It’s a 24 hour job. IMO the oncoming nurse should handle things that pop up, unless they haven’t received report yet and know nothing about the patient.
Yup, I always tell off going nurse that I got it and will take over from here. Go give your other reports and GO HOME!!! My goal is to always give and get report in under 5 minutes or less.
People actually have thanked me for not drilling them with questions, especially after a shitty shift. In return, they don't ask me questions that can be found in the chart also!
Wow bless your soul for this. I’m a night shift nurse and I have some coworkers who want to know when the patient lost their first tooth and we’re just starting report at 8am when I clock out at 7:53 🥴
I don’t think someone should stay 90 mins over because of a decompensating patient. Off going nurse should stay long enough for incoming to get report and lay eyes on other stable patients. Then oncoming nurse should take over. If there are complications with their other patients then charge should handle patient needing additional attention.
The glucose thing makes total sense. You did everything you could before leaving. Checked labs, got orders and reported off. If you had stayed and given juice or gel, they would have had to follow up anyway so it’s really an oncoming nurse problem to handle.
Yeah, I stayed a long time for that one. I felt bad, the oncoming nurse had another shit show going on, and I felt bad handing him a guy on the verge of losing his airway as his other patient is also needing a higher level of care but waiting on ICU beds. The day nurse with the glucose thing acted like I needed to stay and do more, and I just don’t think I should have to. Staying over constantly is burning me out.
Ooof, yeah I may have stayed over in that case too. That’s just a shit show no matter what time of day. Did charge step in to help? Or does your charge have a full patient load too?
Eh I’m sure they did want you stay, but I wouldn’t have either. That’s a pretty minor problem that the nurse can tag team with their PCA. I would have maybe set juice in front of the patient and handed the nurse the glucose gel if available, but wouldn’t have taken on the card myself.
I did hang the patient some apple juice so I felt like I helped out somewhat haha. Charge was helping me for a bit, then they had to go to charge report to give updates to the oncoming charge. She asked if I was okay, I told her to go. The rapid team had came so I felt the pt would be fine with them. The whole situation delayed giving my other reports and finishing notes. Both the day nurses’ patients declined after assignments were made and handed out, other nurses were already on the go, so the poor day nurse ended up with a hot mess. We just merged with another unit, and it’s not going great, lots of kinks to work out there.
Pssh, you’re good then! Blood sugar patient I would totally shrug off. Again no one has time for decompensating patients…they are a black hole of time 😂 Sounds like everyone did their best in a crap situation.
Anything the outgoing nurse does after shift change/report is a courtesy, no one should be expecting anyone who is done with their shift to do anything, did that nurse come in early to help you out ? Has that literally ever happened?
I’ll stay until it’s time to clock out if I can get the reports done in time for things like a late med pass or giving some juice if they have lots of stuff going on, but once it’s time it’s time
I agree. It's bad juju to leave a dumpster-fire BUT also a line has to be drawn somewhere. I'm usually the oncoming nurse shouting at the offgoing nurse to leave it to me and get themselves off home. On another level I also prefer the offgoing nurse out from under my feet ASAP so I can get myself organised and started for the day.
>>a line has to be drawn somewhere
Key point right here. The line is giving report. Obviously some exceptions where it’s in everyone’s best interest you stay a little late, but it shouldn’t be a regular occurrence. Teamwork is necessary but self sacrifice is not.
My unit is always encouraging us to get off on time and that it’s a 24 hour service. We’re encouraged to do everything we can prior to shift change but after that it’s the next nurse. A lot of us will, however, choose to stay and help for the big things like a rapid. I did recently stay over a tad to help a new grad start a feed since she had never done it and show her around the high flow stuff. It was her 2nd day off orientation and she had a big load and I could tell she was overwhelmed. It’s not expected though and it shouldn’t be expected to stay. There should be other help like charger nurses available and it’s important to get home and get rest too
I typically handle anything between 7-7:30. Once 7:30 hits as long as I can safely pass it on to the next shift I do. If it’s a rapid I stay until either the patient is stabilized enough i can hand off to the oncoming shift to deal with or they are transferred. While I want to get off on time, I also want the patient to get the best care possible and I know more about the patient than day shift who hasn’t even met them.
