I’m a baby nurse (new grad) going into day 3 of orientation with my preceptor. She mentioned that she lives close (within 5 mins) to the hospital so she usually gets there early [at a time that places her 40 minutes earlier than the start of her shift] so that she can get her day started ahead of clocking in. When our shift was coming to an end, I hadn’t looked at the time so I thought it was time to go because I saw night shift staff all over... but no, we had at least 45 minutes to even give handoff. One person (still in her coat, who I realized was a nurse) was even there more than an hour before shift start. So I realized this was a majority thing.
But why? Is this a common trend? When my professors in nursing school mentioned this, most scoffed at the idea of working for free. Yes I’m a new nurse but I’m not fresh out of school entering the workforce for the first time. It just feels weird that the notion is - in order to be successful and get home on time we have to work off the clock. I do understand being there in time to get settled (lunch purse away lol, snack eaten, coffee refill, non-patient chit chat, etc.) and getting your ducks in a row, mentally, to begin your shift. I’m not really an early riser but I do get in early enough to be on the unit at an appropriate time. I just feel like I can’t compete with the nurse who’s there an hour early. It’s like I’ll look ill-prepared being on the unit only 15 minutes prior to starting.
I just figure - I’m here for 12 hours and of course I’m still learning time management as an RN but gooooodness! Isn’t half of a day enough?? And if not, why? Do you do this? Is it so that you are able to be ahead or question the nurse who’s giving you report? Is it a reflection of management that it’s allowed or even required in order to feel comfortable with your patients?
I hope this doesn’t come off as offensive or snooty but I am really curious and kinda nervous at the same time.
Wow thanks for all your insight and thoughts. I’m definitely learning that this is something only some of the nurses do but still more than I expected, which makes me a little uneasy about. I haven’t been showing up early-early during these past four shifts and I do feel that I could accomplish the same work pace of those who do. Also no shift will be the same.
Overall, I’m realizing the personality that my preceptor has is definitely what causes her to get there so early. It’s pretty interesting to watch actually - very questioning and sometimes seemingly ready to pounce. It’s also nice to see how different people do things and how one nurse is laid back and calm whereas others are running around. Still not sure if that’s a good thing. ?
I do understand the possibility of HIPAA violations, insurance liability issues, etc. and it just doesn’t seem worth it. I am definitely taking everyone’s advice in finding my own flow.
Specializes in orthopedic/trauma, Informatics, diabetes.
We can't clock in until 0657 so I usually do not arrive much before 0650
I don't understand the coming in early to research patients. What if you have all the same pts from the previous shift??? I have to drive too far to work so I barely make it on time LOL
When I worked bedside, it was a personal preference of mine. It gave me time to look ahead at my orders, especially if I had a complex patient (multiple drips, pumps, an LVAD, tubes & drains, tube feed, lots of skin issues, etc). Perhaps it was because I was a new nurse, but I found that once report was over at 1930 I had very limited time to get my assessments done, meds passed, and nightly care finished. Sometimes I had an early admission and god knows those took forever and would put me wayyyy behind. If it was a particularly busy night, I wouldn't have time to sit down and read recent progress notes. I personally felt better going into my shift with more background on my patient than the day shift nurse was likely to give me.
*Editing to add that I've caught a few med/order errors upon walking into bedside report with the day shift nurse because I'd already looked up my patient beforehand.
We used to have a few people do this, look up their patient info prior to clocking in. Legal put the kabosh on that saying it was technically a HIPAA violation as you are not in the chart clocked in as those patients’ assigned nurse.
I don't work for free and neither should you. Something is seriously wrong if you are needing to donate additional time to the unit. Nursing is 24/7, you can never, and will never, "catch up". Just do not do it. Live your best life and don't worry about what others do or don't do.
