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10 reasons I hate getting admissions at shift change

Thinkstock / Catherine Yeulet

Thinkstock / Catherine Yeulet

While there is plenty to love about nursing (and we try to celebrate that as much as possible), there are also plenty of things that make it a really tough profession. And it’s important to air those frustrations, talk them out and hopefully relieve some of the anxieties around them.

For Brittney from The Nerdy Nurse, one of the hardest parts of the gig is receiving admissions at shift change. She admits herself that “the reasons for this could fill pages upon pages,” but does her best to be concise in a blog post outlying the 10 reasons why it’s so tough. Here are five:

  1. Responsibility for the patient is unclear.
  2. 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.
  3. 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.
  4. It does not matter how much you have or haven’t done of the patient’s 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 one medication that needed clarification!
  5. An order for an NG tube at shift change is never a good thing.

To read the last five reasons why Brittney hates getting admissions at shift change, head on over to The Nerdy Nurse.

How do you feel about admissions at shift change? How about admissions or shift change in general? Tell us in the comments below!

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The Nerdy Nurse

Brittney Wilson, RN, BSN, also known as The Nerdy Nurse, is a Clinical Informatics Specialist practicing in Georgia. In her day job she gets to do what she loves every day: Combine technology and healthcare to improve patient outcomes. She can best be described as a patient, nurse and technology advocate, and has a passion for using technology to innovate, improve and simplify lives, especially in healthcare. Brittney blogs about nursing issues, technology, healthcare, parenting and various lifestyle topics at thenerdynurse.com
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3 Responses to 10 reasons I hate getting admissions at shift change

  1. pjrn77

    As an RN for 38+ years, I am saddened by the negativity expressed fairly frequently in social media. I have a few thoughts about the first five items listed in the blog. They are:
    1. Nurses work 24/7 and when relieved, the ‘hand-off’ report is the responsibility of both nurses…give a complete report/demand to receive a complete report…patients deserve that.
    2. Communication with charge nurse, unit secretary AND DOCUMENT what has been completed and what is pending for the benefit of the patients’ next caregiver’s ability to continue appropriate care.
    3. This happens regardless of time of day; be proactive to your patients’ needs and provide clear explanations about why questions are asked by more than one caregiver.
    4. These relationship issues need to be handled separate from patient care; ignoring a problem contributes to the continuation of it as opposed to resolving it.
    5. Orders come when orders come and, again, hand-off report, diligence by all caregivers, critical thinking…you know – all of those things that contribute to the art of nursing – these things enable quality/safe patient care regardless of time of day.

  2. runningnurse

    Really?? Well, I hate getting ambulances at shift change too, but it can’t be helped. I am under pressure to move the patients out of the ED (in fact, we’re timed and is part of our performance review!!) so I have to get them up to the floor whenever bed control assigns me a bed. If I DO wait till after shift change, I’m giving the night nurse a patient that he/she knows practically nothing about for 30 mins until the floor is out of report.
    I know I’m venting, but I hate the ED always being “the redheaded stepchildren” of the hospital.

    • nurseeli

      I’m a Nurse Supervisor. I see the whole picture of the hospital. I understand that you cannot help when an ambulance comes in, and therefore have to keep things moving. However, sending patients up at shift change has proven to be a bad practice. In my hospital we have a protocol that patients are not to be transferred during shift change. The only exception is a patient needing an ICU bed. Floor nurses take care of 6, 7, sometimes 8 patients. It is impossible for them to properly care for a patient during this busy time when they are trying to finish giving meds, finish charting, etc. in preparation for the oncoming shift. In the ER patients often sit and wait for hours for a bed…none of their meds haven been given (save for ED meds, i.e. pain meds, nausea, IVF, etc). Often times ordered blood transfusions aren’t even started. Point is, the floor nurse is the one doing all these things because once a patient is stabilized, ED nurses don’t do the standard, regular floor nursing duties. If they did, moving them at shift change would be A LOT less of a headache.

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