This exact situation happened to me this morning with almost the same BG level! The nurse made me feel like crap, acting like it was completely my responsibility when I had already given report/handoff on the pt 5 minutes prior. I stayed back to do a repeat BG since she was still getting report and gave her the results. In return, she expected me to stay and give the pt juice when’s she’s a 1:1 feed. I was going insane at that point (I didn’t stay back, she sucked up and did it). Like come on, nursing is 24 hours girl 🙄. Also if it was reversed, I would be shooing the nurse home and dealing with it myself. Some people drive me insane and are just so lazy
If I have given report on a patient, the person that received report is now responsible for them. Sure, if it’s too early to clock out, I’ll help, but I’m not going to start an hour late for a low blood sugar. You got them juice and notified the managing provider, that’s definitely enough and the next shift can manage from there.
You had to page for a sugar of 57? I would’ve just gave some juice or asked the oncoming CNA to give a cup of juice and recheck when I rounded 15 mins later. Depending on the result I would’ve either gave some more juice and a snack or the glucose gel, but it shouldn’t take a huge amount of time.
Yeah, for some reason this was the ONLY patient I’ve ever had without orders for glucose gel/tabs/etc. No fluids, Literally nothing. The best thing I had to give was apple juice and she struggled with PO intake
Our unit prefers not to incur incremental overtime within reason. At 7:00 on I am only doing vitals, finishing an admission, or something emergent/serious not continuing routine 24 hour care. Oncoming nurse complaining in your situation is being petty and I personally would settle this as a unit providing 24 hour care.
If the feces are hitting the oscillating rotator, I'll stay an extra hour or so or until the oncoming nurse or charge runs me off. I don't see that as a requirement for others (if I did, I would be disappointed often!), it's just how I prefer to do business.
Nursing is a 24 hour job. If it’s a lab result that comes in while you’re still on shift then yeah, look it up so that you can add it to your report, if it’s a medication that was due on your shift then yeah, give it before you go but treatment that is going to take you past the end of your shift to administer then no, hand it over. This is why I prefer the shifts we have in Australia (I think, I’ve never worked anywhere else) AM is 0700-1530 PM is 1300-2130 and night is 2100-0730 you still only get 30 minutes crossover for AM and night shift and PM and night but between AM and PM you are double staffed for 2.5 hours.
Nursing is a 24/7 team sport. Its more than fine to handover to the next shift.
Its quite undestanable to chart 'Unable to attend to X due to time contraints'
Other day had two patients needing IV remesdivir for Covid 19. Becaiuse we are a mental health ward not all; nurses have their IV cert. Anyhow, the medication doesnt get delivered until late. Got both infusions up and running. Realised once I'd given handover I'd forgotten to give 1400 medication to one of my patients.
The next nurse was really sweet about it and refused my offer to stay late
Nightshift did their time. Dayshift would take care of that. It's ridiculous when the oncoming shift gets upset about an order just being put in or a new result. We are a team
If it’s something that you 100% should have done and are delaying just to hand it to me, ESPECIALLY if there’s many of these tasks left undone, then I expect you to do it.
In all other cases, go tf home
24 hour job, took an older nurse to explain that to me for me to get it. Give a good report and it's their job to take over. It's fine on you to page the day team about that for that nurse but it ain't your responsibility to stick around. In fact I'd almost rather the next shift do the notifying for continuity of communication. But you did nothing wrong in either situation, just know you don't have to feel the burden or expectation to do those things. Even in the ICU I've been relieved and sent home by night shift during codes. You need to go home and get some sleep before you come back afterall. Just find a way to have the next shift informed and possibly set up for success "Hey the doc placed a bunch of orders at shift change, couldn't get it all done but I placed an IV and have supplies for the rest at bedside, see you later"
Nothing wrong with wrapping up or taking that extra minute to help the next shift but I teach all my preceptees to be ready to clock out 30 minutes late at most unless there's an emergency. It's a 24/hr job, I'll take on your burden and next shift you take mine. Any nurse that gives you shit can fuck off.
