Signing off on another nurses paperwork

[cb9115]

Would you as a RN be willing to finish another RN's paperwork? In my situation I received a late admission, I attempted to finish as much of the paperwork as I could in the hour left on shift, and I did finish the most important assessments and paperwork. All that was left was a skin assessment at this point I need to finish my med pass and charting for other residents. So I passed this one thing off to the night nurse. Not only did they essentially put down my efforts because I didn't finish everything but then proceeded to tell me I should have gotten it all done in the time I had. Which had the admission come on time I could have and would have done. However, I told this nurse that if they were concerned about it being done in a reasonable time they could do it as the patient was still awake. The next shift I am handed a half completed assessment from the day nurse who also said the nurse who started it is the one who needs to finish it. So I gave it back to the same night nurse that night, who then decided to insist and argue that I should have completed it regardless of them starting it. I completely disagree I have never finished another nurses paperwork or assessment. Now I realize I could have just started over and did the whole thing myself, however I did not expect them to tell me I was wrong not to finish it. I see it as protecting myself by not finishing another nurses paperwork which is what I was taught in school but maybe I am wrong and should have finished it. So my question is am I wrong? Or would you have finished that assessment?

[Davey Do]

Would you as a RN be willing to finish another RN's paperwork?

I get handed off partially completed admissions and have handed them off also.

Some nurses will stay over late and complete an admission, for whatever reason. I have the belief that this is a 24 hour facility, I work an eight hour shift, and when my shift is over, it's time to pass the baton.

Of course, there are varying degrees to that belief. For example, it's a rule of thumb that if a patient arrives on the floor one hour before shift's end, the responsibility to complete the admission belongs to the oncoming shift. But if I get an easy admission on MNs and am on the unit with another nurse, I do the whole darned admission if I can.

Generally speaking, we work as a team and everyone does their part, so there's never really been any big problem.

[LPNtoRNtoNP]

I work at an assisted living facility and all of the nurses have seem to have different perspectives on this. I have no issue with the previous shift asking me to complete a skin assessment or something simple. What bothers me is when there are errors with the medications and they seem to brush it off. I hate is when people half @ss their work because you know when the sh_t hits the fan they're not going to own up to it! It seems like the people at your job were being super petty about your situation.

[cb9115]

I do also get admission paperwork handed off many times, which I do not mind doing but there are many parts to the admission paperwork and being all paper every place has its own sign off. I will always get 90% done at least typically the skin assessment is what gets passed because it can be the most time consuming if there are wounds. I don't feel I should have to stay late when another nurse can do that part especially when my facility actually penalizes us for clocking out late. I have refused to complete partial head to toe assessments not signed at the direction of that floor manager, instead I just started over since it was over 24hours since admission. Had I known it would be an issue I would have done the same thing as just starting over. I see it as protecting myself because if I am going to sign off on something I might as well start over to ensure everything is accurate to the best ability to prevent errors.

[BeckyESRN]

I don't know what your paperwork looks like, so I don't know if this is helpful. But, when we did paper charting, if a section wasn't completed by the admitting nurse, I'd fill it out and date, time, initial my work and sign at the bottom. The paperwork got completed, it made it clear that a section or two was filled at at a different time, by a different person. Nursing is a 24 job, if something doesn't get done, the baton is passed to the next shift

[brownbook]

If you cannot complete any aspect of patient care, from admitting assessment paper work, to something the doctor ordered, before the end of your shift, the oncoming shift should do it.

I have seen too many mistakes made because a nurse felt pressured to get something done so the on coming nurse would not have to do it.

Hopefully you work with a decent charge nurse or manager. There may need to be a staff meeting where the ugly words"common sense" are spoken aloud and staff are told that finishing assessments, carrying out doctor orders, etc., are a 24/7 job and oncoming shifts are expected to complete them. That except in unusual conditions, overtime will not be approved.

If you are told by the next shift nurse you have to stay and finish something smile sweetly and say..."Ok I'll go get overtime approval, then I'll stay and finish this."

Sure if every nurse that follows you finds you seem to always leave tasks undone, that is a different issue.

[AliNajaCat]

I would never recommend putting your signature on documentation of work you didn't do yourself. I have seen a lot of crappy initial assessments that have caused problems later, and saying, "I didn't do that part" when yours is the only signature on it is not gonna save your butt.

At least, in the narrative section of the initial assessment, put in a note that says "Sections A, B, C, E, and F done by Jane Smith RN at 2200." Then Mary Jones RN can note that she did Section D at 0100.

If your management has a hard time figuring this out, ask for an opinion from the organization's risk management office. That should clear things up in a heartbeat.

[Here.I.Stand, BSN, RN]

Several places I've worked at say that the admission must be completed within 24 hrs. Besides, shifts are 8 or 12 hrs long; not as-long-as-it-takes-to-get-that-perfect-bow-tied. So no, I get done what I can, and then advise the oncoming RN what remains to be done.

With paper charting, I signed only the forms and assessments that I had done. With electronic charting, each individual box has my info tied as the one who filed it. The boxes the next RN files will have his/her info tied to it. Simple.

[mmc51264, BSN, MSN, RN]

We get admissions at shift change ALL the time. We have 24 hours to complete all paperwork. I start with getting the minimum of a set of vitals, a quick skin assessment to look for pressure ulcers. Make sure they are comfortable, water (or something to drink if applicable) and check lines. many times off going and oncoming nurses can tag team a little but depending on the time, the oncoming nurse ends up doing the bulk of the admission charting. On my unit, we have a very high turnover rate (patients stay 2-3 days at the most) so we are pretty good at getting things done quickly.

Sometimes, I will float to another floor and admission will not be complete after 4-5 days or more!

[quiltynurse56, LPN, LVN]

I work LTC and the last place I worked in had it set up so that if the skin assessment could not be done by the nurse doing the rest of the admission, it would be passed to the next shift. Usually they were admitted on day shift. Most of the time the admission work was completed by that nurse. If the skin assessment was left, we did it on evening shift, usually at the time the CNA was preparing the resident for bed.

[cb9115]

Thank you all for your input. I spoke to my floor manager today regarding this issue and was told that I did indeed do the right thing. I feel better about the situation especially. It is also not the first issue that has been brought up regarding this nurse. I am still a new nurse in my 2nd year of nursing so while I try my best to do everything right I know there are things I still get wrong. Sometimes I let others cause doubt on my abilities even though I feel I am doing really well as a new nurse.

[applewhitern, BSN, RN]

We have policies in place for things like this. We can certainly let the oncoming shift complete paperwork. If the patient is taken care of, orders are initiated (stat drugs, labs, etc.) then the paperwork can be completed within 24 hours. We have an "admission check-off sheet" that you place your initials by the things you got done, and that way the oncoming shift knows exactly what still needs to be done. Pretty simple.