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.
Unfortunately the day shifters are, and will forever be, the golden children. They are the ones that "have it so bad" and doctors "hover over them unlike night shift"... Yeah right.. All the night co-workers feel the same, but we have very little say. If I find my rooms are messy and the day didn't seem that terrible (I can look at the intervention lists and the orders and know that it was a low maintenance day) I might "accidentally" forget to stock things such as needles, syringes, flushes, ect.. in the med room. I've also been known, when day shift has really crapped on me, to wait to give my 40mg lasix right before end of shift (doc likes to round at 0600 and orders it as IVP Now x1 at 0630, giving me a 30 min window).
Never do I do things that would remotely harm patients, but I find a little satisfaction knowing that I might have inconvienced them a little bit.
There was no anger in my post. It was merely a reflection of yours. I mirrored your own questions back to you. If that makes you angry, perhaps you should rethink your communication style.
You aren't giving any of your own opinions, just picking apart other's posts.
Here is some more fodder for the grist:
I thought the doc was rude for leaving a mess and expecting others to clean it up. I thought the oncoming nurse was rude for being loud and angry, which is unprofessional, to boot. I thought the offgoing nurse was uncivil due to the passive aggressiveness displayed by not dealing directly with either the doc or the oncoming nurse.
They were all disrespectful of each other.
What a toxic environment! Which is stupid, because respect, civility, and fostering teamwork makes for a less stressful environment.
I was asking for opinions because the answer was unclear to me. There's been no picking apart of anyone.
You might not have carefully read the OP. If you did, my apology for thinking otherwise.
This happened a long time ago, back when no one expected doctors to pick up their own mess. It simply was not expected that they'd do anything but do their procedure, leave the sharps, bloody knives and sponges, package wrappers, and contaminated wound material lying about for the nurse to clean up. It's just the way things were back then. So we considered this behavior rotten and all wished we'd gone to med school so we could make messes and not have to clean them up, but it was just the standard of the day and we didn't think doctors were rude because of it, just lucky.
The 3-11 nurse was rude, I agree. The docs were already gone by the time she started c/o their mess.
The 7-3 nurse knew nothing about the mess until bombarded by the oncoming nurse about it. I didn't state how she dealt with the 3-11 nurse, so I'm not sure where you saw passive-aggressiveness.
I am not sure how you are reflecting me. It seemed like you just came out swinging. And your post didn't make me angry, it made me hurt and confused because you found the post (and, by implication, I, as the author of it) stupid, and you were unclear about who you thought was incivil, etc.
You haven't answered why you're dragging up a "back in the day" story to poll who was in the wrong. What's your goal here?
By way of answer, an outgoing nurse is not responsible for a new mess that they did not create, did not know about, and could not have foreseen. I'd gladly help an oncoming nurse who asked for help in a civilized manner, though, and I agree with the poster who said that if techs are present, they are responsible for assisting with patient care during nurse report.
I didn't know anyone had asked why I brought it up. Must have missed that.
I sometimes think of things from the past, maybe because I am retiring soon and must be reviewing my life. Also, I see on AN a lot of fighting over the same stuff we were dealing with back when I was a newer nurse.
Sometimes, like this case, I wonder what modern day nurses think, how they handle such things. One thing that stands out about this case is that younger nurses have no understanding of docs creating a mess but not cleaning it up. It's just the way it was. And I don't recall us having techs in ICU at that time. We had a secretary on Days Mon-Fri and that was all.
My goal was just to see if anyone knew of the right way to handle it. Nothing sinister or weird.
