When my shift is over...when can I leave?

**NickiLaughs, ADN, BSN, RN** · Oct 28, 2009

Depends on the policy of your facility. At my work, we are usually required to complete the admission assessment and are allowed to leave care plan and everything else depending on patient's arrival time. I have however, came into work when the previous shift was still literally hooking up the patient to our equipment, and in that case, I would complete the admission because there's no way that nurse could physically get out on time.

ellakate · Oct 28, 2009

I am trying to remember what happened when I worked on a busy med-surg floor. At that time and place, it was acceptable to chart VS, meds, assessment and patient care on the new admit. And ask for help with the admission paper work.

The AM nurse is going to do an assessment at the start of shift. With ETOH, how much real info would you have gotten? (Never know, just asking) This is where good peer relationships come in handy. Ask the oncoming nurse to help you. We have all been there. There will always be admissions late in the shift. All nurses need help.

As for the final comment about being a doormat. If you feel like you are being a doormat, you probably are, just from hard experience. If someone specific always asks for your help, next time ask him/her for help back, like changing an occupied bed.

When I was a young nurse on a busy post-cardiac, intensive care, intermediate care unit, there was a clique of older nurses who would make up mean stuff to humiliate newbies. Among the clique, the infighting was petty, based on who should have been the new head nurse on the unit. In a collateral damage event, one seasoned day nurse left the floor without changing a patient’s bed. As the green PM charge nurse, I was instructed by the head nurse to call Nurse Grumpy on the phone and ask why the bed had not been changed (or some equally inane thing). I did it without question. I got my butt chewed and a reputation as a doormat. The clique would dump on me. Because I didn’t stand up for myself.

This type of loaded communication is not about patient care. It is about focus. The focus is the patient, not the bed, nor exerting control over subordinates. Set up good boundaries. Then respect them. Protect yourself. No one else can do as good a job of protecting you as you can.

When you are in the midst of a tempest in a teapot, ask yourself if anyone will remember this event in 100 years. Then behave accordingly. FWIW :specs:

Meriwhen, ASN, BSN, MSN, RN · Oct 29, 2009

I leave when I've handed off all of my patients and finished my charting. Usually this is on-time. Occasionally, it's not

The unwritten policy at our place is that if admissions come in at the last half-hour of the shift, the next shift has the honor of processing them. Offgoing may get the bulk of the paperwork done and leave the assessment/safety searches/etc. for the oncoming. Whatever isn't done by offgoing is handed over in report to oncoming. I've been on both ends of this, so it does even out fairly in the long run. Though if things are really busy, the offgoing nurse may offer to stay and finish out the admission.

Keep in mind that I'm in psych and with rare exception, our patients aren't in critical condition, so they can wait a little bit (10 minutes or so). Though we don't keep them waiting for very long, as that isn't fair to the patient. That's why we keep telling admissions to avoid bringing new patients to the floor in the last hour of the shift. Now if they'd only listen to us...

nursenewbe · Oct 31, 2009

Okay, okay, I know nursing is a 24/7 job. My problem,however, I am not sure when enough is enough. With the night shift we will have on average of 9-11 patients. We are dealing with sundowners, checking med sheets, hanging abx, pain meds, 5AM meds. Not to mention the new admissions:eek:! The other night, I had 10 patients (1 very confused, 2 patients very anxious and needing a lot of attention) 0440 I found out I would have another patient added with ETOH intox. I am running like a mad woman to wrap thing up because I knew 0500-0700 is high time trying to close charts, pass meds, steroid push meds (please don't let this IV go bad....), do lab draws, note orders (docs making rounds) etc, you get the picture.
My pt came appx 0515. I assess the pt right away, make sure fluids are going, pt safe and stable okay, I can get back in the room by 0600 to do my admission profile (all 15 darn pages of paper work:angryfire) WRONG, I work with a sweet LPN. She is not allowed to do IV push meds or hang blood. Guess what she has....both:eek: Out of the 4 RNs on the floor, I am 1 of the 2 who will not bite her head off for asking for help. So what do you do right?
Back to my original question, I found myself working on the new admission till 0800. I did everything up to calling the doc for meds and orders. I see the other midnight nurses just leaving. I know one will just leave the paperwork for the day nurse. I feel bad doing that because I know they are coming in dealing with issues of their own. If you were in my shoes, will you just put in report "admission profile needs to be done". I am going to speak with my manager tomorrow morning. I did ask him before but I never got a clear answer.
Just wondering your thoughts. I feel like such a doormat at times .

I understand what you are saying, one question is where is the charge nurse and unit secretary. Where is the teamwork. At my place of employment each RN is assigned to a LPN for coverage of IV hanging no questions asked teamwork is a must or you surely will be fired. It is stressed at every meeting. Now you feel llike a doormat I understand I have to jobs. One at the hospital and one at the SNF. The SNF job I am having problems because of the lack of teamwork. Telephone orders are placed in the am on 7-3 shift but the order is not put in the computer ( all of our orders have to be put in the computer because of this new system we have in place) it would seem like if you the am nurse take the telephone order the only thing you have to do turn your chair around and make 2 clicks of the mouse and put the order in, this order that is usually a lab order sits there , 3-11 does not enter it in so now I have to enter it in. Passing the buck, it erks my last nerve and sometimes the lab for a pt-inr gets missed. Night shift crew are always the doormat and I am sick and tired of it. I have 40 patients at night and it is no way I can catch up from 2 previous shifts. The kicker is day shift comes back in the am asked why is the order not taken off the chart, well YOU took the order you should carry it out. I on the other hand have not talked the unit manager yet. I have been stuck at work until 9 am putting orders in the computer and giving report to 2 nurses because I have 20 pts on one hall and 20 pts on the other hall so I am following 4 nurses that is passing the buck I take that back one nurse actually tries. Your question when do u ever get to leave. Nursing is a 24 hr job Do what you can and go home get your nurse manager involved and the LPN that you always hang the iv's for you help her she helps you partner up if you can. Get to know your techs real good they will save your life and your day at work. I love mine. Remember partner up. Also look for another job, your patient load is too heavy in hospital setting because most hospital only give 4-5 pts a piece. Nursing homes very different protocol in Florida the patient ratios are stupid anyway. I really hopes this helps, Good Luck.

sbyramRN · Oct 31, 2009

I work in the ER. I leave as soon as I give report. the only time I really get out late is when my relief is not on time.

nurselori001 · Nov 2, 2009

As a night nurse I draw the line in the sand at 7am. Give report as soon as possible, finish up YOUR work and run for the hills.

FLArn · Nov 2, 2009

I speak to the nsg Sup who has to approve OT; let her know how far the admission paperwork is completed and what is left -- offer to stay and finish. She either approves my OT and I stay and finish or she says no and I pass the ball to the nurse taking on the patient. If I'm working I'm getting paid so that makes it the sup's decision and the next team can be upset with her -- I offered to stay!:sofahider

mzjennx, BSN, RN · Nov 16, 2009

a hospital is 24 hours and care is 24 hours, but and your shift is 8 or 12 hours so your allowed to care for that amount of time it does not have to be done all in one shift. my manager says we can pass out care as long as you clock out on time. i just make sure i have all my charting done on time. if i have to stay back its because **** happens, and you gotta catch up and it cant be passed out to another person. if you have a great unit, they will help so you wont stay back to late. im sorry your co-workers did not have the courtesy to stay to at least help you.

do check with your manager what is the policy. admission always come at change of shift for me. so i will at least assess to make sure they are stable, but as far as opening careplan, teaching, and starting treatment i would give it to the next shift.