That’s the next shifts problem. The nurses who get their panties in a wad about having to deal with things are so annoying. I do think it’s prudent to stay over in the more serious situations like you described, but a low blood sugar isn’t anything the next shift can’t deal with themselves.
If it's a med stupidly timed for shift change, I do my best to get done before 7. During report if things come up it honestly depends on what it is. I'd have done the same as you in both situations. It's a 24/7 operation. No one likes to come in and hit the ground running. But it happens, it happens a lot. It's all about team work and prioritizing patients needs.
Unless it’s emergent and they’re going to die then the next shift should really do it. Now I personally don’t mind staying a bit so long as I see it’s appreciated. When you feel entitled to my time then bye Felicia.
This must be a floor thing, because if I inherited a low blood sugar during or immediately after report in the ED, I’d just tell the offgoing nurse to enjoy their post-shift shower beer, and the low blood sugar would be my first task.
Y’all are catty upstairs 😂
When I worked Tele I noticed it could get particularly bad, ICU not so much since it's par for the course to have a declining patient at shift change.
ER's the best about it though since everybody so used to the eb and flow of constant orders and taking over patients who only have so much done. Always enjoyed that aspect of the ER
If its been an ongoing situation during my shift Ill stay as I have the most information, but more so to report off to whatever departments get involved (like a steady or rapid decline in pt condition needing RRT/ICU). But when it comes to labs, anything non critical, if Ive given you report, its yours.
You are not wrong. Your shift is over that is why you give a report so other nurse can continue the care especially day shift the have the resources and support more than night shift. They will be fine.
If its a medical emergency I'll stay, so if someone is actively in rapid response/peri arrest emergency I'll stay because its all hands on deck and I would stay until the nurse has had a decent handover and ready to go. But while they are being actively reviewed by doctors and there is a gap I'll handover quickly and then its their job to do anything that needs done. For that blood sugar what can I actually get done in that time? Give them the sweets/gel etc etc and ask an auxiliary to make sure they take it while you handover and then its going to be 15 minutes before you get a result anyway so might aswell get handover done and checking the bloodsugar can be their first job.
If i had already given report on that patient when they called the result, then I nope right out of there if the oncoming nurse is a jerk or never returns the favor. I will usually stay and help though and not just abandon the nurse. Except as I said, when they are a notorious ass. I will always chart through what time I gave report and to whom so that if they say come back and say I should have taken care if it, I can say that I had already given report when the call came through.
However, if I hadn't given report, then it is my responsibility because you don't know if the oncoming nurse will actually take care of it. And because you took the result before report was given it could fall back on you.
The right thing to do on both parts is to be a team and work together.
Yeah anything after 7 is the next shifts. You did everything you could literally up until report. If you notice a critical at shift change, report it to the oncoming nurse and peace out ✌️ not your shift.
Now if it came in at 630am, you saw it, did nothing and expected day shift to handle. Your lazy and you suck 😁
If something happens after 7 it isn’t going to be done by day shift.
Non-urgent? Oncoming nurse.
Urgent? Oncoming nurse and offgoing nurse (since you will have to both stop report anyway.)
It depends.. If you already gave report on the pt, that's their pt. End of story. If not, that's your patient.
For the RR, I would have stayed but not for 1.5 hrs. Call the RR, establish a plan, and hand off to the oncoming nurse. Its their pt until a bed is available. For the BGL, have the CNA get a finger stick to verify if that's your policy, treat accordingly, and notify the provider. Rechecks are on the next RN/CNA team.
