Problems with q15 rounds

[AustinPower]

I am one of two RN's on a 20 bed psych unit at night. We either have one or two mental health associates who are supposed to do q15 minute rounds with an RN also rounding hourly on the patients. The problem is that our MHA's often don't round at all and the few that do round only do so hourly. The MHA's at our facility have no respect for the nursing staff and get angry and vengeful if we ask them to do their job. My immediate supervisor has been made aware but they too seem not to care. If I go to my director, I end up with angry MHAs and an angry supervisor. I don't want anything to happen to my patients nor do I want to get in trouble. All of the staff is aware that all of the halls are being videotaped 24/7 but even that is not motivating my MHA or my immediate supervisor

How do they do q15 minute rounds at your facility? Do MHAs do all or most? How do you handle MHAs who don't do their jobs? Should I leave this facility since they don't back nursing staff?

[psych308]

At my facility we were having this same issue. IMO, the problem is the bystander effect. People get complacent with not doing checks due to not having experienced a situation where something went wrong, and everyone assumes the next person will just do it.

A few RNs put their concerns into writing to the supervisor with a suggestion of having assigned round times (either in hour blocks or at a set time each hour per person depending on staffing,) with a document requiring to be initialed as each person walked. It caused a fuss with the people who were set in their ways of never checking, but it took the pressure off of the few people that were constantly having to round all night long. It is definitely a better process now for employees and for patient safety. Try taking the pressure off your supervisor by suggesting a solution and seeing if that helps the situation.

[Psychcns]

Psych308..great idea. In this case the two RNs could go to their manager with a proposed solution! All it is doing is require accountability of the staff doing the checks-that they document them as they are doing them. The RNs should then be required to sign off that the checks were done. Everyone is more accountable and the unit is safe. Management has to support the safety checks are vital. All staff have to believe this. Maybe they shoul put together some Inservices.

[elkpark]

All it is doing is require accountability of the staff doing the checks-that they document them as they are doing them. The RNs should then be required to sign off that the checks were done. Everyone is more accountable and the unit is safe.

Are you really saying you've never encountered a situation where no one does the checks on nights and everyone covers for each other, including the RNs? That's the situation I encountered. I was sent, as a prn RN, to a geri psych unit I had not worked nights on before. I discovered that the standard practice on that unit was for everyone to sit at the nurses' station all night, or watch TV in the the day room, no 15" checks, and, toward the end of the shift, the techs would sit down and check and sign off all the boxes on the check sheets at once. Apparently, the usual noc shift RNs were okay with this. When I saw the checks weren't getting done, and I started getting up every 15" and doing the checks myself, the techs explained to me, with a straight face and complete sincerity, that that wasn't necessary, we didn't "need" to do the checks at night. I explained that we most certainly did, and I would do them myself if no one else was going to do them, because it was my responsibility to ensure that they were done. The way they talked about it, and their complete and sincere astonishment when I said the checks did need to be done, implied that they had been told by someone higher up that the checks weren't necessary at night. After that first night, I never had any problems with the techs doing the checks on noc shift, but I assume they continued their usual practice in my absence. As always, "the buck stops" with the RN; if the RN doesn't have the integrity and sense of responsibility to do the job right, it's not going to get done.

[Kel0725]

On 2/12/2016 at 9:28 AM, shamrokks said:

I'd leave. My techs always do their rounds as scheduled and it's never an issue. If I remind anyone they aren't vengeful and admin backs this up wholeheartedly. Patient and staff safety are a priority.

I Was one of your techs my first time working in psych and as far as I know we had a pretty good get going we worked really well together never an issue with the Q 15’s miss you Tiff! 
So proud of what you’re accomplishing