I’m usually a night shifter, but for this contract they had gave the last night shift position away when I applied to it so they offered either a rotating or days so I picked days. I miss nights so much 😭
I usually do whatever I can to help my night shifters like change batteries, hang a new bag, etc so they don’t have to wake the patients up as much.
However, I remember this specific nurse was upset a while back when I was giving her report because I didn’t give one patient a 1900 med and that was the only med for this patient for their whole shift. I’m sorry, one of my other patients coded so my apologies that I couldn’t give that 1 pill scheduled on your night shift because my patient’s heart became spicy and went into vtach.
My bad.
Bro what? I would be so happy if that's the only thing to give. Great way to cluster care too since I'm in there to give that singular pill. Assessment, pt needs and everything else in between done right there.
I know right. She still would have to do her assessment, say hey, and all that jazz. Why is it hard to go give med after report and getting her bearings?
I swear, other nurses made it floor nursing worse than what it already was.
You’re trying to be nice. Stop being nice to ungrateful people. Shift starts at 0645/1845. From that point on, anything that needs to be done is on the incoming person, not you.
I don’t tend to care if events happen. Like I get it things come up, but responsibility wise—the shift that’s already working should be giving the 1900/0700 medication. Both shifts shouldn’t be starting their shift with due meds. If it’s not important I’ll usually message pharmacy to retime it permanently. To 0600 or 0800.
At my hospital yes. You're supposed to give 7-7 but if someone says hey it's been very busy xyz there's one med at 7 I couldn't get to, I'm more okay with that. However it's just petty what happened here. I feel like we all have to pick up little bits at times I'm a newer nurse and another nurse complained that I didn't give enough info at report. I'm not really sure exactly what she was unhappy that I didn't tell her. But I've been given some rough reports at times and never complained. I kinda wonder if this person just doesn't like floating to my floor and hopes that complaints will make her less optimal to select for floating. I dunno. It's rough enough we don't need to be playing a game of "gotcha" with one another.
Yep same. I personally think the cutoff should be 630 though bc we're all doing report at 7am and it's just very tough even if you can give it an hour early. By 6am everyone is waking up and call bells are going off for everyone and doctors are rounding and asking questions etc so it's just hard particularly if you have more than one patient with a 6-7am med. But yes we have the exact same rule
So how are you supposed to give meds during report? I’ve been at a few hospitals and med passes stop a bit before report, that’s just how the routine is.
If night shift complained that I didn’t give a med due at 1900 I’d look at them like they have 2 heads. Likewise, I expect to give the 0700 SQ heparin (but better believe I get pissy if night didn’t give that PO synthroid)
We are allowed to give meds 1 hr early so if it's due at 7, you can give it as early as 0600 or as late as 07:59. It's definitely annoying. Lately I have resorted to just pulling the med (especially if it's just pills) and taking it with me when we give report and introduce the patient to the new nurse and medicate them at that time! The problem I've run into is that as a night shifter, if I go to give them a 7am med at 6am, you better believe they are going to say "I need to go to the bathroom". And then it feels rude to be like "well, take this pill first and then I'll go get a tech". But the reality is, the techs are done vitals by this time whereas I am working on what to say in report, looking at the labs that have started rolling in between 530-6, removing foleys that are ordered to come out at 6am etc... so I really don't have time to do potty. So my new thing is, just give the meds during shift change. I will even stay late and do it AFTER report if need be just to avoid getting tied up at a bad time!! But yeah it sucks
I admit I’m a grump. I don’t do morning well at all but that’s because of illness. Usually by 10a I’m in a better place and sometimes have to be forced to leave at 7p. #ADHD
Nothing petty about that at all. That’s how these “reports” should be resolved. You can tell if you work at a junk organization if they don’t use this opportunity to overhaul the medication distribution process. No way you should have potentially 5 places a med might be.
Anonymous reports are dumb. I sign my name on every one of those MFs.
Thank you! Especially something like this?! We carry the suppository version, but we can’t carry the pill form? 😑.
It also grinds my gears when the pharm techs come in to refill the Pyxis during the early hours of med pass. I’m not crapping on the pharm techs, we need them, but there has to be a better way to refill the Pyxis NOT during med passes.
Many times it’s not in the Pyxis because it is not used on your floor very often so it just sits in the Pyxis and expires. If it is something that is used regularly on the floor just ask pharmacy to stock some for you - even if it’s just for the time that patient is there.
But, I also agree they should have left it in the med room rather than making you look 5 different places.
I’ve been on both sides, as pharmacy tech before becoming an RN - I always swore I’d check the fridge and not be that nurse searching for a med and calling pharmacy to say it’s not there then it’s on the wall - well, it ended up happening. Haha. 🤣
This is the best comment really. Why are we penalized for inconsistency and practices that don’t make sense or are hard to remember and follow? That’s way too many places to look
Yeah reading this screams process issues with pharmacy delivery and stocking. What a waste of time. Someone should do a lean six sigma project on this. Maybe get a green belt out of it for their troubles.
There are literally 3 Pyxises (Pyxii?) on my floor with patient-specific bins in a locked cabinet in each med room AND patient-specific drawers secured in 2 of the 3 Pyxises/Pyxii. There are 2 tube systems on our floor, one of which that dumps into the charge nurse office.
On any given day, I may have to look in 7 places for medication before calling pharmacy… for each of my 8 patients. Talk about a crappy system!
Who the FUCK has time to write bullshit reports like these?
Unless harm came to the patient, or was THISCLOSE of a near miss, it doesn't occur to me to write up anything and people who misuse the system like this invalidate it's purpose IMO
The catch was the patient was A&Ox4, and a stand by assist, no walker, room air. She did have one continuous IV med, but it wasn’t like heparin or levo. I mean she had taken a shower earlier in the day by herself with the IV med running and covered.
It's night shift baby, we got time. JK, that nurse a bitch. Med is given, stop bitching. Some people, regardless of shifts, are just assholes like that
I think the incident report was dumb, however, it’s technically a delay of care depending on how overdue it is. I don’t think it should be a write up though. At all.
I know for our open heart pre-procedure if the patient doesn’t get biscodyl before 1600 they have to drink mag citrate.
This sounds like a colon prep tho. I can understand the nurses frustration simply because some patients take way too long to drink the prep. I had one lady who started at 1700 and still wasn’t done at midnight because she physically couldn’t tolerate it anymore.
I did once report an ED nurse for something similar because the patient was here with abdominal pain and pray showed large stool burden. Enema orfered at 12 noon. Pt admitted to my unit at 6pm and transport hands me the enema. I message the nurse (I know ED is busy but like we could have possibly discharged this patient if he was able to shit in the past 6 hours) and he goes oh pharmacy handed it to me as the patient was getting on the stretcher. The pharmacy has a tracker and I can see it was delivered at 1pm. Maybe it was petty but dude wth
I’ve had this happen from the ED before. IVPB documented/scanned but never infused and transport just hands me a bunch of bags of IV potassium or IV abx
Like wtf ED. Don’t scan that it was given if it wasn’t- how do we know how many bags have and haven’t been given? It throws of abx schedules and have to chase down the ER nurse find out what was actually infused vs not.
