NayNeyRN

As a night shift nurse- being an after thought or completely ignored for any type of celebration. Our facility is a specialty surgical center with an overnight inpatient pool. Everyone else goes home when surgeries are done and we drop down to skeleton crew nursing staff to take care of the inpatients. Everyone in the facility on days got treated to donuts for nurses week, nights didn’t even get leftovers...?

To be fair to the 5th graders, even though I’m a nurse I’ve always been perfectly happy to roast myself if I am sick and have a fever. I can’t stand the chills.

Definitely not a SNF facility. We are a specialty surgical hospital, very rarely do we have patients that stay more than a day but occasionally we do. We have a very high patient turnover rate, and we have to do these on every single one of our patients, daily (but only on night shift). I get frustrated because we have done these before (and were ineffective), then they went away, and now they’re back. What’s even more frustrating is that we have been fighting a losing battle for years because there are some nurses that walk out the door without having charted a single assessment or rounding note all shift. One in particular always says “I’ll do it tomorrow” and frequently forgets entirely, or will spend all day charting what she should have charted yesterday and so we won’t even have an admit assessment on a fresh surgical patient. When we would bring this to the attention of shift supervisors and our manager, nothing was done, and we got given more work because “if you have time to tattle you aren’t busy enough”.

Getting slammed with multiple admits stacked on top of each other because the previous shift doesn’t do the admit requirements if they come after 1800, Pacu starts calling report at 1845, and then my next admit comes at 1930. So now I have three full admit assessments to complete, and need to do home medication med reconciliations on them so I can do med pass at 2100. Or the the fact that I continuously get the highest acuity patients, or the ones who had complaints and had to be soothed, or the difficult team, etc. because “you’re a strong nurse and you can handle it”.

Blackout curtains to help darken your room. Winter is always a bit easier to me because I go home when it is still dark outside, and then I go to sleep in a dark environment so my body thinks it is night. Once I hit bright sunlight, it tends to jolt my body awake, so I wear sunglasses as well if there’s any light outside. I may just be weird though...

How does your facilities handle 24° chart checks? Other places I have worked, we just verified orders were entered and signed off. But at the facility I work at now, we have a new form we must complete that wants us to also verify that previous nurses have done their charting. This seems excessive to me, as when I posted on here before others told me that I am not in charge or responsible for what others have or have not charted. I don’t think I should be policing whether or not my coworkers are doing their jobs. Does anyone else have any thoughts?

No, what you are thinking of is the nursing report sheet, or kardex. What I am referring to is the initial assessment done on every patient when they first report to the floor post surgery. Your head to toe assessment, that sets the baseline for patient health. For example, if a patient who had a knee replacement was admitted early in the morning, and I do my assessment, and find that the patient has drop foot when I wasn't told that in report, I'll go look at the admission assessment to see if they presented to the unit that way, or if it was a new. The kardex gets handed from nurse to nurse, the assessment is a part of the official medical chart that is subject to legal examination.

Our ER nurses typically do chart auditing. But it's not uncommon for a nurse to do a couple as well. Small facility means we wear many hats

But the patients ARE there? An admit arrives at 10:00 am, and no assessment until the next shift does their daily assessment that has to done every 12 hours. Shift change is at 0700 and 1900, anyone admitted after 1800, the night nurses perform the admit assessments

I've worked second shift at a larger surgical hospital, and occasionally work day shift if they ask, so I know how busy it can get. Any admits that come to the unit after 1800 are the responsibility of the oncoming nurse to assess. There have been many times where I get the patient that came in at 1800, then turn around and get my own fresh admit at 1905 (Sometimes sooner, but some of the PACU nurses try to hold them until after shift change for us). If it was just those not done, it wouldn't be a problem, but she gets admits starting at 1000, with no patients prior to that, and still doesn't get her assessments done. It's frustrating, because if I have a patient who is sedated or has something going on, I'll do a quick look back at the previous assessment to see if it's a new occurrence. I've had to narcan patients just after shift change before.

I 100% agree that pt care takes priority, I'm usually that way myself. But when she has two admits and no other patients the entire day, and NOTHING is done, well, that speaks of poor time management. As far as her telling the orientee to "leave charting for later" it makes absolutely no since, because she told her to give meds and chart later, empty drains but chart later, and all that. It is also pertinent to note, that the facility has computer systems in every patient room. Assessments take me about 15 minutes to complete and chart at the bedside. Meds should be charted as they are given.

I work night shift in a specialty surgical hospital. We get lots of admits, even well into my shift, and patients tend to discharge the next day (not all, but most). There is one day nurse in particular, who never seems to get her work done. She frequently times out the autologous blood re-infusion drains and has to waste the blood, and she barely does her hourly rounding charting. Most concerning though, is she often doesn't enter her admission assessments, saying that she'll come in and do them tomorrow. I had one patient that she did this on, and I went back in and looked at their chart after discharge, and she hadn't entered one at all, and it was now 48 hours post admission. She even told an orientee to not worry about charting, they could do it later and to make sure meds were passed and such, then went home and left the orientee at work hours after her shift trying to catch up on charting. I have brought these issues up with both the day shift supervisor/charge nurse and my unit manager, and am frequently told that "day shift is so busy" or that "they have 24 hours to get the admission assessment in". I feel as though my concerns are being pushed aside and swept under the rug, and I worry for both patient safety (what if we have an emergency or have to transfer a patient out and I can't present all the necessary data because she wasn't charting properly), as well as for my own license when I follow her. I am at my wits end, and I have no idea what I should do.