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.
It doesn't appear there was an incident at all here though. Nothing was done wrong, the patient was cared for and no mistakes were made with there care, I don't see where direct patient harm was done or in danger (like if the nurse was drinking or taking drugs) and we can't always judge everything by what MIGHT happen. According to the OP all the patients needs were met.
As long as humans are taking care of things, there will always be room for error unfortunately.
I have to disagree. Would this behavior be more intolerable if the patient were harmed by the neglect of this nurse? In a just culture, you examine the action of the person... did they know their behavior was wrong? Is there a hospital policy against texting on the job?
If she were driving a car and had an accident, is that okay?
I agree with the posters who suggested the student should let her instructor know, and leave it at that. The instructor then has an obligation to either notify the manager of the unit or the school faculty to communicate back to the nursing staff.
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- i've just had the chance this morning to read the replies to my opening post. i had no idea my asking for an opinion would provoke such outrage, namely from ruby vee.
first and foremost, i came to this board for advice- not for insults.
secondly, my intention was not to judge, which is why i asked in my opening post whether i should just view this as an isolated incident. i also stated in my second post that i understood the follow up povs.
a fellow student also had the pleasure of working with this same nurse in the same unit one week later. not surprisingly, he had the same experience as i did. said nurse was constantly text messaging- or should i put it in a different light so as not to be obnoxious or offend any of the veteran nurses on the board? perhaps this nurse has had a series of bad luck and had to text message again that day? or perhaps, dare i say it.... text messaging all day is simply what she does while she is on the job? yes, i said it. right out loud. blasphemy- i know.
(@ ruby vee) most of the replies to my post have been to jump and defend this icu nurse- while at the same time insulting me. for some reason, to the majority of those that replied, being a student nurse automatically means that i am ignorant to what is fundamentally wrong and right. the newsflash is that i am not ignorant and i do have the ability to decipher what is wrong and what is right. text messaging 70-80% of the time that we (yes, the petty students) are there (from 6a-3p) is not right. something the nurse is well aware of, as evidenced by the fact that her phone went straight into her pocket when the charge nurse was in the vicinity.
i am in my last semester of nursing and i have met and worked with wonderful and caring nurses. on the flip side, i've met nurses that should hang up their scrubs and do something that does not involve human interaction. i can tell every single one of you that if my family member were being taken care of by this specific nurse, i would definitely "rattle cages" and do everything i could do to keep this nurse away from my loved one. could that last sentence be viewed as judgmental on my part? absolutely. so be it.
the premise of my post was to seek advice about something that i thought was possibly unethical. any employee text messaging while on the job is flat out wrong. a professional registered nurse charged with the duty of taking care of critical patients who is text messaging all day is insupportable- whether you’ve been out of nursing school for 33 years or not, ruby.
wow- i've just had the chance this morning to read the replies to my opening post. i had no idea my asking for an opinion would provoke such outrage, namely from ruby vee.
first and foremost, i came to this board for advice- not for insults.
secondly, my intention was not to judge, which is why i asked in my opening post whether i should just view this as an isolated incident. i also stated in my second post that i understood the follow up povs.
a fellow student also had the pleasure of working with this same nurse in the same unit one week later. not surprisingly, he had the same experience as i did. said nurse was constantly text messaging- or should i put it in a different light so as not to be obnoxious or offend any of the veteran nurses on the board? perhaps this nurse has had a series of bad luck and had to text message again that day? or perhaps, dare i say it.... text messaging all day is simply what she does while she is on the job? yes, i said it. right out loud. blasphemy- i know.
(@ ruby vee) most of the replies to my post have been to jump and defend this icu nurse- while at the same time insulting me. for some reason, to the majority of those that replied, being a student nurse automatically means that i am ignorant to what is fundamentally wrong and right. the newsflash is that i am not ignorant and i do have the ability to decipher what is wrong and what is right. text messaging 70-80% of the time that we (yes, the petty students) are there (from 6a-3p) is not right. something the nurse is well aware of, as evidenced by the fact that her phone went straight into her pocket when the charge nurse was in the vicinity.
i am in my last semester of nursing and i have met and worked with wonderful and caring nurses. on the flip side, i've met nurses that should hang up their scrubs and do something that does not involve human interaction. i can tell every single one of you that if my family member were being taken care of by this specific nurse, i would definitely "rattle cages" and do everything i could do to keep this nurse away from my loved one. could that last sentence be viewed as judgmental on my part? absolutely. so be it.