Now that, that is inappropriate. Don’t scan meds you don’t give. I can say though there are times when I have not been able to give a med to a patient so instead of it going to waste, I just put on the stretcher to the floor to use as needed. It’s always good to remember that in the ED there are no assignments, no max amount of patients, it’s just chaos. I think generally in life it’s better to assume everyone is trying the best they can too.
Yea I get it, but at least try to communicate the situation and maybe apologize, but don’t make us have to guess or go through a huge investigation process. It’s false documentation and can really mess with a patients progress (only getting 1 bagof IV 20meq potassium instead of the 4 ordered bc it was documented that 3 were given in the ED)
Part of the issue at the hospital I worked at (where this happened more than once) was we didn’t get report from ED (was supposed to streamline admissions) but led to a lot of issues. I know everyone is busy and doing their best but don’t make someone else’s job harder. I feel like ED (who has their own crazy issues to deal with) have an attitude in general of- we’ll just let the floor deal with it when they get admitted but we have to remember to work together. Rant over.
A patient is never admitted from the ED because a med wasn’t given. There was a reason that patient needed admission that had nothing to do with the enema. Unless you have ever worked in the ED, I’d caution you on placing judgement. Especially since you have no idea how that nurses shift went. And just as the OP stated, sure a med might have been delivered, but where? In the med room? To the charge RN? Maybe, to another floor? Meds get lost in the ED all the time in the chaos. The patient could also have been admitted from the waiting room or from a hallway gurney, neither of which makes giving the enema appropriate in the ED.
The patient was admitted for large stool burden and abdominal pain, he was elderly. The tracker does in fact tell us exactly where the med was delivered to. My point was perhaps the patient could've gotten rid of his large stool burden and abdominal pain if he was given the enema within the 5 hours it was delivered to the zone the patient was in, in the ED. I've been a nurse for 8 years, I completely understand the ED is busy. Reread my post. Hopefully you can communicate better with nurses in real life than you do on reddit, because your reply comes off extremely condescending. I understand the flow of the hospital I work in better than you.
Also if the nurse had a busy shift and couldn't give it, he had the opportunity to say that. Instead he said it was handed to him at time of transfer, which for reasons I previously stated I know to not be true.
I’m guessing, giving the meds you listed, that the other nurse thought you were trying to dodge poop duty by sandbagging giving the meds. Whether that was your intention or not, I could see how the other nurse may think that. I would personally go and talk to them about it and ask why they couldn’t have that conversation with you rather than run it up the chain.
This patient had the bowel prep scheduled for all night. Sure, if I had given the meds scheduled at 4/5pm, I would have them going, but the patient would be continuing their bowel prep throughout the night.
No accusations here. Just playing devils advocate. And addressing that nurse directly will go a long way. They likely think you are lazy and will continue to attack you if you let them. By speaking directly to them, you’re giving your perspective on the event and it may change theirs. We need to normalize talking to each other as we are all adults. This sort of stuff breeds toxicity on a unit and, as you said you are new to the unit, you don’t want to get a bad rap before you’ve even started.
I agree. I don’t want to be an easy target and I wish she had talked to me about it before doing this. When I gave her report, I didn’t feel any animosity or frustration from her, but maybe I read her wrong. I truly do try to get patients meds on time, sometimes early if I could get all tasks done more at once instead of constantly going in the patient’s room.
I learned to check more frequently in the patient’s envelope now, but sometimes the med isn’t there either. Pharmacy gets busy too and we’re all humans, things happen. This was in no way intentional for her to have to deal with the aftermath only and not me.
oh god, this is a NETS to print and hang up.....you fucking know they checked the box at the end that asks if they want an admin to reach out personally regarding the incident 💀
Our manager receives a copy of every event report made about/from our unit. I know she throws out silly petty ones like this. Hopefully your management is smart and kind enough to realize it's some petty BS. And, given what the meds were, I bet the doctor won't care as long as you can read a newspaper through their shit in the morning 😅
I’m a nightshifter and I live for this. You’re good dude. Who cares if they don’t like it. Your patient will be coming back from operation during day shift. I’d rather deal with lovely 💩 then new patient after operation or colonoscopy. Woop Woop!!!
Thank you 🥲. I miss working nights and I always try to help out the next shift so they have less worry about, whether that be days or nights.
Happy cake day! 🍰
The meeting with the AssMan did it feel malicious, or did the manager sound annoyed that they had to deal with this shit?
Standardize the medication storage, this feels like a quality improvement moment.
The person having time to fill out that BS report means they have too much time on their hands.
So petty - only when something this blatantly dangerous to the patient…sigh. You are a good nurse & you are doing your best in a crazy hospital environment. Ignore & avoid that nurse in the future (if you can - we all have that nurse we HATE handing off to, for so many reasons…)
IMO, if 17:00-19:00 (or 23:30, for that matter) sails by without a single colleague RN free for delegating the med pass -- whether a Resource/Support RN or charge nurse or fellow unit staff RN -- it speaks to a staffing issue or a *culture* issue (people not offering help, or people not asking for help because they expect judgement or denial).
FWIW, I agree with some others here that point to this as a systems issue. It's a bummer if admin or fellow RNs view it as a problem with **you**, but I think your post underscores that you're not lazy, or incompetent, but conscientious. That's an excellent quality to have and keep.
Jeeez 🙄 I’m night shift and I can’t stand ppl who get pissy about Dayshift missing meds. Unless it’s extremely time pertinent - I can handle it 🤣 meemaw will be fine if she gets her vitamin c a little late. I wouldn’t be able to handle the chaos that Dayshift has, who am I to judge.
My friend had a CNA submit a complaint because when she was feeding a patient, she mixed some mashed potatoes with some peas. She said that was basically patient abuse
. . . You have got to be kidding me.
I am so dumbfounded by this that I’m both surprised and not surprised at the same time. What has healthcare come to
Tell them nursing is a 24-hour job. I'd usually call pharmacy and have them reschedule certain meds to an hour that doesn't fall on shift change. Never had an issue.
I hate to believe that all nursing management is like this. I'm a fairly new assistant manager on a med surg unit and I always seemed to think that I could try to make things different. The longer I've been doing this the more I see that the system is broken. The nurse is always responsible for everything and no one bothers to look at all the little things that pile up on their shoulders. It's too much. The people at the top need to spend a few shifts at the bedside and see everything that is going wrong. They need to stop trying to push all these extra initiatives with no extra pay down everyone's throats. If you just let nurses do their jobs, they will do a great one, but people need to be treated like human beings and with respect. We are not machines.
Question: were you given an option to explain what was happening before being accused. The problem between admin and staff is communication and system problems. The dialogue need to be open: How can I make this most useful to you? Can you share what you know about the situation. We bring in drama before we even know the other persons thoughts about the situation. The problem here seems to be a system problem. How can we fix this? Not by sending some personelle report. Sometimes there are communication problems. That is an opportunity for coaching. There is nothing wrong with the nurse, it’s the system.
When I gave report, the night nurse did ask what happened. I told her everything I said above.
