When a pt begs you not to go

SmilingBluEyes · Nov 2, 2006

I know this is a real toughie. I bond with families all the time and hate to leave when my shift is up, oftentimes. And, I will stay if delivery is really imminent. Otherwise, I have no choice; I HAVE to go. OT is not allowed w/o charge nurse/director permission where I work. It's not a matter of choice. And working off the clock violates labor laws. I know during labor, this is not a good time to explain this to a patient, but you have to remember this yourself. If you are able to stay, and it won't get you in trouble w/management (or the next shift needs your help), do so. Otherwise, this is one of those times when you have to know how to draw a line, professionally, as hard as it is to do.

If delivery is not imminent, then try to make the transition to the oncoming staff/care as smooth as possible. Introduce the oncoming nurse to the patient and family and reassure them they are in good hands. And then, go. They will do ok, really.

Hope this helps.

eden · Nov 2, 2006

I know they will do ok but I feel really bad leaving them.

If I stay I don't work I just observe and I haven't gotten in trouble for it but I am not really sure if it is allowed in our facility. I never request OT in this situation and I have only stayed a couple times when I knew delivery was imminent

flytern · Nov 3, 2006

If by the last hour of my shift it doesn't look like my patient isn't going to deliver, I start commenting about the next RN coming in soon. I always introduce the next RN and say that I'm leaving them in great hands. After giving report, I say good bye and congratulations. Sometimes I even joke about how the next day I want to hear about how easy it was!

And I always come in the next day (work full time) and listen to their experience.

:balloons:

SmilingBluEyes · Nov 3, 2006

You may not be requesting OT, but in some places, if you are there 10 or 15 minutes (or more/less, in some places) before or after your 12 hour time, it's automatic overtime on the clock. This is how it works where I am. This for me, means, if I don't clock out by 7:48 p.m., automatically, OT and they don't take kindly to paying out massive OT for any reason, unless it's staffing shortages that lead to it. Yes, it's only a "few minutes" here and there but it adds up if this is done often enough by too many staff members. I would be surprised if your manager did not get VERY excited about this (unless for some reason you are salaried, which most staff nurses are not).

Be careful about this-----if you are at all unsure, ask your manager or Human Resources how it works. If you keep amassing lots of extra time, they (mgt) will take notice and not be pleased.

I know you want to put the patients first. That is what makes you a great nurse, I am sure. But you have to be aware of all the issues that involve staying extra after your shift. If you are not clearing this with your charge nurse and/or manager, don't be surprised if they confront you sooner, or later.

Also, you have to know when it's time to draw a line between getting too personally-involved and being therapeutic in a professional way. This usually comes with experience. Also consider if you get overly-involved, you may be on a road to burnout which does neither you, your coworkers, or your patients any good.

The above suggestion about coming in the next day to check on the patient and listen to her story, is a great one. I do that often, also.

Good luck and keep on being so caring. We need nurses like YOU.

ragingmomster, BSN, MSN, RN · Nov 3, 2006

I never have problems with working overtime, we are always understaffed.

What a wonder it would be to have a regular work week. Ah..only in my dreams.

My introduction to a pt is always..."Hi, My name is Ragingmomster and I'm one of the RN's who works here in the Birth Cener. I will be with you until 7AM/PM. What are your plans for today?"

I seem to stay over several times a month to complete a c/s because I hate handing over the circulating reins. I probably only end up over my 12 hours once in every 2 months to complete a delivery though.

classicdame, MSN, EdD · Nov 3, 2006

might help if you give a sort of report to next nurse in the patient's presence. That way she will know you passed along the "important" things (important to patient, that is).

HappyNurse2005, RN · Nov 6, 2006

If i have to leave when a patient i've connected with hasn't delivered (which happened to one patient who I labored for all 12 hours, all night long, pushed with for 2.5 hours before at 630 am, MD attempts vac extraction-unsuccessful-and calls csection.), and if i work in the next day or two, i tell her i will come up to see her.

i don't do this for everyone, more so for the only ones who seem to have connected with me. I wouldn't stay late unless it was a friend.

HappyNurse2005, RN · Nov 6, 2006

oh, and as a PS-one nurse had a friend of hers as a patient in labor. She worked til 7p taking care of her, then volunteered to stay til 11pm(they needed her) at 11pm, she was pushing, so the nurse clocked out, changed back into her street clothes, and came back to stay as a visitor off the clock