What to report to unit supervisor, Advice please!

[AnewerRN]

I will try to be as brief as possible...

Today was a fairly bad day at work. I am a registry float RN at this particular hospital. I was working a general med surg floor and recieved a pt transfer from ICU. RN tells me in report pt is to receive an additional 1 Unit PRBC today (pt has recieved 5 since admit HGB stable today at 9.9, GI bleed cauterized, to go for lower GI in am). Don't recall in report RN ever stating why she had not yet hung todays unit PRBC. I wait for a while for blood bank to call and tell me blood is ready. Never recieve call. Call blood bank. Informed by blood bank blood was ready at 9am. Order for blood was given at 8:30am. Pt did not arrive to general medical floor until 12:45 pm. My question then, why was this blood not transfused? I mentioned this to my unit supervisor when she asked how my day was going. Call down to ICU later that night looking from medication for this pt and wind up getting chewed up by same RN in ICU regarding why I reported this to my nursing super. Later spoke with MD who ordered blood that day (who called ICu nurse a "flake"-irrelevant) and somehow order for HGB post transfusion was not written, either. I know pt was stable. Meanwhile pt having black liquid BM on bowel prep. Am I wrong for reporting to my nurse supervisor. I feel aweful.

[highlandlass1592, BSN, RN]

No you are not wrong and quit feeling awful! There was a delay in care and it should have been reported so it could be investigated. You didn't "report" her, you asked the supervisor to investigate why this care wasn't completed, especially in an ICU where the pt ratios are usually lower. Don't beat yourself up.

[AnewerRN]

Thank you highlandlass.....I really needed that:)

[nurse2033, MSN, RN]

Without knowing all the details there could be many legit reasons blood not given. I don't think you were wrong to be concerned but since there was no harm to the patient, personnly I wouldn't have done that. That ICU nurse probably felt that you were scritinizing her care and were looking for a "gotcha". There is a difference between missing something vital and prioritizing care. I wouldn't worry about it either way, but just remember how it feels when you suddently remember something you forgot to do in your car on the way home. Like I said, this may have been more important than it seems but we are all human.

[AnewerRN]

Without knowing all the details there could be many legit reasons blood not given. I don't think you were wrong to be concerned but since there was no harm to the patient, personnly I wouldn't have done that. That ICU nurse probably felt that you were scritinizing her care and were looking for a "gotcha". There is a difference between missing something vital and prioritizing care. I wouldn't worry about it either way, but just remember how it feels when you suddently remember something you forgot to do in your car on the way home. Like I said, this may have been more important than it seems but we are all human.

This is exactly why I posted. I never intended for this to be a "gotcha" moment. I have never reported another nurse before. Being a newer nurse in the hospital setting I feel like reporting this was terrible karma as I am bound to make a bigger whoops at some point. When the pt was transferred I was just so overwhelmed after recieving a new admit on top of a team I picked up late after being called in. I understand completely about prioritizing, although the only reasoning she stated for not hanging was that she spent time giving the pt a bed bath, talking to the family (mind you pt ambulatory, self care), and BB never called (BB tech stated she told particular RN blood ready at 9am). From this point on I am keeping my mouth shut. It wasn't a big deal.

[reddellrn]

administering the blood is more important than a bed bath. she needs to prioritize better. yes i would have said something too.

[Hoozdo, ADN]

administering the blood is more important than a bed bath. she needs to prioritize better. yes i would have said something too.

There is no reason you can't do a bed bath while infusing blood. Maybe the ICU

nurse was swamped by her other patient. Or "talking with family" turned out to

be 3 hours of talking to a stressed, upset family.

I swear, sometimes I spend more time talking to family and smoothing ruffled

feathers than I do on patient care. Gotta love Press-Gainey and 7/24 ICU

visitation, NOT!

[Flying ICU RN]

Where transfusions are concerned there are two things that I always insure that happen.

1) The order is acknowledged and in process immediately (IE Type & Cross / paperwork).

2) That it is transfused the moment it is available. (continuous f/u with Blood Bank).

If a patient has a bad outcome, I never want to be the cause of delay in a critical treatment. Therefore, I insure that this particular "link" in the chain is strong.

It is very likely as I have seen this many times, that the nurse pushed off this transfusion because of the impending transfer. It is a risk on multiple levels.

Am I wrong for reporting to my nurse supervisor

You were obligated to insure a rapid f/u in whatever form that may have taken.

[chloecatrn]

Am I wrong for reporting to my nurse supervisor. I feel aweful.

I'd have mentioned it. What if this patient had been hard to match and the blood had expired in the interim? Then the patient would have to go without while the blood bank tried to secure more blood products.

[netglow, ASN, RN]

OP, usually while you are in the process of trying to figure out what YOU are supposed to do, you have to do a little back-tracking and dot connecting. You can't help what information you find. You don't have all day to just sit and ponder all of it, you have patients to take care of.

If you think about it, what did that ICU nurse want you to do? You had to figure out if you should get blood in this patient. To do that you would need to do all of what you did.

[Esme12, ASN, BSN, RN]

Thank you highlandlass.....I really needed that:)

You were not wrong and that nurse was lazy...........she was just P.O. because she thought you would'nt go to anybody because you were just a temp......I guessed she learned differently!

[diane227, LPN, RN]

You know, you were right to speak up but the sad part of this matter is that nothing will be done about it. No one will speak with her and she will continue to do this type of thing... transfer her work onto someone else. I saw this all the time where I worked for the last 5 years. That is why I don't work there any longer. I tried for 5 years to get people to do what they were supposed to do and I finally just gave up.