Some nurses make you sick!!!

Nurses General Nursing

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hello everyone!! so here is my vent!!!:angryfire, i work at this lovely ltc , anyway i just got off working 11-7 shift, the supervisor calls me as i am goin home and tells me that the day nurse called her and complained about a resident whos feeding is beeping and the bottle is empty, this resident gets 600 ml every 12 hours and the feeding is supposed to start at 2am, so at 2 a.m i go to start the feeding but there is 400ml in the bottle from the previous feeding,which finished at 12mn the feed is diabetic resource which comes in a 1000ml bottlet! this unit has 40 residents about 8 feedings, so while i'm doing other tasks i wait for the feedings to beep so i knowmy next moves, the day nurse comes in and starts complaining about how heavy the floor is and the feedings. i give report and leave i am expecting that the feed is still running!seeing that i started it at 2am and my shift ends at 7am, anyway she calls the supervisor on me and the supervisor calls me on my cell phone, couldnt the day nurse have spoken to me first?? if the feed ends 15 min after my shift ends am i still liable?? why did she have to call the supervisor to report me vs. starting a new feed and giving the 200ml balance that would complete the 600!

Specializes in NICU.

this is why people are assuming she didn't assess the pt, i think:

at 2 a.m i go to start the feeding but note that there is about 400ml in the bottle

it doesn't definitely mean she didn't do an assessment, but the way it's worded it sure sounds that way.

and i have to agree that i'd be hesitant to criticize the op to her face, from the tone of the post. it's also entirely possible (as long as we're being generous towards everyone's motives here) that the mean, nasty day nurse didn't try to get her in trouble. she may well have just mentioned something about it and the supervisor spun it. lord knows i've made offhand comments that turned into big dramas.

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This is why people are assuming she didn't assess the pt, I think:

It doesn't definitely mean she didn't do an assessment, but the way it's worded it sure sounds that way.

And I have to agree that I'd be hesitant to criticize the OP to her face, from the tone of the post. It's also entirely possible (as long as we're being generous towards everyone's motives here) that the mean, nasty day nurse didn't try to get her in trouble. She may well have just mentioned something about it and the supervisor spun it. Lord knows I've made offhand comments that turned into big dramas.

You know what they say about assuming...........

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Specializes in NICU.
You know what they say about assuming...........

Oh, for Pete's sake.

Given that none of us were physically present, I'd say that anything anyone has to say about the situation is an assumption, right? Really, any advice given on any message board is based on an assumption.

And all I know is that when I assess my patients, I note the amounts in each IV bag and feeding pump. That's part of a thorough assessment.

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Specializes in Day Surgery, Agency, Cath Lab, LTC/Psych.

If it were my patient I would have thrown out the 400 ml left and checked the residual and then hung the next feeding as ordered if the residual was okay. Then, I would have passed on in report to the oncoming nurse the rate of infusion and how much time it had left. I have had situations before where an off-going nurse has given me a poor or incomplete report and I have been "surprised" by a number of not-mentioned details when I go in to complete my own assessment. I'm not upset about the patient condition so much as I am upset about the fact that key details were omitted from the report. We often forget things to say in report, this is why we should jot down notes for ourselves on our brain sheets. Although your actions may have been perfectly reasonable, you need to realize that the passing off of a patient in report is a big deal. This is a great opportunity for you to learn many things. I would suggest being careful in report that you give all the necessary details. You say that you were upset that the nurse spoke with the DNS instead of you first, but you had already gone home when she discovered the feeding. What was she supposed to do?

I would suggest making hourly rounds on your patients and taking good notes on your brain sheet for report--both of these steps may prevent what just happened from happening again. The other thing I would suggest is that after giving report to the oncoming nurse you should ask her, "Am I forgetting anything?" That lets her know that you are open to feedback and questions.

The first year in nursing is the absolute hardest...try to learn all that you can during this time! :)

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Specializes in Licensed Practical Nurse.
where does it say in the posting that they didn't do an assessment?

at 19, learning life and career at the same time can be very overwhelming. where are the other nurses who are working with her? how come they didn't make sure things were done correctly?

also, nursing is continutity of care, not shift care!

team work is a big part of nursing. i see alot of people with the attitude that "thats not my patient" or "i'm a nurse, not a housekeeper"

what ever happened to common curtesy to help one another?

thank you everyone for your responses but the issure i was tryng to raise isnt about the feeding itself, it is about the nurse who heard the feeding beep and then called the supervisor to report me. this isnt really about me being a new grad, anyone makes a mistake, the machine beeped on her shift indicating the bottle was empty and she reported me as not starting the feeding when my shift was already over! i've never had a problem with starting feeds, it just so happened that it was empty and instead of coming to me she instead just called the supervisor to report me, if a feed finishes on your shift, how can you blame the previous shift for not starting it over, it wasnt finished yet!!:idea: and better yet put another nurse in trouble!

