The nurse you dread working after

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Thought this would be a good topic for venting and to maybe help others realize why they may be annoying the next shift.

Came into work this morning to find the w/c blocking the door into the childs room. HOB is flat on a kid with aspiration precautions. Both rails are down...falls and seizure risk. Trash bag sitting in floor filled and tied up. Pulse ox turned facing wall. Ambu bag on the floor. Paperwork out of order/missing. Narcotic sheet not filled out. Flow sheet full and not replaced. Cabinets left open with items falling out. Bag of diapers upside down with diapers falling on the floor. No toilet paper, but empty roll left on top of the toilet and not even in trash. Dirty syringes and med cups. Meds signed off that aren't even in the home. Of course, its not worth complaining to the office, coworker, or parent. So I just fix everything and document to keep the peace and remind myself I don't have to work after that nurse very often.

What annoys you when you get to work after those certain nurses?

While most nurses I work after are fine. There are also the nurses I like working after because everything is ready to go when I walk in. I try to do the same for the next shift after me, knowing that if things go wrong with the patient that at least they will be organized and ready to handle whatever comes up.

Specializes in Peds(PICU, NICU float), PDN, ICU.
To the op regarding aspiration issues:

Was the pt on a pillow?

From what i see among other nurses,a pillow counts as head elevation?

Anyone got info on that?

I see lots of nurses saying it is ok if the pt has a pillow as that counts as hob elevated 30 degrees.

I disagree though.

I also saw infants with gtubes and aspiration precautions lying flat on the crib mattress in the PICU....

A pillow doesn't count when the HOB isn't up. A pillow won't do much in keeping acid from flowing. Also the 485 has specific instructions on how high to keep the HOB up. This is a kid with a history of aspiration and ventilator associated pneumonia. Kid is on a vent.

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Ok thanks SDA.

One nurse told me that since it does not say to elevate hoB for one of my kids with a Gtube on the 485 we do not have to do it.

I always thought something like elevating the HOB for all pts with a gt was common sense and you do not need the 485 to specify it for you.

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Specializes in Peds(PICU, NICU float), PDN, ICU.
Ok thanks SDA.

One nurse told me that since it does not say to elevate hoB for one of my kids with a Gtube on the 485 we do not have to do it.

I always thought something like elevating the HOB for all pts with a gt was common sense and you do not need the 485 to specify it for you.

There are some nursing interventions, that don't need orders. Kind of like gauze around a GT (although I see orders for that from some nurses). Or repositioning to avoid bed sores.

If someone aspirates while in bed, I would bet that one of the questions to the nurse would be asking if the HOB was up. Or what you did to to prevent it.

As an LPN, you could always throw it on the RN if its not on the 485 and something happens. But its not worth getting to that point. The pt deserves a nurse with common sense. If I question why something isn't on the 485, I'll notify my supervisor and document it.

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Specializes in Complex pedi to LTC/SA & now a manager.

The standard of care is HoB elevated ~30* during/ post feed if enteral, especially if aspiration risk. A foam wedge works if the actual bed cannot be elevated. A pillow is insufficient and one pillow will not elevate 30deg.

So follow the standard of care per nursing fundamentals unless otherwise specified. I have one kiddo where due to specific comorbidity we start at 30 and lower to 5 or 10 if needed as >30 increases emesis and sometimes 30 is too much. But again, these are patient specific directives for a very unique kiddo. But the change in condition between upright, fowler , semi fowler, low fowler and supine are dramatic.

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Even worse than the dreaded nurse: the family that leaves piles of dirty laundry, the unorganized work area and absolutely zero supplies in work area... they leave it for the nurse to fix because "that's their job".

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Specializes in Pediatric.

That sounds like an awful situation to walk into. It makes me sad that saying something to your agency wouldn't help matters. I get why it wouldn't, though. I'm sort of surprised the family puts up with all that. Yikes.

In a similiar vein, like someone else said, I don't enjoy working in homes where they don't have the needed supplies. One home, the mom never could keep Tylenol stocked.

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Don't know why but paperwork out of order makes me crazy annoyed!

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Specializes in Peds(PICU, NICU float), PDN, ICU.
Don't know why but paperwork out of order makes me crazy annoyed!

Please come work with me! :-)

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Specializes in Complex pedi to LTC/SA & now a manager.
Don't know why but paperwork out of order makes me crazy annoyed!

I agree. Drives me batty!!!

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Specializes in Med/Surg, Peds, Geriatrics, Home Health.
Wow, guess you had a bad day to point fingers like that. I'm very competent at charting and don't need you to tell me what to chart. Since you feel the need to accuse someone instead of offering valuable input, I'll prove you wrong. My notes always reflect how I find a patient when I arrive. If the HOB is down, I document it and document what I did to correct the problem. If the rails are down, I document it and what was don't to fix the problem. Anyone can read between the lines to figure out what is going on.

For your next accusation, nobody was in the room between the other nurse and myself. I would be giving too much identifying info about the home environment to explain why.

I hope your day gets better, geez!

Be careful SDALPN, sticking up for yourself and calling others out for their behaviors causes your post to disappear. I am also guilty of these things.

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Specializes in Med/Surg, Peds, Geriatrics, Home Health.

amoLucia, I understand where the OP was coming from, your original post did seem accusing. But after reading this response I now also understand where you are coming from. I see now, and she probably does too, that you meant well and did not mean to offend. Others could learn from your example; your apology and explanation was thoughtful and I'm sure the OP appreciated it. Shoot, I forgot to quote your response, but I'm sure you know what I'm talking about.

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Specializes in Med/Surg, Peds, Geriatrics, Home Health.
Agree with everything said about annoying coworkers. To this I would like to add those who take liberties with committing fraud and convince the family to go along. The family then pressures me to do the same. When I tell them why I refuse to break the law, they look at me as if I am crazy. Of course, because the other nurses haven't gone to jail for this, that makes me wrong all the way around.
Oh yeah, that is a bad one. I hate being put in that position.
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