Whose responsibility is the incident report in this case?

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Hello,

As a new nurse, I am a little slow at getting things done. I also work on a really busy floor with constant interruptions, so my med passes are always late. I have 18 patients right now and sometimes up to 22. I am really sick of getting held 3 hours trying to catch up on filling in certain documentation in the MAR, writing my discharge and Medicare notes in the computer at the end of the day, etc. I'm 7-3 shift. Usually by the time I get to my notes I've had it. I'm tired and worn out and frustrated and some days I want to completely give up way before the end of the day. If I still get questions from family or residents, I would try to help. I'd also answer phones since I would document on the computer near the phones, but the longer you stay the more things that come up and it really keeps you much longer than your shift. So I stopped answering phones once I pass off the cart and if anyone asks for anything while I'm documenting, I started referring them to the nurse that took over or an aide on second shift if they can help. It's the only way I get out at a reasonable time (1-2 hours finishing up my daytime tasks, instead of 3 hours extra). Keep in mind, I'm still on orientation and shouldn't even be getting overtime right now.

Anyway, today, around 4pm-after giving report and handing off the med cart-a CNA wheeled a resident out who had blood on his arm. I was finishing up my charting for the day and the nurse said that it was a previous shift incident, but that was the first moment it was brought to anyone's attention so I said, "We're on the second shift now and I'm off the cart so I'm no longer in charge of this patient, you'll have to do the report." She argued with me and ultimately gave in because I said that if I had time during the day to do my notes and they had been done already, I would have been punched out and left the building already right after handing over the cart and reporting off.

Was I in the wrong here? I think it was an old skin tear anyway, but why wouldn't it be her duty to assess and write the report if it was first mentioned on the 3-11 shift?

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It indeed should have been the nurse who took over for you. If you would have volunteered that would be one thing, but since you were already working over your shift, they really should have just taken care of it. Are you in LTC?

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...I would have been punched out and left the building already right after handing over the cart and reporting off.

And that's the problem. When your shift is over, GO HOME. If you're sitting around charting, things are going to keep happening and people are going to keep expecting you to handle them.

It's the next shift's responsibility, in my opinion ....but yet, you're both still on the clock.

Focus on getting your charting done as early as possible. Tasks can be passed on, but charting can not.

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Yes I am. It's the rehab floor in a Ltc facility. I don't think I can handle it. I might be leaving but I'm afraid most facilities will be the same.

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That's the problem! Until I hand off the cart I can't even begin my charting at all! There's way too much to do. Meds are the primary focus and those never even get done on time, then there are orders and miscellaneous requests throughout the day. I just have to write it all down in a to do list and work on that when I hand off the med cart. Then you have treatments to do, which never get finished. I'm honest about it and I don't sign off if I didn't do it but some nurses just sign to be able to get done. I'm going and going right up to 3:00 or later when I catch up on the tasks I couldn't complete earlier then I try to focus on banging out the chart notes. I'm really discouraged. I don't know if it's just this place or if every place is like this but it's overwhelming and there's not enough time in the day for everything that has to be done.

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That's the problem! Until I hand off the cart I can't even begin my charting at all! There's way too much to do. Meds are the primary focus and those never even get done on time, then there are orders and miscellaneous requests throughout the day. I just have to write it all down in a to do list and work on that when I hand off the med cart. Then you have treatments to do, which never get finished. I'm honest about it and I don't sign off if I didn't do it but some nurses just sign to be able to get done. I'm going and going right up to 3:00 or later when I catch up on the tasks I couldn't complete earlier then I try to focus on banging out the chart notes. I'm really discouraged. I don't know if it's just this place or if every place is like this but it's overwhelming and there's not enough time in the day for everything that has to be done.

If you're a new nurse, chances are that you can handle it and you will get a lot faster. Keep experimenting until you find a method that works for you ....but try very hard to knock that charting out early as opposed to leaving it for the end of the shift. Ask someone you trust for advice on how to make it as complete as required, but brief.

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That's a good idea, if I can at least get that done during the day then I can go down the list of all the other tasks as soon as I hand off the med cart and I won't be stuck at the computer right in the middle of the nurses station. Thank you for the encouragement, I really needed that.

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Specializes in LTC and Pediatrics.

I always figured that when report was finished, narc counted and keys handed over to the next shift nurse, that I was now off the floor. Fortunately, wherever I have worked, I was left to do charting. If you can, try to find a place away from the phone to do the charting. Another idea is to tell the caller that you will have the nurse who is on take the call and give it ti her, You will get faster,

About the skin tear, it was discovered and reported on the next shift and with that nurse being the one on the floor, she is the one to fill out the report. Good or you for standing your ground, Hopefully she won't be trying that again.

As has been said, you may want to see what you can do to minimize the extra time. Time management takes time to establish at each place.

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Head on over to the LTC forum...lots of advice on time management in the rehab snf setting.

I've been in SNF for the last 20 years and wouldn't have expected you to do the incident report. Things like this happen. It is life. You are a new nurse and just getting the hang of things. It will take time. 18-22 people isn't bad, so the grass probably won't be greener. If you are still on orientation, you should have a preceptor or someone to help you/ train you. Where is that person?

Do you have a charge nurse or unit manager? When i work 7-3 I refuse to answer the phone unless it is paged to me. During the day, the office staff will answer the phone and direct it to other departments. This helps a ton!

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We are supposed to have a secretary but she's leaving so we've all been expected to answer phones. Since I was signed off on the cart, I haven't been paired with anyone but I am technically still orienting to the facility and will be for another several weeks. Today I'm supposed to be orienting on the desk but my preceptor is equally as busy and hasn't had much time to explain anything. It's so frustrating! I really don't have anyone that is precepting me.

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Specializes in NICU, PICU, PACU.

Usually it is the person who finds the "incident" who fills out the report.

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Yes and I left that facility. I'm still in LTC and it still gets crazy sometimes but not nearly as bad/unorganized as this place.

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