the premise of my post was to seek advice about something that i thought was possibly unethical. any employee text messaging while on the job is flat out wrong. a professional registered nurse charged with the duty of taking care of critical patients who is text messaging all day is insupportable- whether you've been out of nursing school for 33 years or not, ruby.
you are my hero, studying24.7!!! i too always get the feeling the veteran nurses look down on me as well, just because i am a student. their holier than thou attitude is pretty obnoxious if you ask me. they forget they were students too once upon a time. i thought the point of this board was supporting each other whether veteran nurse or student. silly me ....
Specializes in CCU, SICU, CVSICU, Precepting & Teaching.
wow- i've just had the chance this morning to read the replies to my opening post. i had no idea my asking for an opinion would provoke such outrage, namely from ruby vee.
first and foremost, i came to this board for advice- not for insults.
secondly, my intention was not to judge, which is why i asked in my opening post whether i should just view this as an isolated incident. i also stated in my second post that i understood the follow up povs.
a fellow student also had the pleasure of working with this same nurse in the same unit one week later. not surprisingly, he had the same experience as i did. said nurse was constantly text messaging- or should i put it in a different light so as not to be obnoxious or offend any of the veteran nurses on the board? perhaps this nurse has had a series of bad luck and had to text message again that day? or perhaps, dare i say it.... text messaging all day is simply what she does while she is on the job? yes, i said it. right out loud. blasphemy- i know.
(@ ruby vee) most of the replies to my post have been to jump and defend this icu nurse- while at the same time insulting me. for some reason, to the majority of those that replied, being a student nurse automatically means that i am ignorant to what is fundamentally wrong and right. the newsflash is that i am not ignorant and i do have the ability to decipher what is wrong and what is right. text messaging 70-80% of the time that we (yes, the petty students) are there (from 6a-3p) is not right. something the nurse is well aware of, as evidenced by the fact that her phone went straight into her pocket when the charge nurse was in the vicinity.
i am in my last semester of nursing and i have met and worked with wonderful and caring nurses. on the flip side, i've met nurses that should hang up their scrubs and do something that does not involve human interaction. i can tell every single one of you that if my family member were being taken care of by this specific nurse, i would definitely "rattle cages" and do everything i could do to keep this nurse away from my loved one. could that last sentence be viewed as judgmental on my part? absolutely. so be it.
the premise of my post was to seek advice about something that i thought was possibly unethical. any employee text messaging while on the job is flat out wrong. a professional registered nurse charged with the duty of taking care of critical patients who is text messaging all day is insupportable- whether you've been out of nursing school for 33 years or not, ruby.
there are a lot of fundamental questions about this incident that you haven't answered. did the nurse go in and do a quick "sheet check" to make sure the sheet was moving (patient was breathing), his/her color had sufficient contrast with the sheet to be healthy and that the monitor alarms were set appropriately? if so, then perhaps letting him or her sleep uninterrupted until 10:30 was the most therapuetic thing she could have done for him. by the time you've had some experience, you'll be able to eyeball your patients briefly to see which ones are in trouble and which are not.
was she texting? or was she looking up drugs, making notes for that incident report she has to write later, calculating drip rates, consulting a lab value program or looking up policies on-line? if she was texting, do you know for sure that they were personal texts? could she have been texting the physician to let him know the lab values, texting the cath lab to find out what time they're taking the patient or texting the charge nurse about her student who wasn't in the room taking care of the patient as she had expected? where i work, we do all of those things on our cell phones. especially if we have a student or an orientee because there's only one computer in the room and we let them use it.
was she really texting for 3.5 hours, or was she texting off and on for that length of time (consistent with an ongoing conversation with the physician about his plans for the day, the pulmonary consult he was ordering and the tests he wanted done).
in the past, i've worked on hospital policies, unit protocols and the article we were writing for a nursing journal on my palm (with a keyboard, but some pdas don't have keyboards) while precepting. i'm always there if the orientee needs me, i'm not tying up the computer she needs to use, and i'm getting some work done as well. if you didn't know what i was doing (and didn't ask or i didn't tell you) you might assume i was texting or emailing my husband all day. (if you didn't know my husband and his horror for electronics.)
while as an adult, you may be equipped to know right from wrong, i don't think you're equipped to judge a practicing nurse. did you talk to her and find out her rationale for not doing a full assessment for three hours? did you miss a mini assessment while you were looking up meds? you don't mention talking to her about it at all -- just a conclusion that what she did was wrong and that you ought to "report her." but what i found truly obnoxious about the original post is the suggestion that you might "report her to the hospital" without doing any more investigation to find out what was truly going on, and that you didn't consider any intermediary steps along the way before you pulled the trigger on the big guns. your subsequent posts have indicated something a bit different than the original, but that first one was a real doozy!