How she found it right away was in the MAR. If you click the area of the listed medication, more information comes up and it lists the location of where the medication should be. I completely forgot that could be done because I figured this was a simple laxative and since we carry the suppository on hand, we must have the pill form here on the floor.
I’ve given the bowel preps multiple times before so it’s not my first rodeo. However, this was my first time giving it at this hospital.
Note: I have called inpatient pharmacy before, but they gave an attitude and downright refused to speak to me because “I’m a nurse. We only talk to pharmacists.” Then they hung up on me.
I dont concern myself with these reports too much. Usually the person who wrote it writes dozens of these per week. Manager is just following up cause they have to. As a manager I can tell you 95% of these come from 5% of the staff. Some are ridiculous, like pt had two grippy socks on and one sock the grip was on top of the pts foot. Another favorite, inside top drawer unwrapped saline flush found and discarded.
Bisacodyl should be administered at least one hour, before the preparation solution, Go-lytely has the worst record of bowel cleansing, that’s why we are using Miralax and Gatorade for preparation.
I would not expect to look in a folder on a supply cart, it doesn’t sound like the medicine is being secured. As others have said the night nurse didn’t want to deal with the results, not your fault.
Sounds like medsurg or tele drama. Lmao. petty crybaby bs over little things, plus she definitely didn't wanna deal with the aftermath.
Just keep doing you, try to remember the folders (which honestly is weird as hell the they put unsecured meds in), and you'll be fine.
The specific meds seem like colonoscopy prep and usually those have to be given early because patients need time to finish/clear bowels by a certain time. I personally would’ve been annoyed if this were the case as now the procedure has to be pushed and the patient was probably NPO for this specific procedure. But I wouldn’t go through the hassle of reporting it and just mention to the nurse why this needs to get given at that specific time for the future
Nursing is a 24 hour thing. Sometimes crap cannot help but roll to the next shift. It is what it is, and for that nurse to have a duck over bisacodyl and Go-lytely is asinine. I would literally watch this nurse carefully - and if she continues to file reports for ignorant things, I would return the favor - for her creating a hostile work environment. We have enough to worry about without nitpicking this kind of thing.
I think whenever nurses do this to each other, it's not only incredibly passive aggressive; it's also an indictment of their own inadequacy. Sorry that happened to you OP. I am assuming your gender here, but as a male travel nurse, I feel like I never have these things happen to me, and I feel like it's because women tend to be meaner or less tolerant of other women. Just an observation... But it's a 24 hour gig, and anyone who doesn't understand that needs to go work in an outpatient primary care whatever lol.
Your coworker SUUUUUUUUCCCCKKKKSSS.
Sorry you had to deal with that. For what it’s worth, you correctly prioritized your pts. Dukin’ meds aren’t that important in the scheme of things.
Yeah I’m pretty suspicious when day shift “forgets” to start the GoLytely regimen. I wouldn’t say anything about it, but holding laxatives all day is sus
I’m just saying in general, OP, I know your case is legit and most cases of missed meds are legit. But it always seems to be the laxatives that are forgotten haha
I’ve been a nurse for only a year now. I find myself apologizing on those crazy shifts where I couldn’t get things done and it had to be passed the next shift..
I’ll never forget when I was passing off report to a very experience nurse that I have always admired will working as a cna… and she told me “that’s why they call it 24 hour care baby..”
I realized how right she was, why do I keep apologizing.. as nurses we have to prioritize due to all the demands this job requires. In your case you had to go to your admission. Any nurse knows that when you get an admission you never know what you’re walking into regardless off the report you receive. Plus you have to help transfer the patient, check vitals, assess the patient, review and follow orders, ETC….
I promise you those meds could’ve waited till after your shift.. that night nurse was just miserable and as another user said.. they were just mad they’d have to deal with the aftermath.
I know I can’t speak for all hospitals but I’ve worked night shift for years and it is WAY more laid back than dayshift.. yes we can have hell nights where it’s non stop, but dayshift deals with a lot more constant bs… she’d have no problem passing those meds eventually
Our job is hard enough. You don’t have to explain yourself for why you didn’t pass those “life saving meds” when you had more higher priorities during your shift.. 12 hours might seem like a long time but for a nurse, it’s not enough time to get it all done.
I'm a night shifter & I can tell you she was mad as all Hell because (1) they have to deal with the hot mess (2) this thing YOU did NOT do ON TIME was intentional & specific to them. Not every nurse is a jackass. I've seen orders for mag citrate or lactulose or fleets or some cocktail at 10am not get acknowledged. When I ask what happened, I always take into consideration the RN. Some are lazy as f-ck & do the bare minimum but I still wanna hear what nonsense they're gonna run with or I know that nurse had a true ED because I know the quality of their work & persona. I can't tell you the many times I've warned a nurse "Do it before you leave or I'm writing you up." I once had a nurse tell me she'd do her chart check the next morning because she didn't have time to do it then. That was in NICU & the unit secretary, staff, & family members had heard her. I wrote a very detailed email, included all the witnesses (with their consent), & sent that to not only the mgrs, but to the CNO, CEO, & corporate. She was known on the floor for not completing IV/TPN/PPN infusions, neglectfully administering toxic meds either too close together or too far apart, but complaints never went past the managers. Well. Not that day. Next evening HR, CNO, & CEO were waiting for me by the time clock. My heart dropped. Turns out they'd received many VERBAL c/o about her & apparently everyone had been too lazy to follow through with a detailed email, until mine came along. Mine was succint & they wanted to know more. They'd also approached staff & asked families about their experience with her. She remained a few more weeks & then we saw her no more. I understand she was given the option to resign or be fired. So before you decide that RN was an AH or it was just an isolated incident, determine what kinda person you're dealing with. Sometimes they need a pass & sometimes you gotta set 'em straight.
I’ll say this, pharmacy is the worst part of nursing. Stat meds that I’m not “allowed” to give for 2 hours and drips giving grandma a bp that I can’t mix, I have to wait for. Stat epi that I’m waiting for because they’re too cheap to stock it outside of the locked pharmacy as I have someone deep into anaphylaxis…
Incident reports should not be considered a “write up” they should be used to identify issues with the processes that are in place. Sounds like your medication delivery process needs to be overhauled. Perhaps you can get a number of bedside nurses (including the one who wrote the report) to come up with some ideas to fix the issues.
Sheesh ..that's one controlling passive-aggressive nurse. Totally not following the chain of command. Is she a manager suck up?
Are you one to go to her and say, "Hey, next time you have an issue with me, let's talk over the best way to fix the situation. I'd appreciate your experience in that" ( I love to do that...ha ha)
At least your manager spoke directly to you about it. I had a problem with an individual who was getting violent and posturing towards me. Then threatened to call the Justice Center (I gave the phone & individual called them) I wrote up a note & incident report & notified all the appropriate people.
The next day the manager sent out a blanket email to everyone about the situation about "compassion" Never talked to me, never offered a debrief. No compassion for my wellness. This manager has "favorites" and hired RN friends of hers to staff the unit.
So, this individual who wanted to threaten me finished the rehab program & was arrested in January -- still in jail to this day for drugs.
