What's your level of responsibility?

[HisHands, ASN, RN]

I work in a rehab facility. There are three nurses on my unit on my shift. Our average stay is 2-3 weeks, so we get quite a few admissions. Sometimes there might be two admissions on one set, and none on another, so naturally the nurse without the admission goes and picks up the extra on someone elses set. This happened to me the other day, and I'm confused if I did something wrong.

A pt came in at 3:30 (we come in at 3). The supervisor was transcribing all of the admit orders to the MAR while I did the admission, who was on another nurses set. By 5 pm the MARs were completed, I double checked the supervisors work to make sure everything was transcribed correctly, and I gave the sheets to the primary. She had not started her med pass yet. Well, this pt was a diabetic, and I reminded her he was. She had worked with him before as he was a readmit. Either way, he was due for a BS check at 5pm.

At 11 pm I was going to leave and the nurse asked me if I had given this pt all of his meds for the shift. First of all, there is no outlined policy that if you admit a pt on someone else's set, that that pt is yours for the entire shift. She asked me what his 5pm BS was. I told her I hadn't taken it. She received the med sheets before she even started her med pass. She just blatantly skipped over them. She had 4 open beds on her set. Mine was full. I'm not going to pick up her pt, and have a load of 17 while she has a load of 12.

I gave her the sheets in a very timely manner. What's the policy at your establishment? Should I have passed all of his meds and done the check, or was that her responsibility?

Thanks for the advice.

Blessings,

Crystal

[Dolce, RN]

It was very nice of you to admit her patient for her. However, admitting a patient does not make them your permanent responsibility. After you have passed on report to her, including the tasks that still need to be accomplished, the patient is her responsibility. That is the way giving report works. It was not your fault that she didn't get the BG.

[KellNY, RN]

Just playing Devils Advocate here--did she ever actually officially received and accept report for that patient, or did she just get the MARs?

[canoehead, BSN, RN]

If the patient is on her wing she should be attentive enough to notice that no one is going in the room, or going through the MARS and giving meds. Even if she argues that you had the patient she would be charge, and responsible to have some idea of what was going on.

That said- Is there a written record of who had what patient? If it just says Wing A or Wing B even, the patient was assigned to her.

[Tweety, BSN, RN]

Did she accept the patient from you? Sounds like that wasn't clear. However, if she was handed the MARS obviously something should have made it through to her that you were expecting her to do the med pass, otherwise why would she come along later and ask you?

Rather than blame each other, you, your coworkers, and manager need to come to some sort of understanding and have a policy of what to do in this sort of situation. Rather than play the blame game, a patient was put in jeopardy due to a flaw in the system which is you assume one thing and the other nurse assumes another. You know what you get when too people assume?

[fultzymom]

Here we all help out with the admissions whether it is our side or not, but when it comes to taking care of the patient, passing meds, ect it is the responsibility of the nurse whose wing it is on. We do not assume that just because someone helped us get them admitted that it is going to be their patient for the night.

[HisHands, ASN, RN]

I agree that a policy needs to be made. When I gave her the MAR, I gave her report. Where we work Nurse 1 gets rooms A-D, Nurse 2 gets rooms E-H and Nurse 3 gets rooms I-L. She was nurse 1 and I was nurse 3. So, it was definitely her pt, and she knew that completely. She just felt like since the pt was admitted by nurse 3 it should remain nurse 3's responsibility until the end of the shift, which I think is bunk personally. If my set is full, and hers isn't, why should I overload myself? I gave her report at an extremely appropriate time for her to be able to complete the tasks that need to be done for him.

Hope this clarifies,

Crystal

[Rizpah]

Here we all help out with the admissions whether it is our side or not, but when it comes to taking care of the patient, passing meds, ect it is the responsibility of the nurse whose wing it is on. We do not assume that just because someone helped us get them admitted that it is going to be their patient for the night.

LTC / Rehab here - ditto to the above...

[cappuccino]

I agree that if you help a nurse with an admission,it doesn't establish that you are responsible for that patient. You should definitely ask this person what made them think that was the case. So that in the future you won't have any question as to who will take care of the patient......

[crissrn27, RN]

Having worked in LTC I will say that this is just nuts. Unless this nurse was very new and didn't understand the "rules", she has no excuse for not checking BS and giving meds. You are responsible for your assigned areas in LTC and it is not reasonable to expect someone else to give your meds, and check your BS. You were nice enough to help, and she wants you to answer for her screw up. She probably just forgot to give meds/check BS and wants a scape goat. Or maybe she really is new and didn't understand?