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Unusual/Disruptive ways my unit functions

Posted

Specializes in Telemetry, Med-Surg, ED, Psych.

I work on a busy medical/surgical/telemetry unit. I have made notice of a few things that are done that really rub me the wrong way.

Of all the units in the entire hospital, our unit is the ONLY one where team leaders/charge nurses go to a seperate office in the main corridor off the unit to give handoff report. All the other units I have floated to have the TL's giving report on the unit with all the other staff RN's, LPN's and CNA's. In my opinion, the TL/Charge nurse IS the backbone of the unit and is needed on the floor during change of shift. There have been many times when an unusual event (Code, Med error, aggressive patient, ethical problem) during shift change has occured and we needed the charge nurses there for assistance. They always say to call them but they often change there location from either an empty conference room one day to the nurse managers office the next. I really dont understand the mentality of leaving a unit to give report and then coming back acting like its all peachy keen when the staff NEEDED the support of the nurses in charge.

I have addressed this issue with my nurse manager but talking to her is like talking to a brick wall. "Your unit has done that for a long time". So what? Does that mean its a safe way of providing care? That would be like saying that I drive intoxicated many times without an accident - but sooner or later I would get into an accident.

What do you think?

FancypantsRN

Specializes in Cardiovascular, ER.

Personally, disappearing charge nurses are one of my biggest pet peeves. I was a charge nurse, they are regular RN's just like everybody else. Whether they hide out to give report or not, they are still responsible for the unit - and they should have to answer for it if something goes down while they "stepped out".

Aren't staff RN's still responsible for our pt's while we are giving report to the next shift? I would say that to the manager if they are not listening to your concerns.

kessadawn, BSN, RN

Specializes in pediatric critical care. Has 7 years experience.

I can understand the need to get away while giving report as charge, people interrupt CONSTANTLY and I've had days where I have left 45 minutes later than I should have just from others' interruptions in my charge report. And I'm not talking legit interruptions either. Nurses coming in to show pictures of their kid's prom or something. Seriously?

We tried to go to another location as well, but it didn't last. However, we were ALWAYS available in an emergency. Does your charge staff carry a pager or portable phone? They should, so they are always there to support the staff, no matter where they do report.

Edited by kessadawn

Our charges carry phones and any codes (blue, yellow, whatever) are overhead paged so it doesn't really matter if they are still in the unit conference room.

BittyBabyGrower, MSN, RN

Specializes in NICU, PICU, educator.

As the charge nurse of a very busy 50+ bed unit, I can tell you that constant interruptions when I am trying to hand off report to the other charge nurse is really annoying. If there is a code or a parent that is being disruptive, that is one thing, but a med error or ethical problem? That can wait and the staff nurses should be able to handle those kinds of things themselves. I have a lot of responsibilites as the charge nurse, not just the unit and I am not at your beck and call....I have paperwork, staffing, helping, etc that also occupies my time. I also need to be able to hand off report without interruption, just like the staff nurses do. Constant interruptions can means something important is missed.

If they say that you can call them, than do it. Everyone is an adult and you should be able to figure out if it warrants a call to the charge nurse or not. We will listen to what you have to say, but if it is something that can wait 20 or 30 minutes, it will and I will tell you that, as will the other gal/guy. We stay on the unit, but the rules are pretty clear...if it can wait, wait....if it is life threatening, then yell.

Esme12, ASN, BSN, RN

Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma. Has 41 years experience.

It depends on whether or not they take patients. If they have a smaller load of patients they need to get report on their patients first then the floor report. I agree that for a short peroid of time....some questions can wait so report can get over a quickly as possible.

If the charges do not take patients and their only responsibility is charge.....I always had my charge nurses stagger their start/stop hours so a charge nurse was available at shift change for crisis intervention and questions.

Whether or not they leave the floor I have always made it clear they are on beeper and will respond to codes or aggressive patients (which are a n overhead code in most places) but a med error or ethical dilemma can wait....unless of course the ethical dilemma is someone wanting to remove life support or commit murder and the med error requires immediate intervention to preserve life.

Hope this helps

Our charge nurse comes in 15 minutes before the shift starts so he/she can take report from the preceding charge nurse. They stay in the nurses station during this hand off.