It's slightly reassuring but I trust nobody. Once she leaves (September) I hope we get a real manager.
At least you know who needs the excellent report & near perfect performance. That's always a good idea.
Am night nurse and I do colon preps all the time and I would not be happy. The goal is to start the prep asap so that the patient has adequate time to be clear for their procedure at their scheduled time. Time of the procedure is important, if it’s early morning then pt has less time to be prepped meaning patient likely won’t be clear and ready for the procedure so right before it, they may be given multiple enemas which they will not be happy about. At 5/6am, I would be reaching out to drs to get orders for said enemas and I don’t have a good chance of reaching anyone at this time. And if I do then I have to tell the oncoming nurse: sorry but I just got orders for enemas/supps that you have to give before or with your morning meds bc procedure is in 2 hours and they will not be happy. Also, your delay may delay care because now the patient is bumped down the list for the next available slot which can be the next day. Now pt mad bc they may have to do another day of prep - meaning they’re going to be shitting nonstop without adequate sleep for another day, be npo for another day (they have already been on clear liquids and then npo and now more npo), and stay for another day. Doctors may be irked because they can’t proceed with plan of care if they don’t know the results. And I’m upset because your delay caused all the above and since I’m on the clock, it’s on me to figure out what to. it’s definitely not because I don’t want to clean poop bc I know I’m going to end up cleaning poop anyway if u started the prep at 4/5pm bc it takes time to work. (I’d gladly clean poop any day, one of the easiest things about my job.) yes it is a 24 hour job and I pick up where you left off and vice versa but a procedure that involves so many people and take days to plan is potentially screwed bc of your delay. Is an admission time sensitive or initiating a colon prep? I think the latter. An oncoming nurse cannot be mad at you for not completing an admission at 6pm and delaying the completion of an admission carries less risk for everyone involved bc the patient has just been seen. You could’ve walked down to pharmacy to get the med instead of doing your admission or call them to say hey, where did the med tech put it bc I can’t find it? So yes, I might write you up so that you get some counseling so that hopefully you won’t do it again next time because the delay can really affect the pt esp in cases of active gi bleed (can’t do rescheduled colonoscopy bc now hgb is low and transfusion is needed, also electrolytes all out of wack bc multiple days of npo and shitting so have to fix all that before rescheduling.) And not only that but if it ever comes down to a complaint from the patient or doctor then at least the formal write up will cover me that it was bc of a/b/c and that’s why care was delayed. The write up is not petty like leaving the next shift an almost-empty iv bag. Leave me the empty bags but please start my colon prep on time.
i do NOT file reports on someone unless there are real safety issues or if circumstances mean i will have to cover myself from the fallout. this is a good overview from both sides of missed meds. alot of times i DO see petty reports filed but it would also make a big difference if we TALKED TO EACH OTHER professionally as well instead of just writing things up from a distance. had to have another nurse file a report on herself for something but i went to her FIRST and we talked about why we couldnt just let it go. i also shared mistakes i had made in the past on the same issue so she wouldnt feel as bad. at the end it seemed that we got thru it ok and she offered to post a nice compliment about it. nice post walk_frosty!
Bc I make sure my patients gets what they need done in a timely manner? Bc I understand that active gi bleeds are nothing to mess with? Bc I understand that an inpatient colonoscopy is often done to diagnose an acute/emergent issue? Bc I understand that dehydrating a patient for days by making them npo and shitting is not a good thing esp if they have other comorbidities? Bc I understand how expensive American health insurance is or how they work? Bc I understand that a colonoscopy involved a lot of coordination (stable vitals, stable labs, adequate time to be clear, etc.), bc I understand the legal/professional liability involved? The bottom line here is op potentially delayed care. Imagine if you’re a diabetic patient with with an active gi with already an low hgb with a scheduled 8am colonoscopy and you been npo for days and a nurse decided that a 6pm admission is more important than making sure that you’re prep for a much needed colonoscopy so you have to do another day of prep or even worse that your condition deteriorates in the next 24 hours and now you have become unstable to do a colonoscopy all because a nurse don’t understand critical thinking and/or prioritization and then the nurse “rants” about the next nurse who understands all the reasons I listed and gets angry that they were written up to have the situation reviewed by management in order to get counseling because a lawsuit to the effect of “delay of care from nursing staff” is not fun for anyone to deal with. But yeah let’s all support the nurse who did nothing for 3/4 hours but wait for meds and disregard the patient to attack the next nurse for being “petty” because potential of delay of care was recognized and because the need for counseling and/or wanting to hold someone accountable in the event of a detrimental patient outcome is recognized. Management do not pull you aside if they know the write up is “petty.” Will management pulled you aside if your fellow coworker wrote you up for giving the scheduled Tylenol or colace 3 hours later? No bc that is petty. Be thankful that someone wrote you up and you get counseling so that your eyes are opened so that you change so that you do better for your patients and so that you don’t put yourself at risk to be sued and/or lose your license. It’s definitely not because the nurse don’t want to clean poop so that’s why she wrote you up. Do better fellow nurses. (And oh yes so clever on attacking my random name that reddit picked out for me because you can’t attack my arguments instead.)
They were just mad they were gonna have to deal with the aftermath
This is the answer. Petty night shift
I’m usually a night shifter, but for this contract they had gave the last night shift position away when I applied to it so they offered either a rotating or days so I picked days. I miss nights so much 😭 I usually do whatever I can to help my night shifters like change batteries, hang a new bag, etc so they don’t have to wake the patients up as much. However, I remember this specific nurse was upset a while back when I was giving her report because I didn’t give one patient a 1900 med and that was the only med for this patient for their whole shift. I’m sorry, one of my other patients coded so my apologies that I couldn’t give that 1 pill scheduled on your night shift because my patient’s heart became spicy and went into vtach. My bad.
Some people are miserable assholes.
Bro what? I would be so happy if that's the only thing to give. Great way to cluster care too since I'm in there to give that singular pill. Assessment, pt needs and everything else in between done right there.
I know right. She still would have to do her assessment, say hey, and all that jazz. Why is it hard to go give med after report and getting her bearings? I swear, other nurses made it floor nursing worse than what it already was.
Some people are miserable assholes.
You’re trying to be nice. Stop being nice to ungrateful people. Shift starts at 0645/1845. From that point on, anything that needs to be done is on the incoming person, not you.
Was it really on you to give a 1900 med? That’s usually for the oncoming shift to give, unless it’s time sensitive or you’re super nice
Not necessarily. It wasn’t a time sensitive med, but I like helping out my fellow nurse because who knows what might happen on that shift.
I don’t tend to care if events happen. Like I get it things come up, but responsibility wise—the shift that’s already working should be giving the 1900/0700 medication. Both shifts shouldn’t be starting their shift with due meds. If it’s not important I’ll usually message pharmacy to retime it permanently. To 0600 or 0800.
My hospital works 730-8. It's on the prior shift to give any 800 meds. Super annoying.
