Pt got no care all night

medsurgnurse, RN · Mar 21, 2005

Its good that you did an incident report on it. the charge nurse should get disciplined not yourself. You recieved your assignment and carried it out.

aileenve, ASN, RN · Mar 21, 2005

That charge nurse is responsible for that patient! Especially a patient in restraints. Don't the RN's have to do an assessment each shift on all the patients on the ward? That has happened where I work, unfortunately there are always those "passive-aggresives" out there and to CYA you have to check periodically what's going on just to protect yourself:o

LPNer · Mar 21, 2005

That charge nurse is responsible for that patient! Especially a patient in restraints. Don't the RN's have to do an assessment each shift on all the patients on the ward? That has happened where I work, unfortunately there are always those "passive-aggresives" out there and to CYA you have to check periodically what's going on just to protect yourself:o

Here in Ohio the RN must do an assessment on admission. This is not neccessarily the first assessment, but ideally it is. The nurse assigned to the pt does the shift assessment.

An RN is not responsible for my pts, I am responsible for my pts.

However, the charge nurse is responsible for making sure the staff is aware of any changes to the assignment after it is posted!

LPNer · Mar 21, 2005

Its good that you did an incident report on it. the charge nurse should get disciplined not yourself. You recieved your assignment and carried it out.

That floor is a mess in general. We actually have nurses threatening to quit if asked to go there again. I do not see anything coming of this, she is one of the few willing to work full time up there, they surely don't want to loose her even though she is little more than a half witt. (There are a lot of other issues that I try hard to stay out of up there!)

shadowflightnurse · Mar 21, 2005

That floor is a mess in general. We actually have nurses threatening to quit if asked to go there again. I do not see anything coming of this, she is one of the few willing to work full time up there, they surely don't want to loose her even though she is little more than a half witt. (There are a lot of other issues that I try hard to stay out of up there!)

What about the nurse before you who left without giving report on her patient? She should be responsible for the patient until she report off on them.

aileenve, ASN, RN · Mar 21, 2005

Where I work the RN (there are always 2 each shift) must take responsibility for the pts. on the units. Sometimes this gives LPN's and NA's the impression they are not responsible for very much. Any time a problem occurs the mgr says "Who was in charge?" and which nurse was covering that patient? He/She is ultimately responsible. This causes a lot of low morale for the RN's.

Long Term Care Columnist / Guide · Mar 21, 2005

This is every nurse's nightmare! What I don't understand is, WHY did the charge nurse not tell you she assigned you another patient? And how is it that a patient in restraints (what are 3-points, anyway??) didn't have 1:1 nursing with at least a CNA?

That facility sounds like a huge lawsuit just begging to happen.......I'd get my rear-end outta there ASAP, if I were you. :stone

LPNer · Mar 21, 2005

Where I work the RN (there are always 2 each shift) must take responsibility for the pts. on the units. Sometimes this gives LPN's and NA's the impression they are not responsible for very much. Any time a problem occurs the mgr says "Who was in charge?" and which nurse was covering that patient? He/She is ultimately responsible. This causes a lot of low morale for the RN's.

I don't know what to say to you about that other than your facility sure is underutilizing thier LPNs. The law clearly states an RN must be there (in acute care) but it by no means says the RN is responsible for anything other than her own pts, unless you do some kind of team nursing where the team leader is responsible for her team members and all the pts.

We do not function that way, I am responsible for my pts. Of course, I do have to know they are my pts! Which, the charge nurse IS responsible for.

LPNer · Mar 21, 2005

What about the nurse before you who left without giving report on her patient? She should be responsible for the patient until she report off on them.

Apparently she had taped report, and didn't have any updates to pass on.

luvin2nurse · Mar 21, 2005

:sofahider Situations like that are exactly why I am leery of working in hospitals. There seems to be a lack of verbal communication between nurses. It's dangerous to assume that someone will recheck there assignment after their shift has begun. The other nurse should definitely be the one disciplined!!!

LPNer · Mar 21, 2005

This is every nurse's nightmare! What I don't understand is, WHY did the charge nurse not tell you she assigned you another patient? And how is it that a patient in restraints (what are 3-points, anyway??) didn't have 1:1 nursing with at least a CNA?
That facility sounds like a huge lawsuit just begging to happen.......I'd get my rear-end outta there ASAP, if I were you. :stone

It's not the facility, it's that one floor! Nobody wants to get pulled up there! They can't keep regular staff. Of the 4 nurses on the unit last night, only one (the charge nurse) was a regular staffer. I was in from another floor and the other two were agency.

Staffing that place is the supervisors nightmare! Nurses have gotten into the habit of calling just before the cut off time for "calling off" to find out if they are being floated up there. If they are being floated, they will "call off" rather than go. It's so sad.

Until now, I have been willing to go and just CMOA as much as possible. But, darn, still goes the same, I have to know I am assigned before I can do that!

I routinely spend a good portion of the shift changing old IV sites, left in for 4 or 5 days, one night, I found an empty IV bag, went to get a fresh one, hoping the site wasn't gone only to find the order had been written 2 days before to DC the thing!

Another nurse, couldn't find a chart, seems it had been missing for some time becasue the bedside nursing notes were piling up in the chart slot.

She spent a good portion of the shift looking for that chart. Finally found it at 0700 when the day shift unit clerk came in. She tore the chart apart and it was in the process of heading to medical records becasue the pt had been dicharged 3, yes THREE, day earlier!

I could go on all night about this floor. I can not understand how our facility can handle it. It's a great hospital. Pt care is generally excellent, we have a great CVS unit, a great sports medicine surgical unit (that's my floor) and a fantastic bariatric unit. Not to mention a pretty darn good tele unit and sub acute care unit, as well as a highly regarded rehab unit. It's this one floor. It just burns me up that it is sooo bad!