Night-Shift RN Frustrated by Day-Shift Failure to Communicate

Question to Ask the Workplace Doctors about shift-to-shift failure to communicate:

Dear Workplace doctors I am an RN at a hospital in Ohio and I’m running into a huge problem. I work 7p-7a. Every time I go into work for the last month every patient report is not fully filled out.
Charting is not fulfilled and that causes me issues at my job because I’m confused on what I am and not suppose to do to help my patients out. This could affect my job and my patients’ health. There are signs posted all over the hospital and in the break-room for charts to be filled out with everything that should go on each for each shift. Clearly this isn’t working. What can I do so that my coworker and management will address this problem and fix it?

Signed–Off the Chart

Dear Off the Chart:

You realize how vital is proper information. Those under                                                                         your night duty care assume that you and your hospital will do whatever necessary to minimize their pain and return them to health. What can you do to have all the information you need?
You can and should approach this as both an interpersonal communication and a system-wide matter. It’s interpersonal because the RNs and staff you replace are those who learn what patients need and  they should fill out the charts you need. It is a system-wide administrative matter because apparently the charting rules and their implementation fall short. So what might you do? The suggestions below are those you might have already tried and might have to be tried again. They overlap and can be combined and modified to suit your particular situation:

  1. You might log what is and is not charted and how the proper information helps you provide proper care and when information is missing it risks improper care. Dates and patients will need to be on this log. Do that for several days.
  2. Get permission, if necessary, to come on duty 10-15 minutes early to see if the charts are complete and if you need to ask questions and/or seek clarification. This kind of shift to shift interpersonal overlap is especially important when health and safety are at risk. Building a one-on-one respectful appreciation for the work of those you replace is half up to you. You will want to be understood as a pleasant RN re-enforcing replacement coworker and not as a coworker policing/criticizing them.
  3. Gaining a system-wide policy for an overlap of shifts is something you might suggest in informal conversation with supervisors or more formally by scheduling a session with them. Here is where you can ask their help to get proper charting. So as not to be seen as tattling on coworkers your first efforts might be more general–suggesting that a supervisor might meet with you several evenings when you take over to scan the charts with you to see if they are as they should be.

Obviously what has been done isn’t working. And you can make a difference. Can you see this as an adventure in improving communication–using both interpersonal skills and system-wide managing skills? Good hospitals are praised for the kind of care and sense of responsibility that is revealed by your question. May your tribe increase. Working together with hands, head, and heart takes and makes big WEGOS. –William Gorden