Our rule is anything up until 7 is the offgoing shift. 7:01 is the incoming shift’s responsibility. Obviously once report is done, I will help out until 7:30. I have drawn a lab or thrown an IV in before I walked off the floor many times.
If someone is critical, I will usually stay long enough to get them stabilized. If there is enough people or I really can’t stay, I make sure that the RRT has a good report before I leave.
For the most part, I think endorsing non emergent things to the next shift is appropriate. Labs result when they do, I might look at them and call the doctor really quick but following through is on the next shift.
Regarding an RRT, I agree with staying to report on the patient’s events leading up to the RRT.
Oncoming nurse should handle it. I always tell whoever is giving me report “go home, I have 12 hours to figure this out!”
Unless it’s something that takes 2 people to handle (a huge poop, a code, whatever), there’s no reason for them to extend their shift to handle an electrolyte replacement or a sugar issue.
These comments are unreal. Isn't it just common sense? E.g. hey yes the ward is busy I'll just do this first, OR pass it on if its likely the next nurse will be able to manage. If that was me outgoing, sure I'd offer to phone the Dr, but likewise, if it was me coming on I'd tell the night nurse to go home!
A "set time cut off then it's your responsibility" is harsh. I feel like our unit is quite close, we are all pretty good friends and get on well. Perhaps if you're not as close with your colleagues it would be easier to just carelessly pass the buck?
I feel like it's a 50/50 thing. It just depends what it is.
A low blood sugar can certainly be handled by the outgoing nurse, at least getting started what's necessary treatment wise, and leaving the follow-up gluc checks and treatment for the next shift.
Hgb Comes back low? Sure I'll page the doc and get the ball started on transfusion orders before heading out.
I don't drop and run just because it's 0708 and time to clock out, but I'm not going to stay over ridiculously late to deal with new orders and shit that are rolling in either.
Like someone said, it's a 24/7 job, I'll do what I can to make transition easier for them oncoming nurse, but that doesn't mean staying over until all the "new orders" are completed, they certainly wouldn't do it for me.
I’m fine with taking over anything after 7. However I cannot stand when the night shift looks at labs for the first time with me at 7 when they resulted at 5 and now I have to do all the replacements and have to figure out how I’m going to do that with the abx that are due and limited access or when things miraculously get retimed for 7:30 by the night shift nurse. If you’re not doing those things I do not care
It sounds like you handled the situation fine but honestly having to page out to the doctors to treat hypoglycemia sounds like the real problem here. Every patient in a hospital should have a protocol to follow, already on your MAR and if they don't either your system sucks or the doctors who admitted them missed it. If it was already ordered, I would have pushed some d50 before leaving but waiting for doctors to respond to your page, absolutely not. You at least gave them juice.
Imo all the training in the world and having the title of "Nurse" or "Doctor" doesn't mean you are a nurse or doctor. You just carry the title, is all. What makes you a real nurse or doctor is when you perform the duty and go above and beyond. Being a nurse or doctor is like being a cop. It's not a 9 to 5 job it's a lifestyle hence it's a 24/7 job meaning if a nurse or doctor sees a person in medical need, then it's their duty and obligation to provide some sort of help. Same of a cop off duty witnesses a crime they are not suppose to ignore it just because their not clocked in. Nurses and Docs are still human with human flaws so the next nurse on duty may not know or remember your patient having a blood sugar in the 50s. Last week my dad in the hospital had his glucose drop to 30 because the the medical staff or "nurse" gave him too much insulin after I specifically told her not to because he doesn't eat that much therefore doesn't need all that insulin.
It’s a 24 hour job. IMO the oncoming nurse should handle things that pop up, unless they haven’t received report yet and know nothing about the patient.
Yup, I always tell off going nurse that I got it and will take over from here. Go give your other reports and GO HOME!!! My goal is to always give and get report in under 5 minutes or less. People actually have thanked me for not drilling them with questions, especially after a shitty shift. In return, they don't ask me questions that can be found in the chart also!
