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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.
Having worked many years in Med Surg, and floated to ICU, I found that I was so used to working my behind off on the regular floor that the ICU was a breeze. Of course I was not given the most difficult patients, but I was required to check their vitals, and do other assessments on an hourly schedule. I have found that cell phones/ texting/ and now facebook is a sore point with those who do drop everything to care for a patient, and those who make the non-text nurses work harder because they are having to do the texting nurses work. Management does not seem to be able to regulate this. We use cell phones, issued to us, to communicate in house. These do not work outside the building. A patient can not tell the difference in these or your person cell. BTW, using ear buds or blue tooth...really sucks. I find that many nurses can not listen and do their job at the same time SAFELY. Some staff will use their cells during their break and meal time/ and in the break room. That is what is expected.
I have been on the receiving end of a cell phone busy nurse while I was in intensive care. I tell you that when I started throwing everything I could reach out the door.....I would get attention. I was trached and could not talk,my airway would get blocked....and there was alway some idiot that would answer my call light with "can I help you". Did they not label it to know I could not speak?
BTW, do talk with your CI or if you feel comfortable enough, ask your nurse how she schedules her day. She may feel that she knows this patient very well, and does not need to devote too much time to him. NOT CORRECT TO NEGLECT. But I have found that some nurses think that way.
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.
It is indeed sad that an instructor's response would be "leave it alone, clinical sites are so hard to set up"...lest we wonder where health care is going? I feel that this was a valid concern on the part of the OP-some of the responses that I have read have made me want to scream! seems that the I in ICU means more than giving a minimum of care...
I am appalled that any health care professional is casually/constantly texting during work hours. That is a personal activity that should be done on an employees own time. If something is occurring in your personal life that is so important you have to pay attention to it for 3 hours before assessing your critical care patient, you shouldn't be at work. and if you are "looking up meds, info, communicating with MD" why are you not sharing this with your orientee? I highly doubt you would hide in a closet to engage in these "work related activities"! I for one admire the OP for her concern, I do not find her judgemental, she was simply asking for feedback and advice. Not assessing any patient for 3 hours IS negligent in 50 states and anyone who advises avoiding confronting this situation is complicit in that negligence, whether harm was done or not. Good for you, student nurse, for seeing, caring, and having high enough standards for yourself to question something that is clearly unethical, negligent and WRONG. This critical care nurse of 26 years welcomes you with open arms to your chosen profession.
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.
Seems that if someone is textmessaging ALL THE TIME it has become a priority...
i too have seen bad practice at clinicals, except that it was by my instructor and pe. Yesterday, my instructor was 2 hrs late to the floor, and left an hour early, now the schools policies state that no student is to be on the floor alone. We were left alone for three hours. Also we have been instructed to not do pt care :eek:but instead work on our worksheets such as care plans, lab data, medications, nd, and manifestations of illness. I got a verbal warning for walking my pt around the floor. I was told that if your pt is taking up too much time to tell them "i cannot help you right now i have to do my worksheets". The worse part is that i did just that (i do what i am told) and the primary nurse heard it, told the pt care rep she started asking other students if this was correct, which they said "it was". Now i am waiting for the repercussions. Along with that my pe sits on her backside and texts all day as well. Both my instructor and pe take long lunches while us students remain on the floor, having to refuse care, meds, and any procedure that might arise because we are without a instructor. Not learning much except how to cut corners with pt care so that i have as much time as possible to do my worksheets! Paying a lot for this education getting less in return.:up:
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this is just plain wrong!!!
Seems that if someone is textmessaging ALL THE TIME it has become a priority...
It's all about perception. Maybe the student was so annoyed by seeing the nurse text period that the amount of time wasn't really what it seemed or it wasn't as bad as it is being colored here. Not trying to say she is lying, but again, perception. Sort of like when someone thought their fish was "THIS BIG" when someone else didn't think it was that big at all. Who is to say. But she did not see direct negligence in the patient care. If she had then my opinion would be much different. It also sounds to me like the CI was trying more to pacify the student. I think if she truly did feel like there was true negligence she would have opted to further handle things. JMO
As an ICU Nurse who has reviewed all six pages of threads consider this:
-Would you be comfortable as a patient if your nurse was texting on her phone while titrating your cardiac or insulin drip?
-Would you be comfortable as a family member if you saw your mother's nurse constantly texting on her phone?
-Should an ICU nurse feel comfortable letting an unlicensed nursing student watch her patient while she goes to the stock room to text?
I don't care how stable the patient is, they are in ICU for a reason. A patient can go south in the blink of an eye. Even when your patients are stable, it is your duty to listen out for alarms, falls, or other possible events in your unit.
Why are my fellow nurses upset that the nursing student questioned this behavior? Why do you assume she doesn't have enough experience to "understand" the situation? Would you be so upset if a family member had raised the same concern? She may not be experienced but she sounds like she has a decent work ethic. I would rather have this person take care of me as a GN than the other experienced nurse. She would have at least assessed me by 08:30 and payed attention if my alarm went off. Keep up the good work nursing student!
Finally, if you have some personal emergency that requires you to text for 3.5 hours then you need to call in. Otherwise leave the cell phone in your locker. There may be a million reasons or possible scenarios as to why this ICU nurse was texting on her phone. The point is she spent 3.5 hours looking at her cell phone and not the patient! At the end of the day if something happens to your patient nobody will care why you were texting on the phone. Nursing has had to fight long enough to gain respect as a profession. It looks very unprofessional to be constantly talking or texting on your cell phone while on the job.
Ethically, no one should be texting or taking care of personal business while on the job. Any job. When you are on the clock, you are there to work. Period. If there is a personal emergency then handle it professionally. If it requires more than a short break to get it taken care of, then make the necessary arrangements to leave work. Companies consider being on the internet, making personal calls and texting personal business. Doing it while on the job is considered stealing and reason for firing someone.
Ruby Vee, BSN
17 Articles; 14,051 Posts
one of the things i've learned from precepting is that i learn something worthwhile from every student or new nurse i precept. i've never encountered either or preceptor or an orientee that doesn't have some good ideas to pass along, a unique way of doing things that works better than your way or a way to explain that procedure to the patient that's a better way to explain it that how i've always done it. i think perhaps you're judging nurses as "good" and "not so good" on flawed criteria, and deciding that the ones you judge as "not so good" have nothing to teach you except how not to be. you couldn't be more wrong. even the nurses whom you don't like -- or don't like you -- can teach you something valuable if you're open to learning it.
if i came to work for you at a plumbing business, i'd expect that you knew a lot more about it than i did, and i'd expect to learn from you. the fact that i've been a nurse for 33 years isn't going to help me learn to distinguish plumber's tape from a wax seal.
as a student, i don't think you have enough real world nursing experience to judge the nurses you're paired with. and the fact that you seem to believe you're qualified to judge either because you're middle aged or because you've been a patient tells me that maybe you aren't so open to learning from those you don't like. or maybe from anyone.