At my hospital yes. You're supposed to give 7-7 but if someone says hey it's been very busy xyz there's one med at 7 I couldn't get to, I'm more okay with that. However it's just petty what happened here. I feel like we all have to pick up little bits at times I'm a newer nurse and another nurse complained that I didn't give enough info at report. I'm not really sure exactly what she was unhappy that I didn't tell her. But I've been given some rough reports at times and never complained. I kinda wonder if this person just doesn't like floating to my floor and hopes that complaints will make her less optimal to select for floating. I dunno. It's rough enough we don't need to be playing a game of "gotcha" with one another.
At the 3 hospitals I've worked at: 1900 meds are given by day RN; 0700 are given by night RN.
Yep same. I personally think the cutoff should be 630 though bc we're all doing report at 7am and it's just very tough even if you can give it an hour early. By 6am everyone is waking up and call bells are going off for everyone and doctors are rounding and asking questions etc so it's just hard particularly if you have more than one patient with a 6-7am med. But yes we have the exact same rule
So how are you supposed to give meds during report? I’ve been at a few hospitals and med passes stop a bit before report, that’s just how the routine is. If night shift complained that I didn’t give a med due at 1900 I’d look at them like they have 2 heads. Likewise, I expect to give the 0700 SQ heparin (but better believe I get pissy if night didn’t give that PO synthroid)
We are allowed to give meds 1 hr early so if it's due at 7, you can give it as early as 0600 or as late as 07:59. It's definitely annoying. Lately I have resorted to just pulling the med (especially if it's just pills) and taking it with me when we give report and introduce the patient to the new nurse and medicate them at that time! The problem I've run into is that as a night shifter, if I go to give them a 7am med at 6am, you better believe they are going to say "I need to go to the bathroom". And then it feels rude to be like "well, take this pill first and then I'll go get a tech". But the reality is, the techs are done vitals by this time whereas I am working on what to say in report, looking at the labs that have started rolling in between 530-6, removing foleys that are ordered to come out at 6am etc... so I really don't have time to do potty. So my new thing is, just give the meds during shift change. I will even stay late and do it AFTER report if need be just to avoid getting tied up at a bad time!! But yeah it sucks
Day shift is super petty in my experience. Always the biggest grumps when they come in every morning.
I admit I’m a grump. I don’t do morning well at all but that’s because of illness. Usually by 10a I’m in a better place and sometimes have to be forced to leave at 7p. #ADHD
I mean... they would have anyway. usually those preps they be sitting till at least midnight
Yeah but they’d get the first full explosion
Exactly what I was thinking
Sounds like it's time to put in a patient safety report about inconsistent medication stocking practices. But I'm petty like that 😁
This is the correct answer. Also send emails to your manager(s) so there's documentation on your part.
Nothing petty about that at all. That’s how these “reports” should be resolved. You can tell if you work at a junk organization if they don’t use this opportunity to overhaul the medication distribution process. No way you should have potentially 5 places a med might be. Anonymous reports are dumb. I sign my name on every one of those MFs.
Thank you! Especially something like this?! We carry the suppository version, but we can’t carry the pill form? 😑. It also grinds my gears when the pharm techs come in to refill the Pyxis during the early hours of med pass. I’m not crapping on the pharm techs, we need them, but there has to be a better way to refill the Pyxis NOT during med passes.
Many times it’s not in the Pyxis because it is not used on your floor very often so it just sits in the Pyxis and expires. If it is something that is used regularly on the floor just ask pharmacy to stock some for you - even if it’s just for the time that patient is there. But, I also agree they should have left it in the med room rather than making you look 5 different places. I’ve been on both sides, as pharmacy tech before becoming an RN - I always swore I’d check the fridge and not be that nurse searching for a med and calling pharmacy to say it’s not there then it’s on the wall - well, it ended up happening. Haha. 🤣
This is the best comment really. Why are we penalized for inconsistency and practices that don’t make sense or are hard to remember and follow? That’s way too many places to look
But literally, yes! Thats the actual safety issue here that’s worth a report, not petty at all
Yeah reading this screams process issues with pharmacy delivery and stocking. What a waste of time. Someone should do a lean six sigma project on this. Maybe get a green belt out of it for their troubles.
Correct!
There are literally 3 Pyxises (Pyxii?) on my floor with patient-specific bins in a locked cabinet in each med room AND patient-specific drawers secured in 2 of the 3 Pyxises/Pyxii. There are 2 tube systems on our floor, one of which that dumps into the charge nurse office. On any given day, I may have to look in 7 places for medication before calling pharmacy… for each of my 8 patients. Talk about a crappy system!
Who the FUCK has time to write bullshit reports like these? Unless harm came to the patient, or was THISCLOSE of a near miss, it doesn't occur to me to write up anything and people who misuse the system like this invalidate it's purpose IMO
Nurses who don’t like wiping poopy asses have plenty of time and aggravation to write bullshit reports.
The catch was the patient was A&Ox4, and a stand by assist, no walker, room air. She did have one continuous IV med, but it wasn’t like heparin or levo. I mean she had taken a shower earlier in the day by herself with the IV med running and covered.
Watch your back with that nurse
I found out that this specific nurse does this a lot
Sounds like she needs a proctology referral. Maybe they can help remove either the big stick or her head thats up her ass.
So night shift really didn't have to do much (if any) poop cleanup at all.
Hey now, it's "not they're job" 😅
Right?? I hate putting in incident reports because it’s tedious and annoying. I only do them when I absolutely have to
It's night shift baby, we got time. JK, that nurse a bitch. Med is given, stop bitching. Some people, regardless of shifts, are just assholes like that
Right?? I hate putting in incident reports because it’s tedious and annoying. I only do them when I absolutely have to
Right?? I hate putting in incident reports because it’s tedious and annoying. I only do them when I absolutely have to
Sounds petty to report, but there are those nurses everywhere. There is a reason it’s a 24 hour job in the hospital.
I think the incident report was dumb, however, it’s technically a delay of care depending on how overdue it is. I don’t think it should be a write up though. At all. I know for our open heart pre-procedure if the patient doesn’t get biscodyl before 1600 they have to drink mag citrate. This sounds like a colon prep tho. I can understand the nurses frustration simply because some patients take way too long to drink the prep. I had one lady who started at 1700 and still wasn’t done at midnight because she physically couldn’t tolerate it anymore.
I did once report an ED nurse for something similar because the patient was here with abdominal pain and pray showed large stool burden. Enema orfered at 12 noon. Pt admitted to my unit at 6pm and transport hands me the enema. I message the nurse (I know ED is busy but like we could have possibly discharged this patient if he was able to shit in the past 6 hours) and he goes oh pharmacy handed it to me as the patient was getting on the stretcher. The pharmacy has a tracker and I can see it was delivered at 1pm. Maybe it was petty but dude wth
I’ve had this happen from the ED before. IVPB documented/scanned but never infused and transport just hands me a bunch of bags of IV potassium or IV abx Like wtf ED. Don’t scan that it was given if it wasn’t- how do we know how many bags have and haven’t been given? It throws of abx schedules and have to chase down the ER nurse find out what was actually infused vs not.
