Discussion

When is my shift over?

Dec 12, 200817 yr

Firstly, I am 39 years old and a new nurse of five months on an extremely busy med/surg floor which focuses (somewhat) on solid organ transplant.

I am still learning to put things together, and in fact I learn something every single day. I have a full patient load of 5 most days. I take my job very seriously and I NEVER stop. I am not at the nurses' station looking at clothes on the computer, or gossiping. My main goal when I walk in there is to do everything I can as efficiently as I can so that I can get out of there on time. Which means, as close to 7:30 as humanly possible.

This doesn't always work, however. I live an hour away from the hospital, and by the time I drive home I have worked a 15 hour day, if I have to come back the following day I am pretty well ready to drop. So getting out on time is important, and so is doing my job well.

Okay, enough prelude. So the other day I had everything sewed up. All my charting up to date, everyone taken care of, meds current, orders taken off. I was feeling really good. Then something happens after 5 pm. Everyone wants something and everything suddenly has to be done. I had an order for a heparin drip, which I had never done before. I was trying not to stress, because I knew there were lots of nurses that could help me. Trouble was, they were all busy, too, and couldn't get free to show me how to do things. It requires a second nurse check to hang heparin, anyway, so I had to have someone. The heparin wasn't up in the tube station yet, so I couldn't give it, and a nurse told me I needed an aptt to be able to start the drip anyway. So I call to have lab come do this. Meanwhile, transport comes to take my patient to CT. The heparin comes up at the same time. I ask another nurse what to do, and they said to let it wait because, hey, CT will just turn off the heparin drip anyway. Fine. Obviously when the lab came to do the blood draw, the patient was gone.

Pt comes back up, I instantly call to have her blood drawn. We wait for the results, get them, and I'm ready to hang the drip. I have to get a nurse to help me, because I don't know what I'm doing. Other patients are asking for stuff, I'm running to take care of their needs. One patient had stomach contents dripping out of his NG tube all over his bed, I flush the tube and call for the PCA to come change the bed. Meanwhile, a new admit just arrived. It is now 6 pm. Trying not to stress, here.

I asked THREE nurses to help me with the drip, they are busy but one finally comes to help. As I am waiting for her I find that my patient is STILL in his stomach contents in his bed, a half hour after I called for the pca. I find pca sitting at nurses' station, looking sad and forlorn and reading stuff on the computer. I say, "Did you get the page about that patient?" She says yeah, what about it? I said, "It really needs to get done. I understand you're not thrilled about it but it's important to get him cleaned up." She sits there. I am ****** beyond belief.

Still waiting for the nurse to come help with the drip, I talk to my manager about the pca. She says this is the stuff she needs to know is happening and goes to inform pca to get her work done. Pca now hates my guts, as evidenced by the look of hatred as she goes to said room. Oh well...what's new.

Finally at ten till the nurse comes to help me with the drip. Informs me that the info I had gotten from another senior nurse is completely wrong and had to show me the correct way to do it, and she was right. We're working on it, trying to get things done. It is 7:40 before we get out of that room. I am flustered, exhausted, angry, and now I have to give report on 5 people.

The nurse I get to give report to is a pain in the orifice. She's particular, critical, harsh, and loves to show new nurses how smart she is. I was not in the mood. I begin report with the heparin lady, and when said nurse finds that I have hung the heparin she begins firing questions...what is the dose, I tell her, what is the rate? I can't even remember. I said I don't recall what it was but it was double checked and the pump sets it automatically. She huffs and puffs and rolls her eyes. I sigh, "Do you want me to go see what it is?" "YES!" she replies, so once more down the hall I go to get the number that she would have had herself the moment she walked into the room and looked at the pump. I come back with the number, she then asks if the pt has an order for fluids. She does, and she informs me that means she has to have a separate line put in. I am sick inside. It's now 7:45, I wasn't aware of this info before, and she's looking at me expectantly. I said, "Are you wanting me to do that?" she says back matter-of-factly, "That person needs a second line put in." I sigh. Continuing on with the painful report, because I was so tired and so frustrated that I just felt like my report was going all over the place, but still, I answered 99% of her questions. She began instructing me on what causes NG tubes to back up, which I don't mind being given useful info and being taught. But now it is after 8pm.

