Trouble In Paradise

DaFreak71 · Sep 22, 2007

Hi Trudy!

Sounds like you work the night shift and said slacker works days...correct? The nursing supervisor also works days, with the slacker? If so, you probably have little contact with the supervisor, so if she sides with the slacker and resents you for bringing up the issue, how much can that really hurt you? Even if you have to end up bringing this to the attention of the DON, how much fall out could there really be since they both work days?

I would not leave to work on a different unit or a different shift. First off, working days usually means a cut in pay (no differential), secondly, if you have a good night shift team, it would be a shame for you to give that up.

Most importantly though, if you leave and don't say anything for fear of reprisals, who is going to ensure that those patients get the care they need? If her performance is substandard, patients are getting the short end of the stick. Personally, I would feel as though it were my ethical duty to speak up.

Lastly, we all have stress and depression at times. It sucks, for sure, but when it leads to lack of patient care; there is simply no excuse. Hell, I'm bipolar so I know first hand how debilitating depression can be. But the right thing to do is to get help, even if it means taking time off. It should never be a factor in continuing to drop the ball on patients.

Sounds to me like you've taken the right steps so far by confronting her directly. Obviously that's not enough to wake her up. Time for more aggressive measures in my humble opinion.

Don't let her be in control of where/when you work. That's giving someone way too much power over your life. I hope things get better for you and that she will be held accountable for not doing her job.

Long Term Care Columnist / Guide · Sep 22, 2007

Excellent advice, lostdruid!

Hoozdo, ADN · Sep 22, 2007

I think it might be time to ask for a transfer. The nurse who follows me will not follow through on things that have to be dealt with on her shift. If they were emergencies, I'd call a doc myself after hours but they're not. They do, however, need attention. Yet, about 90% of the time, I can count on her to just not ask the doc about them when he arrives during her shift.
What a bummer. :uhoh3: Any thoughts?

What I do is grab a big blank piece of paper and write notes to the doc. I tape it on the front of the chart and it covers the entire cover except for the pt's name. I want to be sure the Dr. sees it. For urgent matters, of course I would page in the middle of the night. I leave notes for things like:

Hello Dr soandso,

This pt needs a nutrition consult. He hasn't eaten anything in the 4 days he has been here.

OR

This pt needs to go to interventional radiology for duotube placement. We have tried twice and it always goes in the L lung.

Then I always say thank you, a happy face, and sign it. It works for me! I don't care who is taking report from me - I just automatically write the note! The doctors breeze by so fast that the nurse doesn't even see them there - so a note makes sense.

caliotter3 · Sep 23, 2007

Don't leave a job because of someone else's poor job performance. Learn to look at the "tasks" as just that, "tasks". Follow up on such tasks on your eight hours to the best of your ability. Don't kill yourself doing someone else's responsibility. However, do keep some unofficial notes at home, in case you should be unjustly criticized during your yearly performance evaluation. An eight hour shift is an eight hour shift. While you may agonize over less than optimal patient care, the only "tasks" in eight hours that you should be concerned with are the "tasks" that you do; not what she does or does not do.

(I learned this the hard way, theoretically ((not emotionally)), when I had to deal with an outright lazy co-worker who was supposed to be fired. I ended up leaving that job, but not voluntarily. I've never recovered career-wise, and I'm certain she still sleeps through her shifts for pay).

leslie :-D · Sep 23, 2007

sometimes our jobs would be so much easier if we could only wear blinders and earplugs.

unfortunately, this only affects our pt population.

while i agree with lostdruid's sentiments, i'm also wondering if you'd be better off trying what hoozdo suggests.

if this nurse and nm are friends, there's a good chance you reporting this nurse, would blow up in your face.

because of this possibility, perhaps leaving notes w/the doctor, as hoozdo suggested, would get your pts the care they need.

i'm not thrilled with this approach, for it is enabling a nurse to give substandard care.

but i'm also trying to realistically warn and protect you from the potentials in this situation.

something to think about, for sure.

if you're happy where you work, then i would not consider leaving as a first resort.

best of everything.

leslie

DaFreak71 · Sep 23, 2007

What I do is grab a big blank piece of paper and write notes to the doc. I tape it on the front of the chart and it covers the entire cover except for the pt's name. I want to be sure the Dr. sees it. For urgent matters, of course I would page in the middle of the night. I leave notes for things like:
Hello Dr soandso,
This pt needs a nutrition consult. He hasn't eaten anything in the 4 days he has been here.
OR
This pt needs to go to interventional radiology for duotube placement. We have tried twice and it always goes in the L lung.
Then I always say thank you, a happy face, and sign it. It works for me! I don't care who is taking report from me - I just automatically write the note! The doctors breeze by so fast that the nurse doesn't even see them there - so a note makes sense.

Wow, this is really great advice! It gets the patients needs addressed and covers her butt at the same time. Very practical indeed!

FireStarterRN, BSN, RN · Sep 23, 2007

When I worked nights, I put a note on the chart for the doctor. On days if I pass something on in report that the other nurse is going to attend to, I make a note in the nurses notes such as "Pt's LOC decreased, becoming agitated, oncoming RN aware". That would be for something I observed right before shift change that isn't a total emergency. That to CYA.

TrudyRN · Sep 29, 2007

Thank you all. Yes, I should fight. But I am too beaten down right now, too battle-scarred from other rounds in the ring to take on another fight - and I think that's what it would be, especially since the patients don't seem to suffer when the other nurses practice medicine without a license (ignore orders, do their own thing with times and products - sorry to be vague, just don't want to be identified) and when they ignore issues. Recently, the first nurse I referred to told me she HAD spoken with the doc about an issue I raised and that the doc is at fault for not correcting the chart. Well, gosh golly gee. How come the nurse doesn't make sure the doc is handed the chart and a pen and makes the blasted correction!!! No, she should not have to but we all know reality. And I had to bring it up again to get this nurse to fill me in on what she says she has attempted to do. She finished by saying she is under lots of pressure and is trying to rid her life of stressors. I took it as a hint that she considers these issues that I raise as stressors.

Also, because the patients aren't suffering, I wonder why I don't just let things go like these others do.

I do keep my records, yes, I do do that.

I have sometimes just gone on and called the doc myself when the hour was approaching an human one. Pisses me off to have to do so - makes me get off late and have to justify OT or work free - but I have to if I really need something taken care of.

I think a transfer would be easier on me. As I mentioned, I am very beaten down just now, with no end really in sight and have to preserve myself the best I can. Is that unethical or is it putting on my own oxygen first so I can help someone else?

How can I get the courage up to talk to the higher up's? Should I?