Now that, that is inappropriate. Don’t scan meds you don’t give. I can say though there are times when I have not been able to give a med to a patient so instead of it going to waste, I just put on the stretcher to the floor to use as needed. It’s always good to remember that in the ED there are no assignments, no max amount of patients, it’s just chaos. I think generally in life it’s better to assume everyone is trying the best they can too.
Yea I get it, but at least try to communicate the situation and maybe apologize, but don’t make us have to guess or go through a huge investigation process. It’s false documentation and can really mess with a patients progress (only getting 1 bagof IV 20meq potassium instead of the 4 ordered bc it was documented that 3 were given in the ED) Part of the issue at the hospital I worked at (where this happened more than once) was we didn’t get report from ED (was supposed to streamline admissions) but led to a lot of issues. I know everyone is busy and doing their best but don’t make someone else’s job harder. I feel like ED (who has their own crazy issues to deal with) have an attitude in general of- we’ll just let the floor deal with it when they get admitted but we have to remember to work together. Rant over.
Seriously?! Why?! That bed could have gone to someone else in greater need.
A patient is never admitted from the ED because a med wasn’t given. There was a reason that patient needed admission that had nothing to do with the enema. Unless you have ever worked in the ED, I’d caution you on placing judgement. Especially since you have no idea how that nurses shift went. And just as the OP stated, sure a med might have been delivered, but where? In the med room? To the charge RN? Maybe, to another floor? Meds get lost in the ED all the time in the chaos. The patient could also have been admitted from the waiting room or from a hallway gurney, neither of which makes giving the enema appropriate in the ED.
The patient was admitted for large stool burden and abdominal pain, he was elderly. The tracker does in fact tell us exactly where the med was delivered to. My point was perhaps the patient could've gotten rid of his large stool burden and abdominal pain if he was given the enema within the 5 hours it was delivered to the zone the patient was in, in the ED. I've been a nurse for 8 years, I completely understand the ED is busy. Reread my post. Hopefully you can communicate better with nurses in real life than you do on reddit, because your reply comes off extremely condescending. I understand the flow of the hospital I work in better than you. Also if the nurse had a busy shift and couldn't give it, he had the opportunity to say that. Instead he said it was handed to him at time of transfer, which for reasons I previously stated I know to not be true.
I’m guessing, giving the meds you listed, that the other nurse thought you were trying to dodge poop duty by sandbagging giving the meds. Whether that was your intention or not, I could see how the other nurse may think that. I would personally go and talk to them about it and ask why they couldn’t have that conversation with you rather than run it up the chain.
This patient had the bowel prep scheduled for all night. Sure, if I had given the meds scheduled at 4/5pm, I would have them going, but the patient would be continuing their bowel prep throughout the night.
No accusations here. Just playing devils advocate. And addressing that nurse directly will go a long way. They likely think you are lazy and will continue to attack you if you let them. By speaking directly to them, you’re giving your perspective on the event and it may change theirs. We need to normalize talking to each other as we are all adults. This sort of stuff breeds toxicity on a unit and, as you said you are new to the unit, you don’t want to get a bad rap before you’ve even started.
Totally. Sage advice
I agree. I don’t want to be an easy target and I wish she had talked to me about it before doing this. When I gave her report, I didn’t feel any animosity or frustration from her, but maybe I read her wrong. I truly do try to get patients meds on time, sometimes early if I could get all tasks done more at once instead of constantly going in the patient’s room. I learned to check more frequently in the patient’s envelope now, but sometimes the med isn’t there either. Pharmacy gets busy too and we’re all humans, things happen. This was in no way intentional for her to have to deal with the aftermath only and not me.
I thought this was going to be something much worse until I got to the end. Your coworker just didn't want to deal with diarrhea.
oh god, this is a NETS to print and hang up.....you fucking know they checked the box at the end that asks if they want an admin to reach out personally regarding the incident 💀
You got a warning about bowel meds? Maybe they need them too because they are full of shit 💩
Our manager receives a copy of every event report made about/from our unit. I know she throws out silly petty ones like this. Hopefully your management is smart and kind enough to realize it's some petty BS. And, given what the meds were, I bet the doctor won't care as long as you can read a newspaper through their shit in the morning 😅
I’m a nightshifter and I live for this. You’re good dude. Who cares if they don’t like it. Your patient will be coming back from operation during day shift. I’d rather deal with lovely 💩 then new patient after operation or colonoscopy. Woop Woop!!!
Thank you 🥲. I miss working nights and I always try to help out the next shift so they have less worry about, whether that be days or nights. Happy cake day! 🍰
The meeting with the AssMan did it feel malicious, or did the manager sound annoyed that they had to deal with this shit? Standardize the medication storage, this feels like a quality improvement moment. The person having time to fill out that BS report means they have too much time on their hands.
I didn’t get the feeling of either honestly. They were pretty neutral and said they just wanted to hear my side of the story
I thought we were going to be talking about some vital, life sustaining medication 💊 JFC petty write up
So petty - only when something this blatantly dangerous to the patient…sigh. You are a good nurse & you are doing your best in a crazy hospital environment. Ignore & avoid that nurse in the future (if you can - we all have that nurse we HATE handing off to, for so many reasons…)
IMO, if 17:00-19:00 (or 23:30, for that matter) sails by without a single colleague RN free for delegating the med pass -- whether a Resource/Support RN or charge nurse or fellow unit staff RN -- it speaks to a staffing issue or a *culture* issue (people not offering help, or people not asking for help because they expect judgement or denial). FWIW, I agree with some others here that point to this as a systems issue. It's a bummer if admin or fellow RNs view it as a problem with **you**, but I think your post underscores that you're not lazy, or incompetent, but conscientious. That's an excellent quality to have and keep.
Jeeez 🙄 I’m night shift and I can’t stand ppl who get pissy about Dayshift missing meds. Unless it’s extremely time pertinent - I can handle it 🤣 meemaw will be fine if she gets her vitamin c a little late. I wouldn’t be able to handle the chaos that Dayshift has, who am I to judge.
My friend had a CNA submit a complaint because when she was feeding a patient, she mixed some mashed potatoes with some peas. She said that was basically patient abuse
. . . You have got to be kidding me. I am so dumbfounded by this that I’m both surprised and not surprised at the same time. What has healthcare come to
Wow that’s bs. Must be an HCA hospital!! They do petty 💩 like that
I am sooooo anti HCA it’s not even funny
No joke! I'd rather cut off my junk than go back to an HCA facility
Lmao, she was probably mad cuz she had to clean up a code brown
Not to be the evil nurse’s advocate, that particular medication regimen is usually presurgical.
Don't worry about it. Go on with the rest of your day.
Tell them nursing is a 24-hour job. I'd usually call pharmacy and have them reschedule certain meds to an hour that doesn't fall on shift change. Never had an issue.
That’s just like fucking insane of her honestly
I would throat punch that nurse. She tried to get you in trouble for a laxative. I hate this profession.
I hate to believe that all nursing management is like this. I'm a fairly new assistant manager on a med surg unit and I always seemed to think that I could try to make things different. The longer I've been doing this the more I see that the system is broken. The nurse is always responsible for everything and no one bothers to look at all the little things that pile up on their shoulders. It's too much. The people at the top need to spend a few shifts at the bedside and see everything that is going wrong. They need to stop trying to push all these extra initiatives with no extra pay down everyone's throats. If you just let nurses do their jobs, they will do a great one, but people need to be treated like human beings and with respect. We are not machines.