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.
It is an important question that our colleague raises above. I have talked about this before in general on this board. I think there are so many issues in our field and it leaves us vulnerable to back-biting. We are in a female-dominated profession and we need to stop throwing each other under the bus and letting our personal feelings confuse the issue. The issue that the OP brought up is still a wide-spread problem all over. I feel sad when I see people attacking each other based on age and/or status (student versus veteran). LADIES (and guys), we need each other. I noticed that people still want to defend their attacking statements on this post. I still think we should stick w/ the issue and not focus on the individuals.
Specializes in CCU, SICU, CVSICU, Precepting & Teaching.
you are my hero, studying24.7!!! i too always get the feeling the veteran nurses look down on me as well, just because i am a student. their holier than thou attitude is pretty obnoxious if you ask me. they forget they were students too once upon a time. i thought the point of this board was supporting each other whether veteran nurse or student. silly me ....
veteran nurses don't "look down on students" just because you're a student. and we haven't forgotten that we were students and new graduates once upon a time. we know what you're going through; you have no idea what it's like to be stuck with a difficult assignment and tasked with a student to teach at the same time you're trying to do your best for your patient or patients. hopefully someday you'll learn, and you'll be in our shoes.
if all you want is "support" from this board, i guess i can't help you with that. especially not with that enormous chip you seem to have on your shoulder about veteran nurses. but if you've come here to learn about nursing from nurses, this is a great place to be. there are lots of veteran nurses on this board who can help you. if we think you want to learn. but from your post, you don't think you can learn from us . . . what a shame.
Specializes in CCU, SICU, CVSICU, Precepting & Teaching.
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.
it is an important question that our colleague raises above. i have talked about this before in general on this board. i think there are so many issues in our field and it leaves us vulnerable to back-biting. we are in a female-dominated profession and we need to stop throwing each other under the bus and letting our personal feelings confuse the issue. the issue that the op brought up is still a wide-spread problem all over. i feel sad when i see people attacking each other based on age and/or status (student versus veteran). ladies (and guys), we need each other. i noticed that people still want to defend their attacking statements on this post. i still think we should stick w/ the issue and not focus on the individuals.
thanks for listening.
the part of the original post that i found most objectionable was the idea that this student actually considered "reporting her to the hospital" without actually talking to the nurse about the behavior. talk about throwing each other under the bus! if she (the op) said she'd talked to the nurse before coming to the conclusion that she ought to report her, i'd have supported her (the op). i still find the idea of reporting someone to the hospital and threatening their reputation, job and livlihood without investigating further to be obnoxious.
i agree that texting, facebooking and surfing the internet while supposedly working are a big problem in the workplace. but i think one needs to investigate to make sure that's exactly what is going on before subjecting a nurse to the sort of hell the op is proposing.
Okay folks, it's time to take a step back from the edge (and the edginess) and return to the original topic. If you want to address each other personally, use the PM system. (Do keep in mind that PM's are still subject to the Terms of Service.)
It's okay to agree to disagree. Sometimes that's the only wise course of action. Please, refrain from taking each other to task in a personal way. It's rarely productive and the escalation in tension and tone can get a thread shut down.
Even if it doesn't come to that, the negative personal interactions really distract from discussing the original matter--what a student nurse should do when she observes a staff nurse doing something she thinks is wrong.
It's really important that a student nurse follow the chain of command. Why? Because she's a student nurse and probably hopes to remain one until she graduates.
Unless a staff nurse's actions threaten to cause immediate harm, you work through your instructor. Period. You trust her to handle the situation appropriately, and then you let it go.
