Who's responsibility is it?

[PEBBLES1]

I am a new nurse, but not new to the field. Here is my question? Who's responsibility is it? If you give report to a nurse and a situation occurs with a patient who should go? Here is the scenio. Report was given to a nurse on a patient. The PCA came to the conference room and asked me if I still had the patient I told her no and that I had given report to his nurse and we will call her Nurse A and we will call me new nurse. The pca told the nurse A that she should go to his room and nurse A said why and she told nurse A that he had pulled out his peg tube. So nurse A turned to me and said "I didn't get report from you New nurse" Anyway, I told her oh yes you did and she refused to move and go see about the patient. Although, I did go, I felt that because she was given report, she should have gone because she had recieved report on her patient. So, the next morning I approached her and she said the reason, why she didn't go was because she was still in report, however, so was I. She was the nurse coming in and I was the nurse leaving. She also said, I had the patient for 12 hours, so that's why I should go. My feelings are, we should have both gone. She was the primary nurse and I could have been her back up. What is your feelings, please let me know what is your take

[MT1403]

Hey there, I totally agree with you. I think both of you should have been in that room to help resolve this situation. You were important in the scenario because you could've provided any valuable information that may be needed on anything that happened throughout the night and you having had the patient for an entire shift know more about the patient than Nurse A. But it was also Nurse A's responsibility because she is this patients new nurse and since she has already gotten report she needed to be the primary one in that room with the patient whether she was in the middle of report or not. Good Luck with your new career!

[SolaireSolstice, BSN, RN]

My understanding is that once you have given report, you have "handed off" care of the patient. However, being that you both were in report, is there no one else who "covers" the patients during that time? I actually had a similar situation recently, and asked my preceptor about what my responsibilty was, and she said it can go either way. Once you've given report, you are done, but taking care of a patient who needs care trumps all.

[retiredlady]

It would have been nurse A responsibility, but as the nurse going off, to be nice you should go in to help.

[PEBBLES1]

Thanks for the 2 comments. I forgot to mention, this patient has been on my floor since May 2010 and he is a frequent flyer, so every nurse on my floor has had the pleasure of caring for this patient

[CoffeeRTC, BSN, RN]

Technically....it is her patient after you give report. Was she done getting report from other nurses?

If I was done giving report, I probably would have said "I'll go check" then come back and get her if it was more than a few minute thing.

[llg, PhD, RN]

I agree the best option would be for both of you to go.

However, if only 1 could go, I would choose the "new nurse" who has been with the patient for the last 12 hours. Nurse A, just coming on to the shift has not had the opportunity to get up to speed with her assignment, quickly assess the patients, establish priorities, etc. She has not yet received her full report. Where I have worked, we have always given the nurse coming on the next shift a few minutes to "digest" the information she received during report and organize her thoughts before having to respond to an emergency (or other situation in which quick action is needed).

Expecting someone whose thoughts are still not organized to step in too quickly can lead to poor performance. Those of us who are already "up to speed" with the patients are best able to make quick judgments and take quick action. However ... the nurses coming on shift should not abuse that courtesy. They should join in the care as soon as they reasonably can.

I'm sorry I don't agree with you OP. But I think the better patient care results when the person already up to speed handles things during report. Give the person coming on shift a few minutes to finish report, digest the information, check her patients, and organize her thoughts before expecting her to handle an unexpected event.

[Nurseinprocess]

I kinda think the pt is still your responsibility until you punch out, at least to a point. No nurse coming onto a shift wants to walk immediately into a problem like that. I don't think any of the nurses I work with would have jumped up and said "Let me take care of it!". Tough call. I know the oncoming day shift expects every little thing to be done when I am handing off pts; God forbid they have to give pain meds to anyone in the first half hr of their shift, or change a bag of fluids within two hours. Of course this doesn't apply to the night shift when afternoons is handing off their pts to us. They can tell me to hang a second unit of blood when the first one was completed 3-4 hrs prior (she had 4 pts, I was walking in to 8 pts!). Nice.

[24 yrs and counting]

I think both should go in, Bedside report helps when issues like this accure at change of shift, It always happens when one it trying to leave and anouther is comming on.

[SaltyNurse]

I'll echo that the responsible thing to do is both go. You, because you know the patient (even if s/he is the patient that's been around the block a few times with everybody or not) and it is bad form to leave a hot mess for your relief, even if it happened just after hand off. And she needs to go in order to see and begin to get a handle on the situation which is now going to be her responsibility. Yes, it is important enough for her to delay receiving report on other patients. Golly darn it, but you just can't avoid some inconveniences once in awhile when you choose this career. And really? What is the big bruhaha? Stick a foley into the tract, do a quickie wipe up of the mess, make sure your patient is going to be safe and not get into any more mischief and page the attending physician. Finish report. Then a nice thing to do would be to offer to detail clean the patient and/or room after report. Courtesies like that will be returned to you. Lack of courtesy will NEVER be forgotten.

[Blouis, APRN]

I agree with the rest of you. Once you have recieved report, it is your responsibility. However the best case would be for both nurses to see about the patient. In our facility, it would be on the nurse coming on but since the nurse reporting knows all the updated info on this patient, both should be there. Even during report, if an emergency comes up, report is on hold and both nurses go see about that patient.

[Redhead28]

I think the responsibility lies with both of you. You as the off going shift, know the patient and what has happened in the last 12 hours. The on coming shift has to be in there to know what is now going on. Report should be interrupted for patient care, the patient should always come first.