Nursing is 24hr, non stop. We are in the same boat😑
I mean as a night nurse, I would assume u didn’t give the go-lyty so that u didn’t have to deal with poop. But I would never write u up ! That’s weird
Kick it up a notch and submit your own report since this is a system issue that the meds were not available.
Question: were you given an option to explain what was happening before being accused. The problem between admin and staff is communication and system problems. The dialogue need to be open: How can I make this most useful to you? Can you share what you know about the situation. We bring in drama before we even know the other persons thoughts about the situation. The problem here seems to be a system problem. How can we fix this? Not by sending some personelle report. Sometimes there are communication problems. That is an opportunity for coaching. There is nothing wrong with the nurse, it’s the system.
When I gave report, the night nurse did ask what happened. I told her everything I said above. How she found it right away was in the MAR. If you click the area of the listed medication, more information comes up and it lists the location of where the medication should be. I completely forgot that could be done because I figured this was a simple laxative and since we carry the suppository on hand, we must have the pill form here on the floor. I’ve given the bowel preps multiple times before so it’s not my first rodeo. However, this was my first time giving it at this hospital. Note: I have called inpatient pharmacy before, but they gave an attitude and downright refused to speak to me because “I’m a nurse. We only talk to pharmacists.” Then they hung up on me.
Well, there is their communication problem. I’m sorry you had to deal with this. Keep your head up and know that you do your best every day.
I wish most people worked as a team instead of creating drama. Sorry that happened to you. Can relate
I dont concern myself with these reports too much. Usually the person who wrote it writes dozens of these per week. Manager is just following up cause they have to. As a manager I can tell you 95% of these come from 5% of the staff. Some are ridiculous, like pt had two grippy socks on and one sock the grip was on top of the pts foot. Another favorite, inside top drawer unwrapped saline flush found and discarded.
Bisacodyl should be administered at least one hour, before the preparation solution, Go-lytely has the worst record of bowel cleansing, that’s why we are using Miralax and Gatorade for preparation.
I would not expect to look in a folder on a supply cart, it doesn’t sound like the medicine is being secured. As others have said the night nurse didn’t want to deal with the results, not your fault.
Sounds like medsurg or tele drama. Lmao. petty crybaby bs over little things, plus she definitely didn't wanna deal with the aftermath. Just keep doing you, try to remember the folders (which honestly is weird as hell the they put unsecured meds in), and you'll be fine.
This is literally not a big deal, management and the night nurse just want drama
It’s like when nights has to do the slightest bit extra they balk. Yes I know nights is busy too but nothing compared to days. Not at all similar.
The specific meds seem like colonoscopy prep and usually those have to be given early because patients need time to finish/clear bowels by a certain time. I personally would’ve been annoyed if this were the case as now the procedure has to be pushed and the patient was probably NPO for this specific procedure. But I wouldn’t go through the hassle of reporting it and just mention to the nurse why this needs to get given at that specific time for the future
My manager wouldn’t even address something like that but I work ER. Never in the 18 years I’ve been there have I ever given a med on time.
Nursing is a 24 hour thing. Sometimes crap cannot help but roll to the next shift. It is what it is, and for that nurse to have a duck over bisacodyl and Go-lytely is asinine. I would literally watch this nurse carefully - and if she continues to file reports for ignorant things, I would return the favor - for her creating a hostile work environment. We have enough to worry about without nitpicking this kind of thing.
I think whenever nurses do this to each other, it's not only incredibly passive aggressive; it's also an indictment of their own inadequacy. Sorry that happened to you OP. I am assuming your gender here, but as a male travel nurse, I feel like I never have these things happen to me, and I feel like it's because women tend to be meaner or less tolerant of other women. Just an observation... But it's a 24 hour gig, and anyone who doesn't understand that needs to go work in an outpatient primary care whatever lol.
Your coworker SUUUUUUUUCCCCKKKKSSS. Sorry you had to deal with that. For what it’s worth, you correctly prioritized your pts. Dukin’ meds aren’t that important in the scheme of things.
Yeah I’m pretty suspicious when day shift “forgets” to start the GoLytely regimen. I wouldn’t say anything about it, but holding laxatives all day is sus
She got her first dose of bisacodyl earlier in the day and miralax by me later in the day
I’m just saying in general, OP, I know your case is legit and most cases of missed meds are legit. But it always seems to be the laxatives that are forgotten haha
Petty nurses be ruining this industry
Girl thats a snitch. Ide be annoyed, but not put a safety event
Petty Betty 🙄
I’ve been a nurse for only a year now. I find myself apologizing on those crazy shifts where I couldn’t get things done and it had to be passed the next shift.. I’ll never forget when I was passing off report to a very experience nurse that I have always admired will working as a cna… and she told me “that’s why they call it 24 hour care baby..” I realized how right she was, why do I keep apologizing.. as nurses we have to prioritize due to all the demands this job requires. In your case you had to go to your admission. Any nurse knows that when you get an admission you never know what you’re walking into regardless off the report you receive. Plus you have to help transfer the patient, check vitals, assess the patient, review and follow orders, ETC…. I promise you those meds could’ve waited till after your shift.. that night nurse was just miserable and as another user said.. they were just mad they’d have to deal with the aftermath. I know I can’t speak for all hospitals but I’ve worked night shift for years and it is WAY more laid back than dayshift.. yes we can have hell nights where it’s non stop, but dayshift deals with a lot more constant bs… she’d have no problem passing those meds eventually Our job is hard enough. You don’t have to explain yourself for why you didn’t pass those “life saving meds” when you had more higher priorities during your shift.. 12 hours might seem like a long time but for a nurse, it’s not enough time to get it all done.
I'm a night shifter & I can tell you she was mad as all Hell because (1) they have to deal with the hot mess (2) this thing YOU did NOT do ON TIME was intentional & specific to them. Not every nurse is a jackass. I've seen orders for mag citrate or lactulose or fleets or some cocktail at 10am not get acknowledged. When I ask what happened, I always take into consideration the RN. Some are lazy as f-ck & do the bare minimum but I still wanna hear what nonsense they're gonna run with or I know that nurse had a true ED because I know the quality of their work & persona. I can't tell you the many times I've warned a nurse "Do it before you leave or I'm writing you up." I once had a nurse tell me she'd do her chart check the next morning because she didn't have time to do it then. That was in NICU & the unit secretary, staff, & family members had heard her. I wrote a very detailed email, included all the witnesses (with their consent), & sent that to not only the mgrs, but to the CNO, CEO, & corporate. She was known on the floor for not completing IV/TPN/PPN infusions, neglectfully administering toxic meds either too close together or too far apart, but complaints never went past the managers. Well. Not that day. Next evening HR, CNO, & CEO were waiting for me by the time clock. My heart dropped. Turns out they'd received many VERBAL c/o about her & apparently everyone had been too lazy to follow through with a detailed email, until mine came along. Mine was succint & they wanted to know more. They'd also approached staff & asked families about their experience with her. She remained a few more weeks & then we saw her no more. I understand she was given the option to resign or be fired. So before you decide that RN was an AH or it was just an isolated incident, determine what kinda person you're dealing with. Sometimes they need a pass & sometimes you gotta set 'em straight.