If the actions of the nurse in question were obvious to a student, you have to believe that her co-workers are well aware of her behavior. If they choose to tolerate it, either she has legitimate reasons for what she is doing, or she is so capable that the technology is not serving as a distraction, or they all indulge in some kind of questionable stuff and they cut each other a lot of slack. It could be that workplace politics protect this nurse or that she has just been lucky so far not to have had bad consequences. Who knows? In any event, as a student, you have no standing to take this on, except to relay your concerns to your instructor.
Stepping outside that chain of command puts you directly in the line of fire. Even if you are correct in your estimation, you probably can't prove anything. You could cost your school a valuable clinical site if enough feathers get ruffled. And you could make the rest of the clinical time miserable for yourself and your classmates. In really bad circumstances, the school could sacrifice you to pacify the facility and keep the site available to future students.
Experienced nurses are just like every other category of people. Some are dazzling in their abilities and their example. Others, not so much. Recognizing this reality will keep you balanced in your reactions and able to assess what you see objectively.
Yes, it can be frustrating to think someone is "getting away with something," but life has a way of catching up with people who take improper liberties. It isn't the job of the student to try to right these wrongs. The student's job is to graduate, pass NCLEX, and join the ranks of the experienced nurses. Then someday she can teach future students good nursing care by example.
I think I'm about to do it! I about to eat my young!!(the graphic image in my head...)
To Study: while i dont think your entire story is a fabrication, it seems to me that it borders on incredulity. Really, you want us to believe that for 3.5 straight hours the nurse did nothing but text message? No assessments, no meds, food, water, toileting, no vitals? Really for over 3 hours? I can do about 90% of my assessments during the warm hand off with the previous nurse.
F/E, just saying good morning to a patient will tell you about his/her orientation, hand shake ability to move self in bed tells you about his muscle strentgh, looking at his skin says wonders about his integumentary assess., being trached or vented or breathing on room air vs. using O2 NC will tell you about his respiratory, is the patient swollen then you already know that the patient has cardiac issues, any drains or tubes from the abdomen is telling me about gastro. does the patient have a foley, well you already know to document exception on the urinary section in fact a peek will let you know color, clarity and amount. and since all paitents in the ICU are monitored you event know rhythm and rate of heart. All this can be done in about 5 minutes of seeing your patient, and other than shaking the patients hand, I havent even touched the patient.
Has this patient been there for a long time? Could it be that this Nurse has had this patient several days in a row, or even for several weeks.
When I was in nursing school I worked with a nurse in the DOU who seemed to be doing bad assessments. I asked how he was able to get things done so fast. You know what he told me? "I look at the patient, it gets easier with experience, and you get faster."
Also, dont you think that if she really was texting for 3+ hours her charge nurse, supervisor, fellow nurses would have noticed? As has been noted on other threads nurses are very caddy creatures and if we see someone sitting on their behinds for too long we will call each other on it. ESPECIALLY if patients are being neglected, because if she really wasn't doing those AM duties then someone else would have had to, namely her coworkers.
I may not agree with everything RubyVee says on this thread or others I do agree that Its not your place to go to administration!! You are a guest there to learn what to do and at times what not to do. Yes we have all been students, yes we have all seen things that diallusioned us, yes we know there is a difference between real world and Ivory Tower nursing.
There is a chain of comand for you to follow, that being to talk to your CI. As RubyVee pointed out, You never talked with the nurse herself. When you finally get to practice nursing on your own and have issues with a coworker, the first thing your supervisor will ask is "have you talked to them about it before coming to me?" So maybe that can be your learning experience from this, take it up with the person you have a problem with first.
I'm sure you'll make a good nurse b/c you wont be doing these types of things, good luck with the rest of your schooling.
I appreciate all of your input, especially the input that falls within the means of social acceptability. Unfortunately, this does not apply to all of the posts. Therefore, I will not be responding to this thread, but I will heed the constructive criticism.
Lastly, Ruby, I thank you for all of the time and energy that you have spent on my post.
JJGRN
31 Posts
I have to disagree. Would this behavior be more intolerable if the patient were harmed by the neglect of this nurse? In a just culture, you examine the action of the person... did they know their behavior was wrong? Is there a hospital policy against texting on the job?
If she were driving a car and had an accident, is that okay?
I agree with the posters who suggested the student should let her instructor know, and leave it at that. The instructor then has an obligation to either notify the manager of the unit or the school faculty to communicate back to the nursing staff.