I was doing a clinical on the Medical ICU unit and the RN that I was working with was CONSTANTLY text messaging instead of caring for her pt. She didn't start doing anything for him until about 10:30 and she came on at 7:00.
What (if anything) should I do? file a complaint with the hospital? Leave it alone as a possible isolated case? The pt was fine and she did what he needed, but it seemed as though she did the absolute bare minimum...
I've been thinking about it since then and would hate to know that my loved one was in ICU and his/her nurse was texting.
As a follow up, I did tell my CI and she said she felt it was unacceptable behavior on the part of the nurse. She did say the nurse quite possibly had some personal issues she was dealing with but should have dealt with it in a different manner.
My CI said that she if she were a patient or a patient's family member she would more than likely lodge a complaint. However, she said in this case to leave it alone because she does not want to lose the clinical site for the school because they are difficult to secure. Politics....
And just to clarify, the RN was definitely text messaging (we have the same phone, so it's easy for me to recognize). And when the nurse would take a break or go to the restroom, she would ask another nurse to look out for her patients. Obviously, she didn't ask for coverage when she went to text message in the supply room......
I understand everyone's point of view. I guess more than anything it was disappointing behavior to see-especially in an ICU. A few texts here and there would probably be acceptable, but in my eyes, to stop in the middle of starting meds, or just as you are about to check a cath for leakage to answer text messages isn't acceptable. I am only a student and am not out there as a working nurse with a full patient load. But when that time comes, I really aspire to treat all of my pts the way I would want my mother and/or father to be treated. If there comes a point that I get burned out, I hope I can recognize it and move into a different area of nursing that is not bedside- in order to continue to do my best.
A few semesters ago at another clinical site, one of the nurses would ask patients to rate their pain, but she would not document what they said, she would document what she perceived was their pain level. So disappointing. Brought that issue to my CI and I got the same response that this CI gave me. "That is completely unacceptable, but don't rock the boat because we need the clinical site."
it never pays to cause ripples in the water unless it will prevent a tidal wave? the nurse may have had an isolated day of having to text to her child because the child was ill or some other major life issue. if she did not neglect or endanger the patient, cut her some slack. most nurses want to give good care, but they are people with families and lives that they are having to live around a set schedule. she probably worked that day because she didn't want to leave the unit shorthanded when she would have rather been at home with her family or whatever else was distracting her.
i have to agree with you. this might have been one night where there were issues at home. 99.9% i never use my phone except at breaks. but occasionally things happen and it would appear to others
that i'm not a good nurse. i don't hide to text, but i get out of public areas because i think it looks better. veteran nurses also get to the point where they know when things are bad or not right. they also know when a good time is to "hide" in an area to send a quick text. we are still humans and things happen at home. it is not possible to just go home.
on the other hand there are nurses out there that don't pay attention to their patients. some text all the time, some hide in the med room, some dissapear, some talk on the phone at the desk and some sleep. but one day is not a good judge if this nurse if one of those.
are you going back? if so, i would be interested if this is normal behavior for this nurse. i think you did the best by just mentioning it to your ci.
forgot to add: the reason why thy banned cell phones at our old facility was because a cna was talking on the phone while someone was hanging in a hoyer lift. one person's lack of judgement can ruin it for others that have some sense of responsiblity.
Specializes in CCU, SICU, CVSICU, Precepting & Teaching.
i had was doing a clinical on the medical icu unit and the rn that i was working with was constantly text messaging instead of caring for her pt. she didn't start doing anything for him until about 10:30 and she came on at 7:00.
what (if anything) should i do? file a complaint with the hospital? leave it alone as a possible isolated case? the pt was fine and she did what he needed, but it seemed as though she did the absolute bare minimum...
i've been thinking about it since then and would hate to know that my loved one was in icu and his/her nurse was texting.
are you sure she was text messaging rather than looking up meds, calculating drip rates, calling protocols up on the intranet? if she was text messaging, are you sure she wasn't texting a physician to ask him a complicated question, texting a clinical instructor to communicate about the type of experience you needed, texting her manager to brain storm about the new heparin protocol she's in charge of writing or texting hr about the final paperwork for the orientee she just precepted?
as far as what you should do, think about what you would want that nurse to do if she believed you were behaving in an inappropriate way. should she file a complaint with your school? write an incident report? report you to your instructor? or just sit you down and talk to you one to one? nurses are people, and some of us are better at giving feedback than others. wouldn't you rather have someone say "i think it's inappropriate for you to be blowing bubbles with your gum in front of patients." than file a complaint with your school or "write you up" in some other way? i think if someone thought i was behaving inappropriately, i'd rather they just talk to me about it. then if i blow you off, you need to consider whether it's important enough to go up the ladder.
