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Report or not when administrators have favorites

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by NeuroICU_RN NeuroICU_RN (New Member) New Member

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Report or not?

  1. 1. Report or not?

    • Report it to my admin
      5
    • Report it to BON
      4
    • Don’t report it
      21

30 members have participated

saskrn works as a RN.

8,659 Visitors; 560 Posts

IMHO, this isn't going to go well for you, BUT, I couldn't live with myself if I didn't report it. There is a difference between a bad report, and no report, and you essentially got no report.

I've been a nurse for a long time in various units, and I would be livid if I were you. She abandoned this patient - the patient literally did not have a nurse at one point.

I would report this to whoever I needed to until something proactive was done.

Good luck!

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8,591 Visitors; 677 Posts

As an Administrator and Nurse I can say things slip through the cracks. Do I have my favorites I can honestly say yes I do. I am human.

I try to use a decision flow that promote happy staff, happy patients. Even if I do not like you, you have called 1800 I hate my Boss on me I will continue to manage in a way I see fit for my facility operation that comply with policy and procedures. I am not a wall flower that expects perfection, I do expect the best care for our patients and a harmonious work environment with staff. I try hard to treat everyone firm, fair and consistent.

Clearly you stepped up and advocated for the patient.

Clearly you stepped up and sought out advice/resolution

Clearly you are a nurse who provides great cares

You stepped into a situation that was fragmented, incomplete, questions arose as to was this patient even taken care of...you stepped up and ensured this patient needs were met.

You texted and really did not get the answers or were ignored, not good but in reality this happens daily in the healthcare arena and in business.

In short you took care of the patient and then reported once your shift was completed.

You were involved in a situation that could have been avoided if people would step up and assumed responsibility after the nurse with the emergency had left. I too would be irritated in this but I would have after the initial try for report just reviewed and assessed the patient and gone on with my shift. I can deal with others at a later time I have things to do.

I really do not see favorites but I do see management lack of responsibility, they should be lucky to have you as an employee.

A lot of managers have been away from direct patient cares and may have forgotten a few steps, I think showing some grace would go far. Why don't you take this to your management as a lesson learned so you all can come up with a plan in case of emergencies we do XXXXX.

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Coffee Nurse has 10 years experience as a BSN, RN and works as a Staff nurse.

16,385 Visitors; 928 Posts

To OP: this is a lousy situation all around and I unfortunately don't have any clear advice on what you should do (aside from looking for a new job if your management is really that bad with playing favorites). I just wanted to speak up and say that I understand where you're coming from and I do not think you're a horrible, compassionless person for being frustrated that a decent report was not given on this patient or able to be gleaned from the documentation. I realize that we are all human and that things arise that compromise our ability to give excellent care 100% of the time (just the other night I thought I would have to leave work because my dad suddenly had to go to the hospital). However, we are also professionals and need to be capable of a degree of emotional compartmentalization. Had that patient had a bad outcome because of the poor report or lack of care for an hour, it would have been two families grieving a loss instead of one.

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Ruby Vee has 40 years experience as a BSN.

11 Followers; 65 Articles; 169,761 Visitors; 13,890 Posts

Just looking for some advice on a situation and whether to report or not or even how high to escalate it.

I work in a neuro ICU as a charge nurse and return to work one day to find that the day shift charge (L) had left early due to an emergency; apparently there was a death in the family. Another nurse took over charge and gave me report, but clearly didn't know very much about any of the patients except his own. I had questions about the final patient that the previous charge, L, had been assigned to that day. This was a fairly stable patient, hence why the patient was assigned to a charge nurse for the day, but nonetheless, this is a neuro ICU and the patient had had brain surgery, was wheezing, and retaining urine. Relief charge had no idea what was going on with the patient and all other day nurses stated they did not assume care of this patient. Relief charge then told me, "I guess the patient didn't have a nurse for the past hour."

I texted the previous charge, L, and apologized for bugging her during her family emergency but just wanted to know who she gave report to since charge report is vague without the fine details. No response. I was left with no other option than to give report on this patient to my night shift nurse based on my limited charge report for this patient.

My director showed up not long after and I explained the situation to him. He tells me, "Yeah, she's (L) not going to text you back. Under the circumstances, just have your night nurse read the patient notes." He leaves. I suddenly get a call from my clinical coordinator, my director's #2, and she tells me that she "heard" I had questions about a patient. I told her I spoke to my director already, to which she had no idea. This leaves me to conclude that L had completely disregarded my text and went straight to our bosses to let them know I was texting her.

This situation frustrates me in several ways. First off, to me, this nurse essentially abandoned her patient because she did not properly transfer care of her patient. Secondly, this patient had no nurse for an entire hour and considering her current state, a number of things could have happened and there would have been no nurse to take accountability for the patient. Patient safety was severely jeopardized here. It also put me in a position where I had to give report on a patient that I was not assigned to, did not care for, and had limited information on. Lastly, this nurse should have been a professional and responded when I texted considering she was the last known nurse for the patient, but for her to go over my head and straight to the coordinator was uncalled for. In the time it took for her to contact the coordinator, she could have replied back to me with a quick text.