"Oh, I'm soooo sorry that happened at the beginning of YOUR shift,....good thing you have time to deal with it. Management would frown on me going even further into overtime to do YOUR work". All smiles with a friendly and sincere tone. In my unit there is the ongoing conflict of who is responsible to do what for an admission that arrives in the last hour of the shift. The on coming shift ******* and moans if all the paperwork, admission database, care plan, whatever, isn't done. I have NO problem just saying that I got the patient hooked up to the monitors, settled and took care of any STAT issues. I will NOT stay late doing something the on coming shift is perfectly capable of doing but just doesn't want to. And yes,...usually it's the day shift nurses doing all the complaining. If the patient arrives in the last hour of the shift, I chart a note, enter vital signs and do whatever I can until change of shift. Whatever is not done,...well,...THAT IS WHAT THE NEXT SHIFT IS FOR!!! What makes matters even worse is, if there is an admission or Post Op coming at the end of their shift,...they delay it in the ER or PACU so they don't have to deal with it at all. Happens all the time in 3-11. Another on going issue is the dreaded bath. In my ICU, baths are expected to be done on 3-11. If I suddenly get an admission at change of shift and then 2 hrs later have to emergently transfer my other patient out, transporting them myself because transport is gone for the day, in order to get another admission,...no bath is going to be done. Day shift still complains even though they rarely get admissions or post ops and have a secretary and aid, which we do not. Where I work, day shift acts very entitled because, it's soooo busy on day shift. Whenever I work day shift, I always comment how easy and quiet it is,....the day shift nurses just say it's an odd day. Yeah, right,..every day shift I work is an odd, quiet day huh??? These day shift nurses are, of course, card carrying members of The Crusty Old Bat Society! Lol!
I was asking for opinions because the answer was unclear to me. There's been no picking apart of anyone.
You might not have carefully read the OP. If you did, my apology for thinking otherwise.
This happened a long time ago, back when no one expected doctors to pick up their own mess. It simply was not expected that they'd do anything but do their procedure, leave the sharps, bloody knives and sponges, package wrappers, and contaminated wound material lying about for the nurse to clean up. It's just the way things were back then. So we considered this behavior rotten and all wished we'd gone to med school so we could make messes and not have to clean them up, but it was just the standard of the day and we didn't think doctors were rude because of it, just lucky.
The 3-11 nurse was rude, I agree. The docs were already gone by the time she started c/o their mess.
The 7-3 nurse knew nothing about the mess until bombarded by the oncoming nurse about it. I didn't state how she dealt with the 3-11 nurse, so I'm not sure where you saw passive-aggressiveness.
I am not sure how you are reflecting me. It seemed like you just came out swinging. And your post didn't make me angry, it made me hurt and confused because you found the post (and, by implication, I, as the author of it) stupid, and you were unclear about who you thought was incivil, etc.
Thanks for clarifying.
You're welcome.
It sounds like you read a lot in to my post that wasn't there. I carefully read the OP. I read the whole thread. I didn't come out swinging and I make no apologies for what I didn't say.
If you were hurt and confused, I am sorry for that. I did not say you were stupid.
I still think the situation described was stupid and I hope nursing has progressed well beyond that kind of petty nonsense.
There was no anger in my post. It was merely a reflection of yours. I mirrored your own questions back to you. If that makes you angry, perhaps you should rethink your communication style.
You aren't giving any of your own opinions, just picking apart other's posts.
Here is some more fodder for the grist:
I thought the doc was rude for leaving a mess and expecting others to clean it up. I thought the oncoming nurse was rude for being loud and angry, which is unprofessional, to boot. I thought the offgoing nurse was uncivil due to the passive aggressiveness displayed by not dealing directly with either the doc or the oncoming nurse.
They were all disrespectful of each other.
What a toxic environment! Which is stupid, because respect, civility, and fostering teamwork makes for a less stressful environment.
KK was not the only one who thought your post was angry....
In my ICU, baths are expected to be done on 3-11. If I suddenly get an admission at change of shift and then 2 hrs later have to emergently transfer my other patient out, transporting them myself because transport is gone for the day, in order to get another admission,...no bath is going to be done. Day shift still complains even though they rarely get admissions or post ops and have a secretary and aid, which we do not. Where I work, day shift acts very entitled because, it's soooo busy on day shift. Whenever I work day shift, I always comment how easy and quiet it is,....the day shift nurses just say it's an odd day. Yeah, right,..every day shift I work is an odd, quiet day huh??? These day shift nurses are, of course, card carrying members of The Crusty Old Bat Society! Lol!