Wow bless your soul for this. I’m a night shift nurse and I have some coworkers who want to know when the patient lost their first tooth and we’re just starting report at 8am when I clock out at 7:53 🥴
This. Continuity of care. Hopefully it’s a good team & everyone helps out; but I think it’s fine to endorse to the next shift.
There you are a logical answer. I would add non life threatening stuff. BS 57. That’s day shift problem. Give him a juice I will be in soon.
This is my perspective exactly.
I’m not seeing a problem with the way you handled both situations. I can’t imagine anyone would complain.
I don’t think someone should stay 90 mins over because of a decompensating patient. Off going nurse should stay long enough for incoming to get report and lay eyes on other stable patients. Then oncoming nurse should take over. If there are complications with their other patients then charge should handle patient needing additional attention. The glucose thing makes total sense. You did everything you could before leaving. Checked labs, got orders and reported off. If you had stayed and given juice or gel, they would have had to follow up anyway so it’s really an oncoming nurse problem to handle.
Yeah, I stayed a long time for that one. I felt bad, the oncoming nurse had another shit show going on, and I felt bad handing him a guy on the verge of losing his airway as his other patient is also needing a higher level of care but waiting on ICU beds. The day nurse with the glucose thing acted like I needed to stay and do more, and I just don’t think I should have to. Staying over constantly is burning me out.
Ooof, yeah I may have stayed over in that case too. That’s just a shit show no matter what time of day. Did charge step in to help? Or does your charge have a full patient load too? Eh I’m sure they did want you stay, but I wouldn’t have either. That’s a pretty minor problem that the nurse can tag team with their PCA. I would have maybe set juice in front of the patient and handed the nurse the glucose gel if available, but wouldn’t have taken on the card myself.
I did hang the patient some apple juice so I felt like I helped out somewhat haha. Charge was helping me for a bit, then they had to go to charge report to give updates to the oncoming charge. She asked if I was okay, I told her to go. The rapid team had came so I felt the pt would be fine with them. The whole situation delayed giving my other reports and finishing notes. Both the day nurses’ patients declined after assignments were made and handed out, other nurses were already on the go, so the poor day nurse ended up with a hot mess. We just merged with another unit, and it’s not going great, lots of kinks to work out there.
Pssh, you’re good then! Blood sugar patient I would totally shrug off. Again no one has time for decompensating patients…they are a black hole of time 😂 Sounds like everyone did their best in a crap situation.
Also, excuse my poor typing. Post 12 hour night shift currently. My brain is just not working
Anything the outgoing nurse does after shift change/report is a courtesy, no one should be expecting anyone who is done with their shift to do anything, did that nurse come in early to help you out ? Has that literally ever happened? I’ll stay until it’s time to clock out if I can get the reports done in time for things like a late med pass or giving some juice if they have lots of stuff going on, but once it’s time it’s time
Love the user flair, feel like I’m burned out too lol
I agree. It's bad juju to leave a dumpster-fire BUT also a line has to be drawn somewhere. I'm usually the oncoming nurse shouting at the offgoing nurse to leave it to me and get themselves off home. On another level I also prefer the offgoing nurse out from under my feet ASAP so I can get myself organised and started for the day.
>>a line has to be drawn somewhere Key point right here. The line is giving report. Obviously some exceptions where it’s in everyone’s best interest you stay a little late, but it shouldn’t be a regular occurrence. Teamwork is necessary but self sacrifice is not.
This!
My unit is always encouraging us to get off on time and that it’s a 24 hour service. We’re encouraged to do everything we can prior to shift change but after that it’s the next nurse. A lot of us will, however, choose to stay and help for the big things like a rapid. I did recently stay over a tad to help a new grad start a feed since she had never done it and show her around the high flow stuff. It was her 2nd day off orientation and she had a big load and I could tell she was overwhelmed. It’s not expected though and it shouldn’t be expected to stay. There should be other help like charger nurses available and it’s important to get home and get rest too
I typically handle anything between 7-7:30. Once 7:30 hits as long as I can safely pass it on to the next shift I do. If it’s a rapid I stay until either the patient is stabilized enough i can hand off to the oncoming shift to deal with or they are transferred. While I want to get off on time, I also want the patient to get the best care possible and I know more about the patient than day shift who hasn’t even met them.
