Receiving report

Thank you.

I give families and nurses 15 min. After that, the agency us paying and I notify the agency so they can handle it. Scheduling isn't my job and its not my place to discuss it with the family. The agency can and will contact cps if the family can't be on time regularly. The agency can contact case managers if there is an issue. Life happens and people are late. But after 15 min, its time to make calls. If it happens on a regular basis, I'll find a case that has less issues. If its a nurse regularly late, I'll call every time until the nurse is dealt with.

I would hope the nurse/family would give me 15 min before disturbing the agency. And I do the same for others. I'm reliable and expect others to have the same respect. But I also realize traffic, accidents, car issues, kids, etc happen. 2 hours of waiting is ridiculous. You deserve pay and the agency pays, not the family insurance. So when the agency loses money like that, they will deal with the family you have pretty quickly.

Regarding report.... if you're already familiar with the case and if there are no extenuating circumstances, what more are you wanting for a report? I had a case where, "He's doing good, nothing new" was a perfectly reasonable report.

However, that was also a case that had a whiteboard on the wall that listed date of last BM, date of last trach change, date of last port flush, etc. If this is the type of information that you need that the mom isn't giving you, simply ASK her -- when did he last poop? When was his trach last changed? When was his port last flushed?

But if his meds haven't changed and his schedule hasn't changed and his treatments haven't changed and his symptoms haven't changed.... what exactly is it that you're wanting her to report to you?

Regarding the family not being there when you're assigned to work, if they don't give you advance notice of a later start time, you should definitely be getting paid from the time you were scheduled to start if you show up and nobody's home. If the agency isn't able to bill for your time, the agency can bring it up with the client's family directly. You deal with nursing stuff, the office staff deals with administrative stuff (like scheduling and billing).

You can also look in the chart at the other nurses' notes over the past several days. That can give you clues how the ct has been recently. Even if I get a decent report from the parent, I still review the chart and usually can pick up an extra bit of information that the parent forgets to tell me. Sometimes you can see patterns in the hourly vitals and suction frequencies that might indicate a concern.

Once, after getting a "she's fine" report, my assessment showed clearly otherwise- diminished lung sounds, elevated temp, increased HR and RR, lower O2 sats, and the nurse from the previous night also documented abnormal vitals, but her notes said nothing amiss and gave the parents a "she's fine" report in the am. Turns out that child was starting with pneumonia and everybody missed it. So if you get an ambiguous report, sometimes you have to rely on your assessment skills to determine the truth.

In October he had back surgery and I had no idea he even had that scheduled. I went in for vague report from mom during my assessment I saw his back bandaged up and my pt told me he had surgery recently. I looked in his notes nothing was mentioned and when mom came home I asked and she said oh yes he did but he's doing good and has had no complaints. Or one time he had fallen out of his wheel chair and mom didn't mention it wasn't during assessment and asking about his day he told me what happened and that he had been seen by the dr.

I do try reading other nurses notes but I know at 6am mom wakes up signs your paper and doesn't want to give you time to place it in his binder. I try placing it as fast as I can being that I'm only there once a week I don't want to take their copy home. But I know his regular nurse will take notes with her and placed them at the end of the week.