After report, as I am gathering things up and go to give my paperwork a last glance, make sure all is okay, she is still firing questions at me about things that she really should go and check out herself. I am really at the end of my rope.

Okay, after this long story, what I wonder is this...when does my shift end? I mean, if there were a med I hadn't given, or something like a documentation issue that needed taken care of, I understand I would need to take care of it before I left. If I was in the middle of some patient care thing and it was time to leave, obviously I wouldn't just drop it and walk away. But the thing about the IV and having to run back to the room to get the rate at which the heparin was running really got to me. My manager says that nursing is a 24 hour job, you do the best you can on your 12 hours and when the next bunch comes in it's time for them to take over. I can't work all night just because they don't want to be inconvenienced by an issues that might have started on my shift but has now bled over to theirs. I don't feel it was my responsibility to start that second IV, and I didn't. I left.

My experience is that some nurses will keep you there until hell freezes over, doing little tasks, calling doctors, etc. as long as you put up with it and bow down to their superior experience. I feel I am being used and run to death, and people have told me I need to be more assertive and stand up for myself. I will do anything I need to do, I work my orifice off, but there are two or three nurses that want me to stay for 40 minutes into their shift and take care of anything they think I should have gotten before. Well, I don't always have the luxury of things flowing so well that I can get EVERYTHING perfectly sewn up. It doesn't always work that way. What, so that's my problem? My shift just keeps extending into whenever because of days like that? I don't feel this is right, but I am looking for other opinions on it.

Gee, sure, why didn't I just stay until about 10pm and finish that guy's new admit paperwork. After all, he DID come in on MY shift!! Oh, and she rolled her eyes on the fact that I didn't get that paperwork done, too, and had to pass it to her.

Thanks for reading...

Hoosiernurse:no: :banghead:

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Dec 12, 200817 yr

Oh wow, what a day! I am still a new nurse too. Luckily on my unit we are like a small family and are willing to help each other out. We will tell each other "go home, I'll finish up what ever wasn't done". I don't have any advise since I haven't been in your situation yet, but wanted to let you know, I'm sorry about the rough experiences.

Dec 12, 200817 yr

I'm a new nurse too, and IMO, it's not your responsibility to put in the second line. The senior nurse should be able to see that you did the best you could in the 12hrs that you had (Evidenced by you showing up late for report).

Dec 12, 200817 yr

I will say this much. If that nurse had told me that i needed a second line iv, and it was that late in the shift, i would have certainly looked at her and said, "well, i'm going to leave that for you, b/c my shift is over."

The more you let ppl dump on you, the more they will. Stick to your guns honey.

BTW-everyone has an occasional bad day. Hang in there.

Dec 12, 200817 yr

Wow! I am so sorry for you. I work 3-11, there is a nurse who works 11-7. I have to give report to her and she always makes me feel like crap. She roll's her eyes at me ( I HATE IT WHEN STUPID SNOBBY PEOPLE DO THAT) when I forget something. I have stayed late as well trying to fix things, that should be being fixed by the 11-7 shift. The only thing that consoles me is karma. It will come back and bite her in the A$$. I have learned to let her ignorance roll off of my shoulders. Also I have come to the conclusion that If she rolls her eyes and wants things done, then she can do them herself. I will no longer stay over, there is no I in team. Wow that felt good to type out. Thanks for my mini vent.

Dec 12, 200817 yr

I guess people forget nursing is a 24 hour job and Some stuff we have no choice but to hand over to the next staff, same as they could easily be handing over stuff to you that they couldn't get done.

Do what you have to do and then leave once it is done. They have to remember some stuff happens at the end of shift and everyone wants to get off on time especially if the hospital will not pay for any time extra you spend there.

Dec 12, 200817 yr

Sooner or later you learn to pass things on. It's a 24-hour job. Sometimes as a courtesy I stay behind to finish up things I started, but I have no problem saying to the next shift "you need to do this.......have a good night".

Dec 12, 200817 yr

There are going to be days that you can't get it all done in your 12 hours and the next shift will have to take over. That is part of working as a team. Now, if it is a consistant problem that is a different story! That nurse sounded very judgemental. It sounds like you take a lot of pride in your work and try very hard to get your job done. It was just one of those days! I am sorry that the nurse you gave report to was not very helpful. You sound like you have good judgement and the problem was with the nurse you gave report to, not you. :specs:

Dec 12, 200817 yr

You did a wonderful job given all that happened on the last 2 hours of your shift.

