Receiving admissions at shift change is probably one of my biggest pet peeves in nursing. The reasons for this could fill pages upon pages, but I will try to be relatively brief:
- Responsibility for the Patient is unclear
- Paging physicians to notify of arrival to floor can become a fiasco especially when you are busy trying to complete admission assessments and get the chart ready for them.
- Patients almost never have an accurate medication list or their bottles.
- There is often 100 family members in the room which makes asking personal and confidential health related questions impossible.
- The patient may be in pain, nauseated, annoyed, tired, and just plain frustrated and is tired of answering the questions they have already been asked at least twice before.
- It does not matter how much you have or haven’t done of the patients admission, the nurse receiving the new admission is always annoyed with you. I have actually stayed over an hour after my shift trying my best to get a patient admitted only to have the receiving nurse make a smart-assed comment about 1 medication that needed clarification!
- I always feel like I am in a rush and will forget to do something.
- If the physicians happens to arrive while you are assessing the patient, all bets are off, and you’ll be there for a while. Firstly because you’ll have to stop doing your assessment so he can do his. Secondly because he’ll often tell you verbal orders, elect not to write them as well, as since you received them you are responsible for completing them.
- The secretaries do not take responsibility for properly transferring phone calls and communications about patients during the shift change time, which can greatly delay the departure of the nurse whose shift is ending. For example: at 7:10, when you shift is done, and you are charting at the nurses station, if the secretary blindly yells out “32 needs to go to radiology” is a demanding and callous tone, and the receiving nurse completely ignores it, then what is the right thing to do? Should you be considerate and take the patient down, to be helpful to the receiving nurse? Would she do the same for you? Is it even a matter of courtesy/responsibility? These issues would not even come into play if it wasn’t for non-direct yelling secretaries.
- An order for an NG tube at shift change is never a good thing.
How do you feel about admissions at shift change? How about admissions or shift change in general?