I work inpatient adult psychiatry. It sort of sounds like a unit culture thing. I would be very concerned about HIPPA violation. As a psychiatric nurse I continue to fine tuned my own boundaries for a healthy work-life balance. This means not working for free, ensuring privacy for the people I care for (HIPPA), trusting the process of report/SBARR and speaking up if there is a concern. These are just a few of the things that allow me to show up to work ready to go each day. I also make a point to not engage with those who want to discuss patient care in the unit break room. I watch comedy or read a book instead. I do these things so that I can continue to work in this very acute setting. There is a high burn out rate for nurses and showing up early, without pay, to read up on patients seems like a way to fast track the burn out.
Specializes in orthopedic/trauma, Informatics, diabetes.
I do chart audits for hypoglycemic events and I go into charts of pts that are not technically mine all the time, I even do it at home (I can access our EPIC through a secure link).
I'd love to hear from a legal nurse how researching a pt before you get report is a HIPAA violation. Curious, not judging or condemning.
Wow thanks for all your insight and thoughts. I’m definitely learning that this is something only some of the nurses do but still more than I expected, which makes me a little uneasy about. I haven’t been showing up early-early during these past four shifts and I do feel that I could accomplish the same work pace of those who do. Also no shift will be the same.
Overall, I’m realizing the personality that my preceptor has is definitely what causes her to get there so early. It’s pretty interesting to watch actually - very questioning and sometimes seemingly ready to pounce. It’s also nice to see how different people do things and how one nurse is laid back and calm whereas others are running around. Still not sure if that’s a good thing. ?
I do understand the possibility of HIPAA violations, insurance liability issues, etc. and it just doesn’t seem worth it. I am definitely taking everyone’s advice in finding my own flow.
Thanks again everyone!
You're right about personality being the driving force. When I was allowed to look up my pts before my shift I did it because it decreased my stress level by being prepared before report and also because I would catch missed things from the day nurse. I'm kind of anal that way and not really laid back. So do what suits your personality.
I generally plan to arrive about 10-15 minutes before 7. I look at my pt assignment and fill out the basics on my brain sheet, print out pt labels, etc. if I’m really early I’ll start filling in what times my pts have meds scheduled. Usually just have time to complete the basics of my brain sheet and print labels before it’s time for huddle. We do have a couple people who arrive about 30+ minutes early to research but it’s only a few people. More show up just prior to huddle than anything else.
Specializes in OR, Nursing Professional Development.
3 hours ago, mmc51264 said:
I do chart audits for hypoglycemic events and I go into charts of pts that are not technically mine all the time, I even do it at home (I can access our EPIC through a secure link).
I'd love to hear from a legal nurse how researching a pt before you get report is a HIPAA violation. Curious, not judging or condemning.
Chart audits are an authorized work duty, which is why those are not a HIPAA issue. While not your patient, it's a legitimate reason to be reviewing the patients' charts.
This sets a bad precedent. If something happens to you, you are not covered by worker's comp. Also, if you access charts and you are not on the clock, legally it is a HIPAA violation although your hospital would probably never do anything about it. I suggest you contact a labor law attorney or find a job that is a better fit for you. If you have to show up early to survive, there are better options elsewhere.
NurseOrBust13
15 Posts
Wow thanks for all your insight and thoughts. I’m definitely learning that this is something only some of the nurses do but still more than I expected, which makes me a little uneasy about. I haven’t been showing up early-early during these past four shifts and I do feel that I could accomplish the same work pace of those who do. Also no shift will be the same.
Overall, I’m realizing the personality that my preceptor has is definitely what causes her to get there so early. It’s pretty interesting to watch actually - very questioning and sometimes seemingly ready to pounce. It’s also nice to see how different people do things and how one nurse is laid back and calm whereas others are running around. Still not sure if that’s a good thing. ?
I do understand the possibility of HIPAA violations, insurance liability issues, etc. and it just doesn’t seem worth it. I am definitely taking everyone’s advice in finding my own flow.
Thanks again everyone!