Carleyp

Hi friends, I'm an RN (ADN) of 2 years - new to LTC and new to allnurses! I'd really appreciate any opinions anyone has to offer about a situation (or person) at work that is starting to worry me. In brief my question is....Who takes the ultimate responsibility for an order being missed or transcribed onto the MAR incorrectly? Is it the Day shift RN who notes that he/she has taken the order off of the chart but; forgets to fill out the lab request, transcribes meds onto the MAR incorrectly or doesn't remember to write a resident's doctor appointment on the calendar? Or is the night nurse to blame for the potential med error or mistake because she signs the 24 hour chart check? (I'm in LTC now but when I worked acute we had to sign q shift or 12-hr chart checks so at least you technically couldn't be blamed for another nurses mistake.) I work 6p - 6a in LTC. My hall has 30 residents, with anywhere from 6 to 13 of them being skilled. As a newly hired staff RN I have various night shift duties such as; day shift staffing, Peg tube feeding changes with q day site care, O2 tubing and Foley cath changes, monthly MARs, etc. My problem is with the day shift RN that I follow. After she gives me report she always tells me how harassed her shift was and she basically tells me that it's my job to catch her errors. She loves to use the expression, "It's on you!' Meaning she isn't responsible for her mistakes because I'm the one signing the final chart check. Well last night I had to send 2 residents to the hospital and I didn't even get to complete the chart checks. Am I still responsible for her errors? This same RN admits to changing medication administration times so that more meds will be given on the night shift. She says she has to do this or she would have a "4-hour med pass". She also doesn't chart on skilled pts because she has too much to do. I think her "time constraints" may be due to a lack of focus. LPNs from other halls (who don't even know our pts.) fill-in on her days off and are able to pass meds on time and do the required charting. Part of this nurses problem may be that she schedules herself for six 12-hr shifts in a row so that she can have lots of days off in a row. The problem is she gets too tired and starts making too many mistakes. I've had several heart to heart talks with this nurse but she refuses to change. The worst part of the problem is that she is in an addiction recovery program...I'm worried that if I complain and she gets fired she may not be able to find a "monitoring" friendly employer. What a dilemma!!! Hey, venting here does seem to make you fell better. (Thanks for reading all of this.) -Carley