Saturday, August 22, 2009

In April I wrote a post called "Nursing is a 24 hour job"

This, I suppose, is somewhat of a corollary.

Two days in a row, I have gotten patients from the same nurse. Rumor has it that she used to work ICU/Stepdown. You'd think she'd be able to handle some measly Tele patients.

Two days in a row, I started receiving report 10-15 min late, because she is running around crazy trying to finish things. I *know* day shift has a lot more going on. But when you give report late, you steal 15 minutes from my shift. I have my day carefully calibrated, and even 15 minutes can screw things up sometimes.

Now that we are computerized, the first thing I do when I get on is set up my eBrain. I still have a paper brain, but this one keeps my patients where I can see them quickly on the computer. Yesterday, I set things up to find that one of my patients has 6 overdue meds that were scheduled for 1330 & 1400. The nurse is aware of one of them, some IVIg (an immune factor), is late because the pharmacy needed to send up special tubing. That's fair. But what about the other 5? I know that I have a 2200 med pass (one hour before end of shift) and I plan accordingly, trying to get them all in starting at 2130. But she didn't even realize they were there. Today, there were 2 overdue meds each for 3 patients.

This blows my mind, because she should have an "Overdue Med" column on her eBrain. I see mine every time I use the computer, multiple times an hour.

Usually her excuse for not being up-to-date with everything is that she got an admission. I know the day shift is more used to discharges than admissions, but come on. It's not like you have to wait for the UA to take all your orders off and put them in the chart. Or you have to wait for the pharmacy to receive all your med orders and get them into the computer. It's all done instantly. Click click click click click. Acknowledging new orders takes seconds. The admission interview, granted, is a little longer than before, but it's still mostly the same. And charting is another set of clicks.

I wonder if she forgets she has Resources. Or if Resource is too busy on Days. I know that the moment I found out about all the overdue meds, I let my Resource know that I'd need help catching up with my day or I'd be way behind. And my Resource went over and passed the meds so I could assess my patients and start my shift properly.

Apparently I'm not the only one complaining, because the manager asked me to write up specific instances for an employee performance review. And she got a talking-to. I feel really bad about that, because I know what it's like to get a talk from them. But I also hate having to clean up after people who should know better.

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