I'm stuck with the decision now whether to report this or not because I truly think that it was wrong what this nurse did and that the patient's safety was jeopardized. I completely understand that emergencies happen, but proper handoff of this patient should have taken place. My reservations in reporting it though, are that for one, my administration is incredibly corrupt and they will throw anyone under the bus to get what they want, and will retaliate like they have with several of my colleagues. My admins are also very friendly with the day shift staff, as is how it usually is when night shifters are treated like the orphan children. So I know for a fact that if I reported this day nurse, that they would do everything in their power to protect her. Even my CNO and my director are very tight with each other, so that puts me in the line of fire with my entire chain of command.

What do I do? What are everyone's thoughts?

I am curious as to where you see the "favoritism" alluded to in your header. The previous charge nurse had a family emergency and had to leave work early. She reported off to another nurse, who dropped the ball on the patient the original charge was watching. Or maybe the original charge dropped the ball. She had a family emergency.

Sometimes balls get dropped. It is certainly not a matter for the BON, and you've already escalated it to your director. What more do you want to do? See this nurse in stocks? Extract a pound of flesh? She had a family emergency and she dropped the ball. Yes, it's less than ideal, and the patient certainly could have been negatively impacted. It does not sound as though that actually happened though.

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5,090 Visitors; 241 Posts

No need to report.

To be honest, when I was a charge nurse of a 30 bed unit. I'd rather not take any report from any CN... cause they don't know half of whatever's going in with the patients! :woot:

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1 Follower; 13,289 Visitors; 1,470 Posts

What I did was when I showed up, I attempted to find out if anyone had assumed care of the patient. Nobody had. So I gave report on the patient to the best of my ability to the oncoming nurse based off what I had, and helped her ensure the patient was stable. We inserted a foley, got the patient respiratory treatments, and then continued on with the shift. I feel that I did my job and improvised the best I could.

From what I understand, the director and coordinator were the ones that approved her to go home, so they were well aware of the situation. As far as the gap being filled, that's where the lapse in care was since the gap never got filled. Accommodations for this nurse were made as accommodations have been made for other nurses on day shift with similar emergencies. On the contrary, we've had a couple of night shift nurses go through the same issue and were forced to stay the duration of the shift or were written up.

I understand where you're coming from when you say that it's life and all because I've had to leave due to emergencies before and I've also been in such a rush that yes, I've forgotten to give report on a patient before leaving as well. But when that happened, I immediately went back to give report or I even called when I was driving to give report and answer questions. I didn't just disregard the correspondence and go directly to someone else to call the unit for me.

I didn't report or write an email to my director because yes, I know, things happen. Let me clarify that I'm not upset at the fact that she had to leave or the fact that she didn't transfer care properly. Things happen, yes, it's life. But if she knew she didn't do it properly, at least try to fix it or reply when I try to reach out.

You are assuming that she called someone else. You don't know that she did. She may have, as is her prerogative while experiencing grief. Perhaps she can sense your hostility and prefered to speak to someone kind in the moment. Her decision and none of your business. But you don't even know that.

She had a death in her family. That's a crisis. You were not in crisis with the patient. There was no specific information you needed that only she had. You should not have contacted her. Please think for a moment. If she was your close friend and you knew she was distraught over a death would you text her over this? I think not. How even less appropiate to text someone in that position with whom you are not friends.

Your behavior is inappropriate. If you were to "report her" for this it wpuld border on harassment. If I were your manager and received such a report I would counsel you on civil behavior in the workplace. If you repeated this kind of behavior I would write you up.

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Swellz has 6 years experience and works as a RN.

9,196 Visitors; 582 Posts

I feel like people are really overreacting here. I get it OP, it was a patient safety issue. I'm sure she was distraught, but what if something had happened to that patient during that hour? But honestly, it also sounds more like this particular issue is just one of many and set you off because of the history of experiences on your unit. At this point you've already said something to the logical people, so I think you're right to let it go.

Edited by Swellz
more thoughts

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3 Followers; 33,820 Visitors; 4,168 Posts

You were totally wrong to bother the nurse who had a death in her family.

(assuming it was immediate family and mostly not expected; if not, well, I'll feel more charitable toward you)

You freaked out about what "could" have happened. While I do understand that, you just, IMHO, used terrible judgment when you tried to reach the other nurse. You could have simply read the chart, assessed the pt yourself, gone to the Manager or whoever was next in the chain of command and might have known something about the pt, and realized that the previous Charge would have been in shock and how rude it was of you to bother her for what really was not an emergency.