I have quite a few issues with baths during the morning myself. The day shift nurses consistently complain that we aren't giving our patients baths and we aren't getting our patients up. I pretty much always bathe at least 1 patient, but I can't create more time in a shift, just ain't happening. As for admits, day and night have about equal, but day shift does do more transfers to the floor obviously, to THEIR benefit (the quicker in your shift you can transfer, the less you have to chart/do... We night shift have to hold them ALL throughout the night so that day shift can do a transfer at start of their shift...).
It just gets to the point where we are bugging these poor patients every hour starting at 0400 (the final physical exam for the shift), then at 0500 for labs, then at 0600 for meds.. At this point we've now kept these patients up since 0400am....... Sleep doesn't matter I guess...
Remind the oncoming RN that this is a 24 hour facility and that it is everyone's responsibility to provide patient care including environmental cleanliness.
Here is my question. Why not delegate that responsibility to the aide?
I have quite a few issues with baths during the morning myself. The day shift nurses consistently complain that we aren't giving our patients baths and we aren't getting our patients up. I pretty much always bathe at least 1 patient, but I can't create more time in a shift, just ain't happening. As for admits, day and night have about equal, but day shift does do more transfers to the floor obviously, to THEIR benefit (the quicker in your shift you can transfer, the less you have to chart/do... We night shift have to hold them ALL throughout the night so that day shift can do a transfer at start of their shift...).
It just gets to the point where we are bugging these poor patients every hour starting at 0400 (the final physical exam for the shift), then at 0500 for labs, then at 0600 for meds.. At this point we've now kept these patients up since 0400am....... Sleep doesn't matter I guess...
yes, we have to hold the transfer patients,........until we NEED an ICU bed,....then magically, a bed becomes available on the floor. Never fails. Nothing worse than trying to get a new ICU patient taken care of with 2 other patients, one of which you now have to quickly finish charting on, call report and physically transfer yourself. Never seems to make sense to "those who are not us" to transfer patients when you can, not when you HAVE to. Additionally, the patients get annoyed when they are suddenly transfered in the middle of the night.
My concern is they walked in the room, saw hazardous materials and sharps in the room, and did not immediately pick them up. I understand this is not a recent event, but if this happened today and I was the oncoming nurse I would clean the mess up and file an event report to investigate. The doctors shouldn't have left the room dangerous, and it didn't look good on the outgoing nurse (even if you weren't aware a mess was present, it still looks bad).
It's sad that it looks bad for the offgoing nurse that doctors left a mess in one of her rooms, including sharps and bloody sponges, etc.
Even if she didn't know about it, even if it happened in the last 15 or 20 minutes of her shift when she's tied up with giving Report, even if she made rounds shortly before the docs rounded and had left everything clean and orderly, it somehow is her fault.
Remind the oncoming RN that this is a 24 hour facility and that it is everyone's responsibility to provide patient care including environmental cleanliness.
Here is my question. Why not delegate that responsibility to the aide?
I don't think we had any aides in ICU back then. This was a long time ago, but that's my best recollection. Otherwise, that would have been a great idea.
OP was new, seemed shocked by the 3-11 nurse's loud and angry approach.
I agree, it's a 24 hour thing. Oncoming nurse certainly had a right to question the reason for the mess, but should have been nice about it.
Agreed but they think they are God, and gone to boot. However, I have worked with an otherwise dear male nurse that would open his diabetic needles and other supplies in the supply room and leave his packaging on the shelves, I was always cleaning up after him, he was gone. I'm sure I wasn't the only one. My husband is the same way. Open any food package and leave it on the counter or table instead of throwing it in the trash that is RIGHT THERE. No amount of mentioning it will change them. I think it is passive aggression.
Kooky Korky, BSN, RN
5,216 Posts
Oh, you imp! LOL, good for you.