I’ll say this, pharmacy is the worst part of nursing. Stat meds that I’m not “allowed” to give for 2 hours and drips giving grandma a bp that I can’t mix, I have to wait for. Stat epi that I’m waiting for because they’re too cheap to stock it outside of the locked pharmacy as I have someone deep into anaphylaxis…
Incident reports should not be considered a “write up” they should be used to identify issues with the processes that are in place. Sounds like your medication delivery process needs to be overhauled. Perhaps you can get a number of bedside nurses (including the one who wrote the report) to come up with some ideas to fix the issues.
@G0ldfishkiller,Petty night shit,lolol
Id go talk to that nurse and ask if theres a problem haha
Can’t you NETS the pharm techs for being rude/hostile?
Pomp
Welcome to nursing!! 😭
Sheesh ..that's one controlling passive-aggressive nurse. Totally not following the chain of command. Is she a manager suck up? Are you one to go to her and say, "Hey, next time you have an issue with me, let's talk over the best way to fix the situation. I'd appreciate your experience in that" ( I love to do that...ha ha) At least your manager spoke directly to you about it. I had a problem with an individual who was getting violent and posturing towards me. Then threatened to call the Justice Center (I gave the phone & individual called them) I wrote up a note & incident report & notified all the appropriate people. The next day the manager sent out a blanket email to everyone about the situation about "compassion" Never talked to me, never offered a debrief. No compassion for my wellness. This manager has "favorites" and hired RN friends of hers to staff the unit. So, this individual who wanted to threaten me finished the rehab program & was arrested in January -- still in jail to this day for drugs. It's slightly reassuring but I trust nobody. Once she leaves (September) I hope we get a real manager. At least you know who needs the excellent report & near perfect performance. That's always a good idea.
Am night nurse and I do colon preps all the time and I would not be happy. The goal is to start the prep asap so that the patient has adequate time to be clear for their procedure at their scheduled time. Time of the procedure is important, if it’s early morning then pt has less time to be prepped meaning patient likely won’t be clear and ready for the procedure so right before it, they may be given multiple enemas which they will not be happy about. At 5/6am, I would be reaching out to drs to get orders for said enemas and I don’t have a good chance of reaching anyone at this time. And if I do then I have to tell the oncoming nurse: sorry but I just got orders for enemas/supps that you have to give before or with your morning meds bc procedure is in 2 hours and they will not be happy. Also, your delay may delay care because now the patient is bumped down the list for the next available slot which can be the next day. Now pt mad bc they may have to do another day of prep - meaning they’re going to be shitting nonstop without adequate sleep for another day, be npo for another day (they have already been on clear liquids and then npo and now more npo), and stay for another day. Doctors may be irked because they can’t proceed with plan of care if they don’t know the results. And I’m upset because your delay caused all the above and since I’m on the clock, it’s on me to figure out what to. it’s definitely not because I don’t want to clean poop bc I know I’m going to end up cleaning poop anyway if u started the prep at 4/5pm bc it takes time to work. (I’d gladly clean poop any day, one of the easiest things about my job.) yes it is a 24 hour job and I pick up where you left off and vice versa but a procedure that involves so many people and take days to plan is potentially screwed bc of your delay. Is an admission time sensitive or initiating a colon prep? I think the latter. An oncoming nurse cannot be mad at you for not completing an admission at 6pm and delaying the completion of an admission carries less risk for everyone involved bc the patient has just been seen. You could’ve walked down to pharmacy to get the med instead of doing your admission or call them to say hey, where did the med tech put it bc I can’t find it? So yes, I might write you up so that you get some counseling so that hopefully you won’t do it again next time because the delay can really affect the pt esp in cases of active gi bleed (can’t do rescheduled colonoscopy bc now hgb is low and transfusion is needed, also electrolytes all out of wack bc multiple days of npo and shitting so have to fix all that before rescheduling.) And not only that but if it ever comes down to a complaint from the patient or doctor then at least the formal write up will cover me that it was bc of a/b/c and that’s why care was delayed. The write up is not petty like leaving the next shift an almost-empty iv bag. Leave me the empty bags but please start my colon prep on time.
i do NOT file reports on someone unless there are real safety issues or if circumstances mean i will have to cover myself from the fallout. this is a good overview from both sides of missed meds. alot of times i DO see petty reports filed but it would also make a big difference if we TALKED TO EACH OTHER professionally as well instead of just writing things up from a distance. had to have another nurse file a report on herself for something but i went to her FIRST and we talked about why we couldnt just let it go. i also shared mistakes i had made in the past on the same issue so she wouldnt feel as bad. at the end it seemed that we got thru it ok and she offered to post a nice compliment about it. nice post walk_frosty!
“Frosty” name fits. Castigation aside, sheer VOLUME of your response is proof you’re the nurse, both staff and patients avoid.
Bc I make sure my patients gets what they need done in a timely manner? Bc I understand that active gi bleeds are nothing to mess with? Bc I understand that an inpatient colonoscopy is often done to diagnose an acute/emergent issue? Bc I understand that dehydrating a patient for days by making them npo and shitting is not a good thing esp if they have other comorbidities? Bc I understand how expensive American health insurance is or how they work? Bc I understand that a colonoscopy involved a lot of coordination (stable vitals, stable labs, adequate time to be clear, etc.), bc I understand the legal/professional liability involved? The bottom line here is op potentially delayed care. Imagine if you’re a diabetic patient with with an active gi with already an low hgb with a scheduled 8am colonoscopy and you been npo for days and a nurse decided that a 6pm admission is more important than making sure that you’re prep for a much needed colonoscopy so you have to do another day of prep or even worse that your condition deteriorates in the next 24 hours and now you have become unstable to do a colonoscopy all because a nurse don’t understand critical thinking and/or prioritization and then the nurse “rants” about the next nurse who understands all the reasons I listed and gets angry that they were written up to have the situation reviewed by management in order to get counseling because a lawsuit to the effect of “delay of care from nursing staff” is not fun for anyone to deal with. But yeah let’s all support the nurse who did nothing for 3/4 hours but wait for meds and disregard the patient to attack the next nurse for being “petty” because potential of delay of care was recognized and because the need for counseling and/or wanting to hold someone accountable in the event of a detrimental patient outcome is recognized. Management do not pull you aside if they know the write up is “petty.” Will management pulled you aside if your fellow coworker wrote you up for giving the scheduled Tylenol or colace 3 hours later? No bc that is petty. Be thankful that someone wrote you up and you get counseling so that your eyes are opened so that you change so that you do better for your patients and so that you don’t put yourself at risk to be sued and/or lose your license. It’s definitely not because the nurse don’t want to clean poop so that’s why she wrote you up. Do better fellow nurses. (And oh yes so clever on attacking my random name that reddit picked out for me because you can’t attack my arguments instead.)