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Specializes in Licensed Practical Nurse.

in future, i think the best thing is to let the oncoming nurse know that the feed is still running and always tell her how much is up (remaining amount) the last time you checked it. this way she knows when to plan to hang a new bag/bottle. offer to check it before you go... she may just say, "thats ok, i'll check it, go home and get some sleep!". atleast this way she is aware of it.

i will take this piece of advice, thanks!! working at night with 40 residents and like 8 feedings its easy to forget , thanks!!;)

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Specializes in Licensed Practical Nurse.
lots of things wrong here, but does that really warrant a call to the employee? couldn't all of this have been brought up the next day when she/ he worked? i think i would have waited and spoke to the nurse when she came on the next shift and reviewed the policy of tube feedings.

i can't tell you how many times i came on a shift to an empty tube feed, a beeping pump etc. yeah...it isn't very nice, but if it happens all the time, you bet i might say something.

thankyou michelle, thats all i was trying to say!!

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Specializes in Licensed Practical Nurse.
i also cannot get past the fact that the op infused the 400 cc's that she found when she went to hang the new tube feeding.

but, my bigger concern is that the op stated the patient receives 600 cc's of tube feeding q 12 hours, that @ 2 am when she went to hang the new tube feeding is when she discovered that not all of the previous feeding had infused. why was this not discovered until 2 am? i may not be seeing the whole picture here, but it appears that the evenng shift missed this as did the op until 2 am. does the oncoming shift do pateint rounds with the previosu shift?

the feed starts at 2 am in the morning, it was m.d orders!

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Specializes in Licensed Practical Nurse.
Okay, original poster said 600ml q 12hrs - so the bag had not been up over 24 hours - only 12. So those that have complained about the length of the time it hung, it could have been perfectly within her guidelines. I know at the hospital I work at, bags are not to hang over 24hrs, so she would've been within our guidelines. I can completely understand the original poster. As new nurses we are always under the scrutiny of everyone and trying our hardest to do everything correctly. It sounds like this other nurse was just being a pain. Yes, the OP should have stated about the tube feeding in report, but if the nurse who received the patient had a problem - she could've called and asked the night nurse. If the night nurse's explanation was unsatisfactory, then she could've called the nursing supervisor. I'll tell you what, I learn a whole lot better from my fellow nurses pointing out things to improve my practice (It's called Constructive Criticism) vs being called by the nursing supervisor to tell me I'd screwed up with

something.

thank you widi 96! you said it better than me!!

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Specializes in Med-Surg/Tele, ER.
thank you everyone for your responses but the issure i was tryng to raise isnt about the feeding itself, it is about the nurse who heard the feeding beep and then called the supervisor to report me. this isnt really about me being a new grad, anyone makes a mistake, the machine beeped on her shift indicating the bottle was empty and she reported me as not starting the feeding when my shift was already over! i've never had a problem with starting feeds, it just so happened that it was empty and instead of coming to me she instead just called the supervisor to report me, if a feed finishes on your shift, how can you blame the previous shift for not starting it over, it wasnt finished yet!!:idea: and better yet put another nurse in trouble!

i find it distressing that you're still focused on the "what happened to me" aspect, rather than the "what i learned" aspect. your thread became about you as a new grad because your original post indicates you need some counseling on this issue, and from the information you relayed it's possible you're just missing some knowledge that will help you in the future. from what you've written, it seems you're so focused on being right about how you were treated that you're unable to also learn from the experience.

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Specializes in Licensed Practical Nurse.
I find it distressing that you're still focused on the "what happened to me" aspect, rather than the "what I learned" aspect. Your thread became about you as a new grad because your original post indicates you need some counseling on this issue, and from the information you relayed it's possible you're just missing some knowledge that will help you in the future. From what you've written, it seems you're so focused on being right about how you were treated that you're unable to also learn from the experience.

oh I learned something alright! I learned that some nurses are quick to report you! what else was there in it for me to learn??? I know about feedings, what else do you think I should've learned??? honestly?? Maybe I should have went straight to the what the problem was, putting aside the issues with the the feeding and what time it was and when it was hung, etc.. etc..., what I am asking is was it right for the day nurse, who came in complaining about the workload on the floor (I forgot to mention that!) to call the supervisor who called me at home to tell me the feed isnt started, when clearly it ended on the day nurses shift!!( should I have waited around for the whenever the feed ended to restart it??) Tell me what you think!!

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Specializes in LTC, Med/Surg, Peds, ICU, Tele.
I find it distressing that you're still focused on the "what happened to me" aspect, rather than the "what I learned" aspect. Your thread became about you as a new grad because your original post indicates you need some counseling on this issue, and from the information you relayed it's possible you're just missing some knowledge that will help you in the future. From what you've written, it seems you're so focused on being right about how you were treated that you're unable to also learn from the experience.

She's only 19

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