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/outpatient FP,derm,allergy/private duty.
. . . 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.
I rarely read a narrative note from fellow nurses that doesn't start with the general appearance of the patient, with details such as you described. I make a habit of describing how I left them as well. We have check-off boxes for cleaning, changing tubing, cannisters, etc as well so I'd really love to see what messy nurse writes in her nurse's notes. Sounds like she's setting herself up for a big fall at some point if she is falsifying or not completing her documentation.
Ugh, came in today to find a note to all nurses, from super nurse, about how we should be positioning our patient and what setting the fan should be at. Also, where the tubing and wires should be placed while attached to the patient.
Ugh, came in today to find a note to all nurses, from super nurse, about how we should be positioning our patient and what setting the fan should be at. Also, where the tubing and wires should be placed while attached to the patient.
Uugghh. Those nurses. That stuff is overkill. Its one thing to leave a note about positioning if a nurse find something that helps. Its another when the nurse wants to control what goes on when they aren't there.
I found something on my case the other day where a nurse (who leaves those silly kinds of notes) placed tape on the end of the bed and write which way to turn the crank to move the HOB up and down. Really? I'm sure each nurse can figure that out. And if they don't know, its a 50/50 chance they'll get it right. And if they don't, they'll figure it out with no harm to the patient either way. If I were the parent, I'd be upset if someone put notes all over the place about stuff like that.
I like all my coworkers, but I do tend to chuckle and roll my eyes when a nurse feels the need to passive-aggressively micro-manage everyone else via notes. In my experience, it is rarely done in the spirit of patient safety, but rather a way for an overly-controlling, obnoxious nurse to ingratiate herself to parents. I'm a closet control freak, and it caused me enough problems in my pre-nursing career for me to NOT do the same in this profession. If a nurse is a little messy, I let it go, because not everyone is the same. If a nurse is late, I don't sweat it. Life happens. I'm not the boss of anyone, so it's not my job to nitpick unless I feel I'm being abused or walked on (I'm no doormat, but I have learned that if my buttons are easily pushed, I often need to re-arrange my button board).
If it's a matter of patient safety, you approach the nurse tactfully and respectfully without accusing. If it's a new nurse, you help educate them without intimidating them. And if it's an ongoing problem that poses a risk to patient safety, you take it to the case manager and let her be the one to leave notes, updates, and remind nurses of the POC/policies.
I will say though, the only nurse I've ever truly dreaded working with was the hyperactive one who added chores to the cleaning list, stopped Mom from doing housework and said it ought to the nurses' job, etc. Come on, lady, I *like* my downtime, please don't make me feel like a jerk for refusing to be a maid!
Is there harm in telling a pt's Mom that Sally is watching tv,and understands what her parents are saying even though she is brain damaged? (She really is not watching tv,and her eyes do not follow it) She has aw/sleep cycles as far as i know.
Or the other nurse who told the pt's mom that she had a dream Sally was walking when Sally has no purposeful movement and cannot walk?
What about actually writing in the nursing notes that Sally is watching tv when she has that dx?
I never thought about it too much until another nurse said its unprofessional.
Is there harm in telling a pt's Mom that Sally is watching tv,and understands what her parents are saying even though she is brain damaged? (She really is not watching tv,and her eyes do not follow it) She has aw/sleep cycles as far as i know.
Or the other nurse who told the pt's mom that she had a dream Sally was walking when Sally has no purposeful movement and cannot walk?
What about actually writing in the nursing notes that Sally is watching tv when she has that dx?
I never thought about it too much until another nurse said its unprofessional.
I would bring this matter up with the clinical nursing supervisor as it seems the other nurse might need some education on what is going on. It is the nursing supervisor's job to see that she gets the message. If you can approach this nurse, you can say something to her, but in many cases, nurses are not open to suggestions. She might turn on you. Better to leave the enlightening duties to the supervisor.
Makes me very, very glad I am the only nurse on my particular case, the parents are normal, and I work nights and they like me. Double bonus: My patient is super-cute and weaning off the vent!
Is there harm in telling a pt's Mom that Sally is watching tv,and understands what her parents are saying even though she is brain damaged? (She really is not watching tv,and her eyes do not follow it) She has aw/sleep cycles as far as i know.
Or the other nurse who told the pt's mom that she had a dream Sally was walking when Sally has no purposeful movement and cannot walk?
What about actually writing in the nursing notes that Sally is watching tv when she has that dx?
I never thought about it too much until another nurse said its unprofessional.
I usually stick to clinical references only. Professional behavior is key to success across the board.
I will say though, the only nurse I've ever truly dreaded working with was the hyperactive one who added chores to the cleaning list, stopped Mom from doing housework and said it ought to the nurses' job, etc. Come on, lady, I *like* my downtime, please don't make me feel like a jerk for refusing to be a maid!
How about when the nurses in the hope don't clean up after their treatments? I'm a big fan of using family approved cleaning supplies and only cleaning client care areas and commonly used items ie: light switches table tops hand rails trash can lids. With PCG consent of course. Decreases bacteria and viruses that keep out pts less chance of becoming ill.
How about when the nurses in the hope don't clean up after their treatments? I'm a big fan of using family approved cleaning supplies and only cleaning client care areas and commonly used items ie: light switches table tops hand rails trash can lids. With PCG consent of course. Decreases bacteria and viruses that keep out pts less chance of becoming ill.
Leaving a mountain of gauze, bandages and trash is different from being a little messy. I recognize some nurses don't do hospital corners, may not unclutter workspace, might forget to toss a 4x4 wrapper. I've never encountered a nurse who blatantly didn't clean up after treatment, although if I did, I would ask something like, "Hey, you are okay? There was a lot of trash/clutter in patient X's room, just wanted to make sure you're alright and didn't get hit with the shift from hell." If it was a habitual problem that was a cause for real concern and nothing changed, I'd take it to a case manager (possibly without naming names, would depend on the circumstances), because I consider my fellow nurses to be my colleagues and teammates, not people to be bossed around and undermined. I rely on the CM to address and enforce patient issues when gentle reminders and guidance don't work.
To be honest, my agency strongly opposes cleaning beyond keeping the patient area neat and uncluttered. I have vacuumed or taken care of patient laundry in the past, and kept countertops, tables and anything used for patient care sanitized, but I would not do any of that outside the immediate patient area. If I did so, other nurses would be expected to do the same, the family might change their expectations and expect nurses to do work they are not mandated to perform, and it general it sets a bad precedent. I am not too good to fold patient clothes clothes or lysol a surface where meds are counted, but I am very careful in what I choose to do.
nursel56
7,122 Posts
I rarely read a narrative note from fellow nurses that doesn't start with the general appearance of the patient, with details such as you described. I make a habit of describing how I left them as well. We have check-off boxes for cleaning, changing tubing, cannisters, etc as well so I'd really love to see what messy nurse writes in her nurse's notes. Sounds like she's setting herself up for a big fall at some point if she is falsifying or not completing her documentation.