the IV infiltrate.
Yeah, I'll pick up the slack for a new grad learning their way or a trusted colleague having the occasional bad day (we all do but it better be rare). Other than that I'll tell the slacker nurse in no uncertain terms they stink exactly once. After that I'm informing the nurse manager in writing & after that the Union is getting involved. I go to work & do the best I can and get my work done. I expect the same from my coworkers. If I'm gonna do part of their work I should get part of their check.
There's an easy way to fix this....for every infiltrated IV, missed meds and disconnected NGs...you fill out an incident report. An incident report has to be followed up and has to go through Risk Management. Once they start to see the same name appearing time and again it will be dealt with very quickly.
Great insight I see in everyones posts. I do end up taking it personal and that is one of my downfalls. I will take pieces of your input and use it in my own nursing practice
Why are you allowing him to give you an incomplete report? I don't work in the adult world, but in the NICU we look at each patient together and the oncoming nurse makes sure IV looks good, inspects dressings, IV pumps are set correctly, suction working, ambu bag working, code sheets posted. The oncoming nurse must accept the patient before the off going nurse can leave. If an IV was infiltrated, an patient incident report would be filed and that nurse would be responsible for starting a new one. If multiple IVs were bad, there would definitely be some words said.
If an IV was infiltrated, an patient incident report would be filed and that nurse would be responsible for starting a new one. If multiple IVs were bad, there would definitely be some words said.
Seriously? Is an infiltrated IV like some sort of "never event" now or something?
Or are you talking about one that, like in the OP, clearly has not been assessed or maintained properly?
Seriously? Is an infiltrated IV like some sort of "never event" now or something?
Or are you talking about one that, like in the OP, clearly has not been assessed or maintained properly?
An infiltrate that hasn't been assessed for hours and hope that the next nurse doesn't notice until after you are gone, plus multiple patients with bad IVs is pure laziness and needs to be addressed.
Have Nurse, ADN, RN
3 Articles; 719 Posts
I must respectfully disagree with this. This isn't a new grad she's dealing with. Pool nurses are suppose to know their stuff. And, she isn't his manager so he won't take her seriously.
Giving him a free ride for a bit is not what a safe and prudent nurse would do. She needs to protect the patients - now.