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!
[i'd agree if it were an isolated incident, but what if she's been making mistake after mistake? i'm happy to help where i can, and i hope when i'm experienced, i'll be able to take new grads under my wing. but if someone's really struggling and making a lot of mistakes, i'd probably say something. it would be up to the supervisor to figure out how to handle it most constructively.]
why assume that gt4everpn is making mistake after mistake? i didn't see anything in the post to suggest that they are incompetent.
and if they were then yes it would need to be reported to the supervisor and i would hope that the hcf would take positive action such as a preceptorship program, or something similar. calling someone after a busy shift on to tell them off doesn't really seem the best way to go about it.
i'm not assuming anything. i was simply asking a question. and still, it wasn't the day shift nurse who called her. it was the nursing supervisor who chose to handle it the way she did.
I think the point is that instead of speaking to the nurse involved, the person reported it to the supervisor. Some nurses do this when they really should be speaking to the nurse involved first.
Day nurses are, and have ever been quick to "get" night nurses on anything they think is irregular, to get help! They think night nurses have very little to do, as they have so much more to do, make less $$, and usually have fewer patients assigned to them.
You may want to look up the guidelines under your state's law, to see how the staff:patient ratio should go, copy that (if your unit is understaffed) and hand it to the day supervisor (who may or may not be appreciative).
Whatever you do, don't give the "evil" eye, or get into a squabble with the nurse who reported you. That night's over, tomorrow night is another day! I've been there, and learned the hard way.........
I remember as a new grad, uhhhhhh....okay, I'll date myself here, 19 1/2 years ago and went to work in a long term care facility. They threw me on the skilled floor and I hated it with a passion for that very reason. I knew nothing about the feeding tubes and had NO orientation. You're just supposed to know these things. And maybe you should have asked someone else about the feeding or if you were there by yourself, called either the day nurse that would have hung that feeding or your DON to see what proper procedure was. There should have been a policy and procedure manual on your floor also that would have told you about feedings. Look and see. Just remember this, if it doesn't add up....which the left over 400cc didn't.....then something was already wrong before you took over and finding out the reason before just jumping in and restarting the feeding would have been prudent. But as was said, this person has 6mo. experience and haven't we all screwed up????????? I agree on the bacteria thing. Feedings are only to be out for so long. But put this behind you and realize that it is a learning experience. Our first duty is to do no harm and if the patient is okay then that write up from the day shift nurse will come back to bite her/him in the backside someday. There are nurses out there that ascribe to the "How many people can I write up in my career?" philosophy.
I remember as a new grad, uhhhhhh....okay, I'll date myself here, 19 1/2 years ago and went to work in a long term care facility. They threw me on the skilled floor and I hated it with a passion for that very reason. I knew nothing about the feeding tubes and had NO orientation. You're just supposed to know these things. And maybe you should have asked someone else about the feeding or if you were there by yourself, called either the day nurse that would have hung that feeding or your DON to see what proper procedure was. There should have been a policy and procedure manual on your floor also that would have told you about feedings. Look and see. Just remember this, if it doesn't add up....which the left over 400cc didn't.....then something was already wrong before you took over and finding out the reason before just jumping in and restarting the feeding would have been prudent. But as was said, this person has 6mo. experience and haven't we all screwed up????????? I agree on the bacteria thing. Feedings are only to be out for so long. But put this behind you and realize that it is a learning experience. Our first duty is to do no harm and if the patient is okay then that write up from the day shift nurse will come back to bite her/him in the backside someday. There are nurses out there that ascribe to the "How many people can I write up in my career?" philosophy.
if you had read all the postings, you would realized that there may have been nothing wrong with that 400 ml hanging........
Specializes in Med/surg, ER/ED,rehab ,nursing home.
some nurses are insecure in their job and can not handle the work load. A suggestion? Why not have a new set up in the room ready to go! Be it a new bottle or complete change. Also turn up to full volumn all pumps. It has been a while since I worked at a LTC facility, but I was the only nurse for over 40 + patients. CNT's were the help, but only so much one can do.
Specializes in Jill of all trades, master of none?.
I agree.
Did you check to see if the feeding tube was clogged? The pumps don't always beep when this happens.
Did you check for proper tube placement? These things can dislodge and migrate.
Did you aspirate gastric contents to see how much residual was left?
If too much is left, you may need to call the doc. The next bolus may need to be held. The rate may need to be reduced, or pt may need a new med order to promote gastric motility, or whatever else the doc wants.
Also, feeding hanging around that long can quickly grow bacteria. I would not have infused it.
I understand you are upset about being reported, but please evaluate your own actions or lack thereof.
Thank you so much for that helpful message. As a student nurse who will be experiencing this next semester, this message will stick in mind and potentially save me in a similar situation. Yes, I've read this, but given facing it for the first time, would I have remembered it? I will now. Thanks again!
if you had read all the postings, you would realized that there may have been nothing wrong with that 400 ml hanging........
Forgive me for trying to encourage this girl. I think that if you had read all of my email, all I said was that she should have investigated it to see if something was wrong. Don't attack me. You are exactly the type nurse that she's talking about. I have over 19 years experience, and I realize that there might have been issues making the feeding run behind somehow, but that should have been told to her in report then!!!!!!!!! It didn't add up to the MAR so something should have been questioned. Now with that said, I will gladly bow out of this discussion.
Forgive me for trying to encourage this girl. I think that if you had read all of my email, all I said was that she should have investigated it to see if something was wrong. Don't attack me. You are exactly the type nurse that she's talking about. I have over 19 years experience, and I realize that there might have been issues making the feeding run behind somehow, but that should have been told to her in report then!!!!!!!!! It didn't add up to the MAR so something should have been questioned. Now with that said, I will gladly bow out of this discussion.
lololololololololol....NOO, i am not......been on the receiving end of it though......my point to you was only that in LTC they often use feedings with 48 hour hang times....this is apparently an intermittent feed...and the fact that there was some hanging did not, on its face,
indicate a problem of any kind......and as "dear abby" used to say, i dont give advice on the unasked question.....rough quote......lol, cant get over the idea that i am one of THOSE nurses!!!!!!!
FireStarterRN, BSN, RN
3,824 Posts
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