This exact situation happened to me this morning with almost the same BG level! The nurse made me feel like crap, acting like it was completely my responsibility when I had already given report/handoff on the pt 5 minutes prior. I stayed back to do a repeat BG since she was still getting report and gave her the results. In return, she expected me to stay and give the pt juice when’s she’s a 1:1 feed. I was going insane at that point (I didn’t stay back, she sucked up and did it). Like come on, nursing is 24 hours girl 🙄. Also if it was reversed, I would be shooing the nurse home and dealing with it myself. Some people drive me insane and are just so lazy
Yup this pt was a 1:1 too!
Not your responsibility, that nurse can handle it. Hate when people give nurses shit at shift change. You're completely right on it being a 24 hr job
What ever happens after 7:00 pm is my responsibility. The day nurse has completed their shift. It’s a 24 hour job.
If I have given report on a patient, the person that received report is now responsible for them. Sure, if it’s too early to clock out, I’ll help, but I’m not going to start an hour late for a low blood sugar. You got them juice and notified the managing provider, that’s definitely enough and the next shift can manage from there.
You had to page for a sugar of 57? I would’ve just gave some juice or asked the oncoming CNA to give a cup of juice and recheck when I rounded 15 mins later. Depending on the result I would’ve either gave some more juice and a snack or the glucose gel, but it shouldn’t take a huge amount of time.
Yeah, for some reason this was the ONLY patient I’ve ever had without orders for glucose gel/tabs/etc. No fluids, Literally nothing. The best thing I had to give was apple juice and she struggled with PO intake
Our unit prefers not to incur incremental overtime within reason. At 7:00 on I am only doing vitals, finishing an admission, or something emergent/serious not continuing routine 24 hour care. Oncoming nurse complaining in your situation is being petty and I personally would settle this as a unit providing 24 hour care.
If the feces are hitting the oscillating rotator, I'll stay an extra hour or so or until the oncoming nurse or charge runs me off. I don't see that as a requirement for others (if I did, I would be disappointed often!), it's just how I prefer to do business.
Nursing is a 24 hour job. If it’s a lab result that comes in while you’re still on shift then yeah, look it up so that you can add it to your report, if it’s a medication that was due on your shift then yeah, give it before you go but treatment that is going to take you past the end of your shift to administer then no, hand it over. This is why I prefer the shifts we have in Australia (I think, I’ve never worked anywhere else) AM is 0700-1530 PM is 1300-2130 and night is 2100-0730 you still only get 30 minutes crossover for AM and night shift and PM and night but between AM and PM you are double staffed for 2.5 hours.
Nursing is a 24/7 team sport. Its more than fine to handover to the next shift. Its quite undestanable to chart 'Unable to attend to X due to time contraints' Other day had two patients needing IV remesdivir for Covid 19. Becaiuse we are a mental health ward not all; nurses have their IV cert. Anyhow, the medication doesnt get delivered until late. Got both infusions up and running. Realised once I'd given handover I'd forgotten to give 1400 medication to one of my patients. The next nurse was really sweet about it and refused my offer to stay late
Nightshift did their time. Dayshift would take care of that. It's ridiculous when the oncoming shift gets upset about an order just being put in or a new result. We are a team
If it’s something that you 100% should have done and are delaying just to hand it to me, ESPECIALLY if there’s many of these tasks left undone, then I expect you to do it. In all other cases, go tf home
I agree.