as a student, you have very little idea how things actually work in the icu as opposed to how you think they should work. it would be a great idea to get some experience under your belt before you start judging.
are you sure she was text messaging rather than looking up meds, calculating drip rates, calling protocols up on the intranet? if she was text messaging, are you sure she wasn't texting a physician to ask him a complicated question, texting a clinical instructor to communicate about the type of experience you needed, texting her manager to brain storm about the new heparin protocol she's in charge of writing or texting hr about the final paperwork for the orientee she just precepted?
good point. i am the one who often trouble-shoots problems between my hospitals and the schools who do clinical rotations here. it's very common for both students and staff nurses to misinterpret what they see in the behavior of the other. when i investigate situations, i often find that either the students misinterpreted what was actually happening with the nurse and patient -- and/or the nurse misinterpreted what was happening with the student and instructor.
i've learned not to take either group's comments at "face value." i have learned to talk directly with the people involved to find out their perspective before assuming that the first report of wrong-doing i hear is accurate.
personally ... while i know there can be "bad apples" in every bunch, i find it hard to believe an icu nurse could be so neglectful of her patients and not have her collegues complain that she is not pulling her own weight. that would be pretty rare.
Specializes in Emergency, Critical Care (CEN, CCRN).
+1 to IIg. There are just too many unknowns in the situation to make a definitive call. The staff RN could have been texting an MD, a PA/NP, an ANM or anyone, really. I'm a little concerned if the RN really was off the floor for that entire length of time, but again, if her patient load was appropriately covered and her fellow RNs saw no issues with her behavior, I'm not sure where one might point to a definitive fault. It's less-than-optimal practice, but it's not glaringly at-fault.
That said, I did rotate through one or two "Hell units" as a SN where the nurses really ARE that incompetent and patients' lives really ARE at risk. In that case, the proper hierarchy is: Staff RN --> Clinical Instructor --> Faculty of Record --> Director of Program.
In my SN career, I had a total of three incidents where I had to involve my CI on non-resolvable issues with a staff RN (unsafe practice r/t infection precautions, unsafe practice r/t medications, and lateral violence r/t poor unit culture, directed toward both my RN preceptor and myself), and in every instance the CIs backed me to the hilt and/or took it up with the offending RN's manager. However, in each case I made absolutely sure of my facts and documented my situation before "pulling the trigger" and calling my CI. I'd advise the same level of caution to anyone else in that kind of situation.
There is nothing wrong with a nurse text messaging in THIS situation. Her patients' needs were met. As a floor nurse, let me tell you students all something: we live in a world where nurses text messages ALL OF THE TIME. That doesn't make someone a bad nurse. If a patient is in pain, they drop the phone immediately and to medicate them. It's when text messaging becomes your priority is when it becomes a problem.
The very unfortunate truth is that you will see lots of nurses who don't live up to your expectations. So far in clinicals I've seen everything from the distracted (texting, carrying on personal conversations while calculating meds, talking on the phone while charting, etc.) to the not-so-caring ("I'm not going to do anything about that pt's fluid overload. Let the doctor figure it out.") to the truly dangerous (coming in completely hungover and talking about how she couldn't see straight). You will, too.
Although the nurse you were assigned to work sounds lazy and uncaring, we don't know all the facts and you, as a student, are not in a position to start a ball rolling that may cost a nurse her job, professional reputation, etc. I would mention to my clinical coordinator (or whoever assigned you to this nurse) that you had some questions about what you saw that day, for instance, how soon after receiving report SHOULD a nurse go in to do an assessment on the patient? In that way, you can discuss the (possibly) substandard care you witnessed without pointing a finger at someone else.
You may find that some of your best learning experiences come through witnessing when things don't go as well as possible; you can set your own personal bar high!
Ruby I love your forthrightness and that you just tell it how it is you have my complete respect. I also agree with you 100% that what the OP needs to do is talk to the RN - simple, enough said.
