Who Should Clean Up, Offgoing Shift or Oncoming Shift?

[Kooky Korky]

You are the Day RN 7-3:30.

You see Docs come in to Round about 1515. You do not see which patient they see first.

You go in to Report Room a moment later, come out at 1528, sit down to chart (first chance all day to do so). You have had no break that day except a quick potty run, including no lunch. You have about 1/2 hour's worth of charting to do and you will be on overtime, which is highly discouraged.

3-11 RN comes to you at 1540, tells you that Room 3 has a mess in it and you have to clean it up. She is loud and angry and speaks none too calmly.

Docs had done some procedure on Rounds while you were in Report and had left the aftermath (trash, sharps, bloody stuff - this was a long time ago when blood and sharps were left wherever).

On the one hand, you did not know there was a mess because you did know the docs were on the unit, but you did not know what they were doing because you were in Report. Also, you still had to chart and were already on OT.

On the other hand, is it right for the 3-11 nurse to walk into a mess which, she argued, happened before she was on duty? She was on duty, technically, at 1500, came out of Report about 1528.

So who should do the clean-up?

[Kooky Korky, BSN, RN]

Maybe just me, but I always strive to leave things tidy, neat and complete when I go off. And I kinda like having the same courtesy from the other shift. It's a habit I grew up with; leave things as you would like to find them, sorta thing. And I have worked all shifts, and still I feel this way. Don't leave something YOU would not want to find when you arrive. However, I won't start a shift war; it's not the hill I want to die on.

Agree with your general desire to leave and find orderliness.

Please address the specifics of the stated situation.

[Kooky Korky, BSN, RN]

The docs should clean up their own dang mess.

I generally make sure my own messes are picked up, but no way am I going into OT to clean someone else's. Besides, in the time oncoming RN spent hunting and griping at offgoing RN, oncoming RN probably could have had it cleaned up.

Or reminded the MD their mom doesn't work here.

Back then, docs made messes, never were expected to clean up after themselves.

[Kooky Korky, BSN, RN]

To me it's about pride. I wouldn't dream of handing over a mess unless I was in the middle of a crashing patient situation. I took pride in the fact that when I handed over a patient in the ICU that they were bathed, had fresh sheets, that all lines were labeled and within expiration date, all drips were labeled and had a spare bag hanging if they were due to run out, trash was emptied and CRRT bags changed, mouth care done, fresh gown and new dressings. I would clean the rooms to my liking when I took over the shift because I can't work in a mess, but I would do the same before the next shift came in regardless. I'm a neat freak and I despise mess.

It's sometimes a bit soul destroying because you get to know the nurses who are slobs and handing over the patient to them was disheartening because you know you'd come back tomorrow to a bomb site. Clean as you go, restock as you go, and always make sure the necessary things are done. There's always those occasions when you can't keep up because the patient is very sick, but if you've built a good reputation others will get to understand that that's not your normal. I'd never want the reputation of being the slob. I used to get so mad at one nurse in particular because I'd walk on the unit and invariably she was sitting at the desk on her phone or chatting and obviously had time to clean, but I'd walk in the room and there was mess everywhere, dirty table top, dressings out of date, patient looking disheveled and trash overflowing. No excuse for that.

Understood. Please address the specific stated situation, though.

[Buyer beware, BSN]

Well Kooky, I think it's both. So clean as you go and no one is left holding the bag with you might guess what's inside it.

[meanmaryjean, DNP, RN]

You are the Day RN 7-3:30.

You see Docs come in to Round about 1515. You do not see which patient they see first.

You go in to Report Room a moment later, come out at 1528, sit down to chart (first chance all day to do so). You have had no break that day except a quick potty run, including no lunch. You have about 1/2 hour's worth of charting to do and you will be on overtime, which is highly discouraged.

3-11 RN comes to you at 1540, tells you that Room 3 has a mess in it and you have to clean it up. She is loud and angry and speaks none too calmly.

Docs had done some procedure on Rounds while you were in Report and had left the aftermath (trash, sharps, bloody stuff - this was a long time ago when blood and sharps were left wherever).

On the one hand, you did not know there was a mess because you did know the docs were on the unit, but you did not know what they were doing because you were in Report. Also, you still had to chart and were already on OT.