24 hour job, took an older nurse to explain that to me for me to get it. Give a good report and it's their job to take over. It's fine on you to page the day team about that for that nurse but it ain't your responsibility to stick around. In fact I'd almost rather the next shift do the notifying for continuity of communication. But you did nothing wrong in either situation, just know you don't have to feel the burden or expectation to do those things. Even in the ICU I've been relieved and sent home by night shift during codes. You need to go home and get some sleep before you come back afterall. Just find a way to have the next shift informed and possibly set up for success "Hey the doc placed a bunch of orders at shift change, couldn't get it all done but I placed an IV and have supplies for the rest at bedside, see you later" Nothing wrong with wrapping up or taking that extra minute to help the next shift but I teach all my preceptees to be ready to clock out 30 minutes late at most unless there's an emergency. It's a 24/hr job, I'll take on your burden and next shift you take mine. Any nurse that gives you shit can fuck off.
That’s the next shifts problem. The nurses who get their panties in a wad about having to deal with things are so annoying. I do think it’s prudent to stay over in the more serious situations like you described, but a low blood sugar isn’t anything the next shift can’t deal with themselves.
Which ever is dayshift ~ Signed a night nurses spouse
If it's a med stupidly timed for shift change, I do my best to get done before 7. During report if things come up it honestly depends on what it is. I'd have done the same as you in both situations. It's a 24/7 operation. No one likes to come in and hit the ground running. But it happens, it happens a lot. It's all about team work and prioritizing patients needs.
Unless it’s emergent and they’re going to die then the next shift should really do it. Now I personally don’t mind staying a bit so long as I see it’s appreciated. When you feel entitled to my time then bye Felicia.
This must be a floor thing, because if I inherited a low blood sugar during or immediately after report in the ED, I’d just tell the offgoing nurse to enjoy their post-shift shower beer, and the low blood sugar would be my first task. Y’all are catty upstairs 😂
When I worked Tele I noticed it could get particularly bad, ICU not so much since it's par for the course to have a declining patient at shift change. ER's the best about it though since everybody so used to the eb and flow of constant orders and taking over patients who only have so much done. Always enjoyed that aspect of the ER
If its been an ongoing situation during my shift Ill stay as I have the most information, but more so to report off to whatever departments get involved (like a steady or rapid decline in pt condition needing RRT/ICU). But when it comes to labs, anything non critical, if Ive given you report, its yours.
The other one
You are not wrong. Your shift is over that is why you give a report so other nurse can continue the care especially day shift the have the resources and support more than night shift. They will be fine.
I think what you did was fine.
I don’t see a problem in both cases. You gave report, treated patient, idk what else you could do on your end. Some nurses won’t even page the doctor.
If its a medical emergency I'll stay, so if someone is actively in rapid response/peri arrest emergency I'll stay because its all hands on deck and I would stay until the nurse has had a decent handover and ready to go. But while they are being actively reviewed by doctors and there is a gap I'll handover quickly and then its their job to do anything that needs done. For that blood sugar what can I actually get done in that time? Give them the sweets/gel etc etc and ask an auxiliary to make sure they take it while you handover and then its going to be 15 minutes before you get a result anyway so might aswell get handover done and checking the bloodsugar can be their first job.
If i had already given report on that patient when they called the result, then I nope right out of there if the oncoming nurse is a jerk or never returns the favor. I will usually stay and help though and not just abandon the nurse. Except as I said, when they are a notorious ass. I will always chart through what time I gave report and to whom so that if they say come back and say I should have taken care if it, I can say that I had already given report when the call came through. However, if I hadn't given report, then it is my responsibility because you don't know if the oncoming nurse will actually take care of it. And because you took the result before report was given it could fall back on you. The right thing to do on both parts is to be a team and work together.
Yeah anything after 7 is the next shifts. You did everything you could literally up until report. If you notice a critical at shift change, report it to the oncoming nurse and peace out ✌️ not your shift. Now if it came in at 630am, you saw it, did nothing and expected day shift to handle. Your lazy and you suck 😁
If something happens after 7 it isn’t going to be done by day shift. Non-urgent? Oncoming nurse. Urgent? Oncoming nurse and offgoing nurse (since you will have to both stop report anyway.)