But I do disagree that the post is obnoxious, self-righteous and judgemental. The OP is a student and has posted on here because she feels she has a difficult dilemma. Although it was back in the dark ages I remember being a student on placement - I truly thought I could cure the world and had this holier than thou attitude that not only would I be the best nurse EVER but I would do no wrong. If I saw perceived wrong doing in my mind I would have felt compelled to put it right. I did not have even the most rudementary understanding of how a department worked and would have seen everything in black and white terms. You are so right when you say that the OP lacks any real working experience of ICU and this for me is the point. Surely it is up to us to guide and make the OP aware of the far bigger picture. That way she can grow into a balanced, fair and rounded nurse. I know that I made it through the early years because older and wiser nurses saw through my single mindeness and guided me in the right direction.
Specializes in M/S, Tele, Sub (stepdown), Hospice.
i found the op's post to be obnoxious, self-righteous and judgemental. and if that offends, i stand by my statement.
clearly i never learned to sugar coat anything and have a lot of work to do on tact. i still stand by my statement.
wow.........harsh. she didn't feel right about the situation & came here for advice - she didn't immediately go off & report it to the hospital. i think she did the right thing.
we don't know what that nurse was doing while texting.....texting physicians, etc. she could have also just been playing around & texting friends too. nobody knows. point is, she had a patient & thank god nothing happened but does that make it ok? texting here & there ok, but making that a priority while at work, not ok. sure the patient was taken care of but what happens next time.......she or her patients may not be so lucky.
for those who think the op is obnoxious, etc. can you honestly say you'd be 100% comfortable with this same rn taking care of your mother/father/son/daughter in the icu?! i think not.
my sister had a seizure in the middle of her c-section. the rn on the night shift was sleeping for almost 2 hours at her desk that night. nothing happened to my sister (she hasn't had a seizure since then) but that doesn't make it ok that her nurse slept during her shift!!!!!!!!!!! there are too many "what if's" to be negligible, especially when it comes to patient care.
Specializes in CCU, SICU, CVSICU, Precepting & Teaching.
ruby i love your forthrightness and that you just tell it how it is you have my complete respect. i also agree with you 100% that what the op needs to do is talk to the rn - simple, enough said.
but i do disagree that the post is obnoxious, self-righteous and judgemental. the op is a student and has posted on here because she feels she has a difficult dilemma. although it was back in the dark ages i remember being a student on placement - i truly thought i could cure the world and had this holier than thou attitude that not only would i be the best nurse ever but i would do no wrong. if i saw perceived wrong doing in my mind i would have felt compelled to put it right. i did not have even the most rudementary understanding of how a department worked and would have seen everything in black and white terms. you are so right when you say that the op lacks any real working experience of icu and this for me is the point. surely it is up to us to guide and make the op aware of the far bigger picture. that way she can grow into a balanced, fair and rounded nurse. i know that i made it through the early years because older and wiser nurses saw through my single mindeness and guided me in the right direction.
just my thoughts
i, too remember being a student. i didn't think i could cure the world nor did i have a "holier than thou" attitude. i didn't think i was anywhere near smart enough or knowledgable to be a nurse, and pretty much anything i saw a real nurse doing would have been right just because a real nurse was doing it.
i still think the op was obnoxious and judgemental.
Studying24.7
18 Posts
As a follow up, I did tell my CI and she said she felt it was unacceptable behavior on the part of the nurse. She did say the nurse quite possibly had some personal issues she was dealing with but should have dealt with it in a different manner.
My CI said that she if she were a patient or a patient's family member she would more than likely lodge a complaint. However, she said in this case to leave it alone because she does not want to lose the clinical site for the school because they are difficult to secure. Politics....
And just to clarify, the RN was definitely text messaging (we have the same phone, so it's easy for me to recognize). And when the nurse would take a break or go to the restroom, she would ask another nurse to look out for her patients. Obviously, she didn't ask for coverage when she went to text message in the supply room......
I understand everyone's point of view. I guess more than anything it was disappointing behavior to see-especially in an ICU. A few texts here and there would probably be acceptable, but in my eyes, to stop in the middle of starting meds, or just as you are about to check a cath for leakage to answer text messages isn't acceptable. I am only a student and am not out there as a working nurse with a full patient load. But when that time comes, I really aspire to treat all of my pts the way I would want my mother and/or father to be treated. If there comes a point that I get burned out, I hope I can recognize it and move into a different area of nursing that is not bedside- in order to continue to do my best.
A few semesters ago at another clinical site, one of the nurses would ask patients to rate their pain, but she would not document what they said, she would document what she perceived was their pain level. So disappointing. Brought that issue to my CI and I got the same response that this CI gave me. "That is completely unacceptable, but don't rock the boat because we need the clinical site."
.... thanks for your replies.