On the other hand, is it right for the 3-11 nurse to walk into a mess which, she argued, happened before she was on duty? She was on duty, technically, at 1500, came out of Report about 1528.

So who should do the clean-up?

The physician who MADE the mess should do the clean up.

[Buyer beware, BSN]

Back then, docs made messes, never were expected to clean up after themselves.

Yes, that is was the way it was back then in many instances. But call it what you will, it was always a matter of training the young ones. (social ineptitude syndrome)

Anyway, the least they could always do was to dispose of their own sharps. Many nurses have been unnecessarily stuck because of this down through the years. (boobytrap under used drape syndrome)

But in the end if they didn't comply, it was always a good way to gauge their douchebag quotient so as to be strategically unavailable in trying to promote playing well togetherness.

[Been there,done that, ASN, RN]

You've endorsed the patient to the oncoming nurse. It is their responsibility now. If you were able to leave on time, you wouldn't even be there.

I would take it to management. They will not want you staying over longer to clean up. It's a 24/7 job and stuff happens.

Certainly the doctors should clean up their own mess. Some do , some don't . In this case, it's a moot point because the doctors are gone.

[Rose_Queen, BSN, MSN, RN]

Understood. Please address the specific stated situation, though.

You do realize that threads take on a life of their own and that you can't dictate how someone responds, right?

Healthcare is a 24/7/365 world. It is going to be impossible to get everything done within only 8 hours of that 24. That's why nurses who expect everything to be done and all loose ends tied up irritate me- it's impossible. That said, neither the oncoming or off going nurse should have had to clean up that mess- the physician who made the mess should have cleaned it up and been held accountable if it wasn't.

[AlwaysLearning247, BSN]

I don't think a nurse should have to stay overtime when nursing is a 24/7 job! I say the next shift but I also think the doctors shouldn't go in and make a disgusting mess. It boils my blood when they do that. I've had a surgeon come in and throw my patient's old dressing on the floor, it was disgusting. They need to be spoken to, no nurse should have to clean up after a huge mess. That is why I love when the residents and PA's come to do procedures, they come up to me and ask me where all the stuff goes afterwards and they don't leave a mess. I understand it is frustrating on your part and also for the nurse coming in at 3 but she has no right to take it out on you either.

[mushyrn, BSN, RN]

This is exactly the sort of pettiness and divisiveness that nearly makes me regret entering nursing. I cannot believe that adults behave this way. If your shift is 7-3, you work 7-3, and anything after that is the next shift's business. I actually hate coming to work, getting report, and then having the night RN start explaining that "Oh, I'll clean that up, I'll finish that, I'll hang this, I'll do that..." ... I'm just like, go home. I can handle working my hours and whatever that entails. It's time for you to go home.

And I utterly hate when people say "Well, are you going to finish the care plan? (or some other stupid crap)" No, the patient got here 30 minutes ago, I am not going to do any of that. It is your time now.

Seriously. The level of pettiness, laziness and absolutely ridiculous behavior from adults in nursing is so discouraging. I have never seen another profession or healthcare sector behave the way nurses do, save maybe the most petty members in phlebotomy (you know the ones I'm talking about).

Some people need to grow up and become professionals if we want to call nursing a "profession".

[elkpark]

Back then, docs made messes, never were expected to clean up after themselves.

If this is a beef from "back then" when physicians weren't expected to clean up after themselves (which was many years ago, anywhere I've been), what's the point of starting a thread about it now?

[Meriwhen, ASN, BSN, MSN, RN]

The physician who MADE the mess should do the clean up.

In an ideal world, they would. But this world is far from ideal, so we're treated as though we're the ones who made the mess, not the MD.

Regarding the specific situation...technically, after 1530, I would consider it to be the job of the next shift. If the evening shift nurse kept squawking at me, I would ask the charge/manager what they wanted me to do in this case, letting them know that I'm already on OT...and so the charge/manager could perhaps address it with the MD.

Likewise, should all of this have happened overnight and I walked into it after report at 0730, I would just consider it as part of my shift and take care of it. And again, let the charge/manager know so it could be addressed with the MD.