Chill out if you want to not lose your job and be seen as "over the top".

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3 Followers; 33,820 Visitors; 4,168 Posts

If your unit is so corrupt, have you thought of looking for employment elsewhere?

Anytime favoritism has impacted my duties or schedule, I've just gotten out of dodge. I have found it is hard to prove favoritism and hard to get in favor of the favorites. Sometimes it is just best to move on.

While this is understandable, it just is not always possible to throw away one's pension, seniority, etc. Sometimes, we do have to stay and cope.

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3 Followers; 33,820 Visitors; 4,168 Posts

If I wanted to get this person in trouble, I would have reported her already and not be asking for advice.

But reporting to BON was a choice in your poll.

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3 Followers; 33,820 Visitors; 4,168 Posts

You're definitely entitled to your opinion about me, but you don't know me. I've been in this same situation before and I still gave report and ensured my patient was stable and handed off properly, regardless of how poor my report may have been and I always answered questions after I left work because it was still my patient.

I have no compassion? I've personally covered for several people for bereavement or emergencies, even if that made me work 6 nights in a row before. When things weren't done, I always tell them, "I'll take care of it, go take care of your family." I've taken on unsafe patient assignments so that nurses can leave for emergencies.

Why did you ask the question if you are going to be upset when some people disagree with you????

In the future, if you need to leave, you tell the boss you must, must, must go because you are not safe to do pt care due to the shock of whatever the issue is. Don't ask, tell them. And they can fire you, write you up, say you abandoned the patients and you will tell BON that you'd had a sudden death of an immediate family member and you were simply in shock. We are human, not automatons, we do sometimes need to leave work. And if your immediate boss won't help you, go over her head and tell them you are not safe at this point, and keep going til you reach the very top.

Of course, expect to be fired. I'm not saying it's easy or pleasant. You just have to do what you have to do. Break down and cry, howl, fall on the floor and roll about. Sit and suck your thumb. They'll escort you to your car.

Stop being nice to others if you have to. Life is hard. Sometimes, no matter what, we do have to suck

up the pain and soldier on.

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3 Followers; 33,820 Visitors; 4,168 Posts

Let me just clarify this for everyone:

I did NOT report her nor go off half-cocked running to the BON. The only reason the BON is even on there is because my entire administration protect each other, and I can't trust any of them. So who else do I go to? These were my thoughts during the whole process:

1) I think it was wrong that this patient did not have a nurse because the patient was definitely sick. Had something gone wrong suddenly, who would have been the one responsible? I'm not taking responsibility if something bad had happened. Had it been your own family member and you found out they had no care for the time, how would you have felt? I think there was definitely a lapse in this patient's care and I definitely think this is a patient safety issue.

2) I have NO animosity towards this nurse whatsoever. NONE. We joke around, we laugh. We're not friends because I only interact with her during change of shift, but I've never had any issues with her. She's an incredibly smart nurse and she's damn good at what she does. So there is absolutely no reason for me to even want to get her in trouble.

3) she lost someone and that is something I wholeheartedly understand. I am truly sorry for her loss and that's why didn't impulsively start writing emails or filing complaints. It could've been her kids that were hurt for all I know (it wasn't), so I definitely wasn't going to add insult to injury. I even hated that I had to text her because I really did not want to bother her. My only need to even text was that there were still some questions left unanswered about the patient that were not documented, and that would have directed us to what to do next for the patient.

4) in regards to everyone saying we should've looked through labs/notes/etc. WE DID. The key point here is that we were asking about things that were NOT DOCUMENTED. Hence why I felt it was important that she should've responded and why simply hearing from admin to "look at the notes" was insufficient. And in regards to HIPAA, simply asking the name of who report was given to on patient in room #__ is not releasing any personal info.

I guess maybe I should've rephrased the original post differently, because I'm realizing that it sounds like I am trying to put the blame completely on her, but that's not the case. There was just a lack of accountability here. I do feel that the ball was dropped here somewhere and if it were my own family member that was the patient, I would've been upset at the lapse in care.

I felt that I corrected the situation the best I could and made do with what I had. We handled it.

I was upset initially because I was walking into another situation I had to clean up, and it happens more frequently than I would like on this unit. But in a nutshell: I'm over it. I'm not doing anything about it. I have no grudges or ill will towards this nurse. I've already let it go.

You remind me of a nurse I used to work with. She was so hyper. She c/o about me and caused some trouble for me. But eventually the boss saw my side of things and fired her. Too hyper.

Maybe you need a break from ICU.

BTW, I do agree that since the nurse took the time to text or call the boss, she could just as quickly have replied to you. She just was not at her best and should not be expected to have used her best judgment right then.

Your boss should have come to the unit immediately and stuck around while stability was achieved on HER ward. Where the devil was she? So many bosses are such lazy devils.

Edited by Kooky Korky

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