RN trainwreck

There is a RN that I know who I am very concerned with getting report from. She does not include necessary information all the time...like the person did not urinate her shift !! Or she blows off things that are really important. -not putting a new iv in someone who is on continuous heparin or not doing a set of vitals or the pre op checklist for a first case for surgery-No one will do anything about it and she just keeps messing it up. And messing it up for the rest of us who she gives report to....Granted, I make mistakes...but I am a new nurse...But it is so difficult getting people from her...even when I think I have fine tooth combed through everything...sometimes I miss something...like today I missed something until the end of my shift -cause it was busy, blahblahblah- What should I do?

I'm still a student so I don't know what to say, just chiming in to give you some online moral support. (a lot of those things she is doing are pretty big no-no's like the pre-op checklist! and the new IV)

I think you should talk to this person. "Yesterday after you left, I found........." and also inform the charge nurse or first in the chain of command. Often people bitterly complain to one other about such a person and don't do anything about it. Or they report it to the manager and "nothing is ever done". Following up with the individual on an one-to-one level, as well as a management level might work.

Also, as you say you must realize that we all miss stuff and make mistakes, yourself included (although you were able to justify it with "I'm new and it was busy", you also have to give others, even us experienced nurses the same consideration you're asking of us to give to you). It's a 24-hour operation and we should support each other through these things.

Maybe you need your own checklist to ask HER when she reports off to you.

Did he void?

IV? Yes? Running what and what rate?

Febrile?

Make it up for yourself, plug in her stuff, and ask about the gaps.

I know, it shouldn't be this way, but it often is.

As you gain more experience you will get better at knowing what questions to ask during report to bring out the problems. Sounds like you have already made progress in that area.

The next time it happens, I would definitely address it directly with her, in a non-confrontational manner. When a person knows they will be held accountable for his/her actions, it improves the quality of work.

Maybe you could request to do a walking round with her during or after report to possibly catch some of the issues while she is still there. Also, I would consider doing a chart check immediately after getting report so that if there are orders she didn't pass along you will know about them at the beginning of the shift rather than the end.

Just to be clear ... are you saying that she doesn't chart things like I/O, vitals, etc. ... or just that she doesn't include them in her verbal report to you?

If it's just that she's not giving you this info in report ... then what you're saying is that she doesn't give report the way YOU would like it and therefore you're calling her an "RN trainwreck."

Hmmm ...

If she doesn't include I/O in report ... perhaps it was WNL. You have 2 options: look it up (or see it when you chart your own I/O later in the shift) or ask her during report if you consider it to be necessary that you know right now. Anything else is, IMO, passive-aggressive and unproductive.

:caduceus::monkeydance:On our floor we have gone to an SBAR format for report.

_S situation--why the patient is ther, cc,age ,hx, etc

B_ backround--what has been done to date:tests ,consults, abnormal labs etc

A_ asessment: vitals--WNL r what they are, I&O, BMs , Blood sugars etc

R_ recommendations : what should be done: pending tests, labs, discharge arrangements etc

We use one original and update it in the front of the chart--we keep one as our report sheet to use for the day and then update for the next shift.

It seemed stupid at first but it helps alot because you can follow it as you give report and do a systems approach if you want

Also if you our reorting to the sam next -then you just update it.

As for someone missing things in report: approach her first to let her know that she missed things before going above her. She will probably be glad you did. Don't be a tattle tale when you are new....no one is perfect. Everyone makes mistakes, the important thing is to learn from them.

Maybe you need your own checklist to ask HER when she reports off to you.

Did he void?

IV? Yes? Running what and what rate?

Febrile?

Make it up for yourself, plug in her stuff, and ask about the gaps.

I know, it shouldn't be this way, but it often is.

Good Idea!

I agree with the above post. Let her give report, and when she's finished ask her questions to fill in the holes.

Maybe you need your own checklist to ask HER when she reports off to you. Did he void? IV? Yes? Running what and what rate? Febrile? Make it up for yourself, plug in her stuff, and ask about the gaps. I know, it shouldn't be this way, but it often is.

In defense of your patient and yourself, this is an excellent suggestion. If you get negative answers, ask this person if she has time to go with you to the room (or computer, or chart) to obtain the info, or to stay after "for a few minutes to get that IV started for me while I finish getting report (or something similar)." We all have days that circumstances keep us from doing what we don't want to have to leave for another nurse. When it consistently happens, you know that someone either isn't a good time manager, or is just lazy. Talking with the person first, and then with your Manager, as the other posters have suggested is the best way to go, in my opinion.

Maybe you need your own checklist to ask HER when she reports off to you.

Did he void?

IV? Yes? Running what and what rate?

Febrile?

Make it up for yourself, plug in her stuff, and ask about the gaps.

I know, it shouldn't be this way, but it often is.

excellent suggestion,,,I have seen this used by nurses and they love it. Many actually make a report paper for themselves and make copies to use everyday.

As a new nurse, take into consideration that some orders are standard The IV will run at 75 ml/hr. The patient will get insulin drip tritated q 2 hrs, or Subq Lovenox given daily as a preventive. Asking questions is a great way to receive the answer you need, but know your policies. Reporting a nurse may actually backfire on you, be prepared to accept and live with the rebuttal, and have your professional life examined too. I have seen this happen sooo many times.

As a new nurse, take into consideration that some orders are standard The IV will run at 75 ml/hr. The patient will get insulin drip tritated q 2 hrs, or Subq Lovenox given daily as a preventive. Asking questions is a great way to receive the answer you need, but know your policies. Reporting a nurse may actually backfire on you, be prepared to accept and live with the rebuttal, and have your professional life examined too. I have seen this happen sooo many times.

I've never seen 75cc/hr as a standard IV rate. It is a common rate, but is still variable from patient to patient.