Heparin drips can be intimating when you are not familiar with them. The protocol is pretty straight forward , it is the original calculations which are the headache. They can always be checked with pharmacy or the computer if you have a program for it. This is why two nurses do the calculations, heck we have had times when there are four of us as we are all tired and can't think to save our life. :bluecry1:

Any procedure which takes two nurses is a headache as everyone has things to do and it sometimes hard to correlate the free time together.

Second line needed for what first off. I understand the need if in indeed other fluids are ordered. That is not always the case.

Do not feel badly when you need to pass on to the next shift, sometimes there is nothing more you can do beyond putting yourself into overtime which can get you in trouble with management

Dec 12, 200817 yr

You described, to a tee, one of the nurses on our unit. Whenever I had to report off to her, I'd feel dumb, inept, and near tears. I finally talked to someone about her and found out she's always been this way. And although she's been "talked to" about it, it's still tolerated. Fortunately there are only one or two like her. Unfortunately, it's not going to change. :banghead: I've learned to cope by coming back at her, respectfully and kindly, but assertively. When she asks what rate something's running, if I don't remember, I "remind" her to look at the MAR (which she'll need to do before giving any meds anyway). Most of what she asks can be found in the written report, the doctor's notes, the Kardex and the vitals' record, all of which are easily accessible (we use computer charting and everything's easy to look up). If she insinuates that I should have done something on nights or finished something that came up late, I say something like, "I'm really sorry that didn't get done. I wish I'd had time, but I didn't." and leave it. Since I stopped letting her intimidate me, she's started treating me with a little respect. However, now she acts like she wants to be my buddy and confidante, which she will never be. But at least she doesn't make me cry anymore.

As much as I hate "gossip" and preconceived biases, I wish someone had warned me about her. I've watched her with other new grads and see how she does the same to them. I've since taken it upon myself to warn new grads about her, hopefully in a non-gossipy way. I hate to see her make people feel stupid, especially when we're doing the best we can. I hope you find a way to deal with nurse(s) who treat you that way and that you'll come to realize that the problem is them, not you. Some of them forget that they too were once the new kids on the block. And some of them think that they have to treat as they were treated. Somehow, they believe that being humiliated is considered a rite of passage. It's up to us to change that.

Dec 12, 200817 yr

This used to happen to me all the time. I'm approaching a year now, and it's getting better.

For one thing, as the day progresses, I write anything that happens that I know I need to tell the next shift, in red on my brain sheet. This has helped me a lot with the question-squad.

I had the exact same thing happen with a heparin drip where the oncoming old-timer was apalled that I couldn't give her the rate. I stood up to her though, assured her it had been double-checked and said, you'll see the rate when you check your orders.

If I have a hectic end-of-shift and have things unfinished that I would have like to have gotten done, I start my report by saying, I'm sorry I have to leave a few things for you, it was an afternoon from hell...

At this point, I feel confident that I am not a slacker and the oncoming nurse either knows that, or not, it's not my problem.

Dec 12, 200817 yr

Oh wow, what a day! I am still a new nurse too. Luckily on my unit we are like a small family and are willing to help each other out. We will tell each other "go home, I'll finish up what ever wasn't done". I don't have any advise since I haven't been in your situation yet, but wanted to let you know, I'm sorry about the rough experiences.

Sounds like a really good unit! :up: We run into this quite a bit with 'change-of-shift' deliveries and it is funny how different it is depending on whether it is AM or PM. If it is at 6:45 AM, some of the day folks will stall around because they have to get report and sometimes act annoyed that there is anything left undone, anything. However if it is 6:45 PM, they are yelling at us to come in and take over so they can get out on time, finish their charting, whatever, and they don't mind leaving a laundry list of stuff they couldn't get to. :confused:

Dec 12, 200817 yr

Unfortunately there will always be nurses who make the new ones feel inferior. I don't know why nurses do this to each other but it isn't going to change. All you can do is your best for your 12-hour shift. Your manager is right, nursing is a 24-hour process. Anything that doesn't get done is passed on to the next shift. Your shift ends when you are done giving report, in my opinion. If you can honestly say you did everything you could possibly do during your shift then walk out the door and feel good about yourself. Don't let other nurses make you feel inferior, they were new once too.

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When is my shift over?

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