If there is one thing in this profession that I am SUPER passionate about, it is having each others backs! Most would refer to it as team work. This is HUGE in the profession of nursing. This job is not meant to be done by itself. It’s a team effort. Which is why I LOVE my CCAs, Techs, LPNs, Fellow RN’s….the list goes on. Being a float nurse, I go to many different floors in the hospital. EVERY floor has a different culture and way of doing things. It’s really funny to me because this is how every hospital is. I’ve noticed that they all kind of have their own “floor policies” on a topic. Sometimes very different from another floor you’ve worked on. That’s one of the hardest things about being a float nurse is becoming acclimated to each floors expectations and policies. It takes time, but I can say after a year, I have FINALLY got a good grasp on things. Unfortunately, I’ve learned a lot through mistake. Well…I say mistake, but really it was just that I didn’t know! It’s impossible to learn the whole hospital in 3 weeks of floor orientation. I’d get that email or phone call from my manager about the little things that I didn’t do that had been reported. Nothing that harmed my patient, just applying to floor policy. I would get “talked to” and then have to sign some silly paper stating I was educated and basically the next time it happens, it’s going to effect my evaluation at the end of the year. And this is what I want to write to you about today. This all comes back to that nurse that followed you that night. And found something that you may have not done, or not done correctly in their eyes, and they felt the need to write it up, report it, and have disciplinary action ultimately taken against you. All because they decided that “fill in the blank” was wrong.
Hear me out yall. There are some issues that NEED to be reported and brought to the attention of a higher up. Issues like (all in which I have witnessed):
-a potent IV med hanging on the wrong patient.
-A stat platelet order that was supposed to be transfused at 5 am before a morning surgery and the nurse deferred to day shift because she was “busy.”
-Blood ordered on an extremely anemic patient that wasn’t transfused.
-a critical lab result that was never reported.
basically anything that did or could have truly harmed a patient and compromised safety.
THOSE are all issues that need to be addressed. Those are SERIOUS issues. I am so tired of witnessing nurses throw each other under the bus for the SILLIEST of things. WE ARE A TEAM! I have worked both day and night shift, and realize that both have their advantages and disadvantages. Day shift is hard in the sense that we are running around like chickens with our heads cut off, chasing MD orders, updating families, changing dressings, sending for tests, and basically being the ring master of a giant circus. All while making sure that everyone one of your patients and their families are safe and content. Night shift, lets be real, you are just trying to stay awake! AND THAT’S HARD! Working against your own internal clock. Patients do this little thing called “sun downing.” It’s only seen on the “Dark Side” aka NIGHT SHIFT! It can literally ruin your night! Have you ever seen the movie “Mad Max?” The bald headed men who are on the “bad side” spray their mouths with some chemical that makes them go crazy and wreak havoc all around them, because they are willing to do something crazy bad at that moment to die for their Master (the bad guy)?? Anyone? Well thats kinda what sun downing is like with some of the older patients at night! ANYTHING is possible and it’s typically NEVER good! So between babysitting, passing meds, staying awake, and keeping patients safe, it’s a lot to handle!
As you can see, BOTH shifts have their difficulties. We never know as nurses what our shifts are going to bring. We do the best we can, with the time we have, prioritizing the important tasks, delegating the ones we can, and doing all that we can in a 12 hour shift. When I come on to a shift and look at my morning meds and see that a 0630 synthroid wasn’t given, I don’t go; “Oh my gosh, I need to report this!” No. This nurse clearly didn’t see it, and probably was really caught up! No big deal. I’ll pass it right now to the patient. (First making sure it wasn’t given and just accidentally didn’t get scanned.) Was the patient harmed? No. Did anyone get hurt? No.
When I walk into a room to receive bedside report coming on to shift, and see that my patients IV fluids are almost empty, I don’t look at my nurse whose been busting her butt for 12 hours and say, “ Are you going to replace those fluids?” No….I note it in my head and bring a fresh bad when I pass their meds in about 30 minutes. No big deal. “I’m hear for the next 12 hours, you go home, I got this!”
When receiving bedside report and a patient complains of nausea or pain, it can make the off going nurse feel uncomfortable, annoyed, and stressed because they feel like
“Oh great, this nurse is going to expect me to get them medicine and I haven’t gotten anything charted in the past hour.” Some nurses are rude enough to say, “You’re getting them pain meds, right?” It makes you want to turn around and say “No B, I’ve been here for 13 freaking hours chasing bed alarms and haven’t charted a lick and you’re on for the next 13 hours! HELP A SISTER OUT?!”…..but to avoid conflict you bite your tongue and say “yah, that’s fine” because you sort of still feel it’s your responsibility even though you’ve technically reported off. NO NO NO!!! BE A TEAM PLAYER! Support each other. Ask the patient if they can hold off on nausea medicine until you can get their morning meds in a few minutes. If they say no, then work with that off going nursing and figure out who is going to get the medication. See if there’s anything else you can do for the person in the mean time while they get the meds. WORK TOGETHER. This job is already hard in its nature, we don’t need our fellow co-workers to make it more difficult.
Lastly, lets rid the Tattle Tale culture in nursing! It eats at my core when I witness it It’s not about pointing fingers at each other for what didn’t get done. If an order got put in at 6pm, there is a strong chance that day shift nursing is running around crazy at that time and may not see it. They may not even see it when they sit down to give report to you. If its not STAT and it’s not something that is going to harm the patient, don’t go doing an incident report on something like that. Just pick up where the other left off. We all make mistakes. We all have our hard days. The last thing we need after the shift from hell is a manager calling stating that you didn’t do X, Y, or Z, and the nurse reported it. WE ARE ALL IN THIS TOGETHER. I don’t know why this profession has a lot of nurses in it that feel the need to report anything and everything, but its not necessary. It can be demoralizing for that new nurse, who is absolutely awesome but still learning. It can eat at your heart for that anxious nurse who is type A and does everything right, but makes a very SMALL mistake once, it gets reported and it ruins her whole week. This pushes GOOD NURSES away! I think these “incident reporting” policies were created to really catch BIG issues. Issues that truly harm the patient and compromise their safety. Unfortunately, they’ve become abused, and it causes a lot of emotional discomfort for people! That’s a big deal to me! There is DEFINITELY a time and place for serious incident reporting and I firmly support it, but I think there needs to be stricter guidelines about things that need to be reported and things that just need a small coaching. Some hospitals have really strict consequences for these kinds of things! It takes a lot of time in my shift to fill out an incident report so it needs to be worth it. Otherwise, I have lives to save. Aintgottimeforthat.
QUIT throwing each other under the bus. If that kinda stuff makes you feel good and powerful, then get of this profession. Because nursing requires a TEAM PLAYER! GOOD TEAM PLAYERS! We need to have each others back all of the time. It’s a 12 hours shift. A lot of things happen in that shift. Keep a positive attitude! Give help! TAKE help when offered. Laugh! Smile when its not too hard! This profession is my heart! Nurses are some of the COOLEST people that I know! I want to better it. I want to bring issues to light that are important to me, and this is one of them. Quit wasting your energy pointing fingers and being negative. Be safe. Be smart. And carry each others backs. Pick up where the other left off. And be a TEAM! Your heart is mine!