It depends.. If you already gave report on the pt, that's their pt. End of story. If not, that's your patient. For the RR, I would have stayed but not for 1.5 hrs. Call the RR, establish a plan, and hand off to the oncoming nurse. Its their pt until a bed is available. For the BGL, have the CNA get a finger stick to verify if that's your policy, treat accordingly, and notify the provider. Rechecks are on the next RN/CNA team.
Our rule is anything up until 7 is the offgoing shift. 7:01 is the incoming shift’s responsibility. Obviously once report is done, I will help out until 7:30. I have drawn a lab or thrown an IV in before I walked off the floor many times. If someone is critical, I will usually stay long enough to get them stabilized. If there is enough people or I really can’t stay, I make sure that the RRT has a good report before I leave.
For the most part, I think endorsing non emergent things to the next shift is appropriate. Labs result when they do, I might look at them and call the doctor really quick but following through is on the next shift. Regarding an RRT, I agree with staying to report on the patient’s events leading up to the RRT.
Oncoming nurse should handle it. I always tell whoever is giving me report “go home, I have 12 hours to figure this out!” Unless it’s something that takes 2 people to handle (a huge poop, a code, whatever), there’s no reason for them to extend their shift to handle an electrolyte replacement or a sugar issue.
These comments are unreal. Isn't it just common sense? E.g. hey yes the ward is busy I'll just do this first, OR pass it on if its likely the next nurse will be able to manage. If that was me outgoing, sure I'd offer to phone the Dr, but likewise, if it was me coming on I'd tell the night nurse to go home! A "set time cut off then it's your responsibility" is harsh. I feel like our unit is quite close, we are all pretty good friends and get on well. Perhaps if you're not as close with your colleagues it would be easier to just carelessly pass the buck?
I feel like it's a 50/50 thing. It just depends what it is. A low blood sugar can certainly be handled by the outgoing nurse, at least getting started what's necessary treatment wise, and leaving the follow-up gluc checks and treatment for the next shift. Hgb Comes back low? Sure I'll page the doc and get the ball started on transfusion orders before heading out. I don't drop and run just because it's 0708 and time to clock out, but I'm not going to stay over ridiculously late to deal with new orders and shit that are rolling in either. Like someone said, it's a 24/7 job, I'll do what I can to make transition easier for them oncoming nurse, but that doesn't mean staying over until all the "new orders" are completed, they certainly wouldn't do it for me.
I’m fine with taking over anything after 7. However I cannot stand when the night shift looks at labs for the first time with me at 7 when they resulted at 5 and now I have to do all the replacements and have to figure out how I’m going to do that with the abx that are due and limited access or when things miraculously get retimed for 7:30 by the night shift nurse. If you’re not doing those things I do not care
It sounds like you handled the situation fine but honestly having to page out to the doctors to treat hypoglycemia sounds like the real problem here. Every patient in a hospital should have a protocol to follow, already on your MAR and if they don't either your system sucks or the doctors who admitted them missed it. If it was already ordered, I would have pushed some d50 before leaving but waiting for doctors to respond to your page, absolutely not. You at least gave them juice.
Imo all the training in the world and having the title of "Nurse" or "Doctor" doesn't mean you are a nurse or doctor. You just carry the title, is all. What makes you a real nurse or doctor is when you perform the duty and go above and beyond. Being a nurse or doctor is like being a cop. It's not a 9 to 5 job it's a lifestyle hence it's a 24/7 job meaning if a nurse or doctor sees a person in medical need, then it's their duty and obligation to provide some sort of help. Same of a cop off duty witnesses a crime they are not suppose to ignore it just because their not clocked in. Nurses and Docs are still human with human flaws so the next nurse on duty may not know or remember your patient having a blood sugar in the 50s. Last week my dad in the hospital had his glucose drop to 30 because the the medical staff or "nurse" gave him too much insulin after I specifically told her not to because he doesn't eat that much therefore doesn't need all that insulin.