"REAL" nursing

WickedRedRN, BSN, RN · Apr 14, 2008

Wow...I have to say Wow! I have seen some bad practices by other nurses, but pre signing out all your meds for the night....that kind of takes it. What if someone codes or goes out early in her shift and she has already signed that she has given meds? Oy!

My first position out of school I was just off orientation and the charge nurse handed me a chart and told me to write up a shift assessment for this pt. I began asking questions about him and was preparing to go do an assessment, when she told me no, we all write assessments on this shift, no one has assigned pts, we work together, blah blah blah. I politely told her I was not charting on something I had not done and went out to complete them. The next day I called my boss and asked for a shift change.

To me, yes, real world is different from nursing school, but you should never, NEVER compromise your integrity. I do things as "by the book" as I can and I don't let those who have circumvented patient safety influence me. Bottom line is, it's MY license and I am going to do what I have to do to keep it.

DutchgirlRN, ASN, RN · Apr 14, 2008

what other things have you seen other nurses do that you learned the opposite in nursing school? those of you that have fallen pray, how long were you an actual rn before you started straying from the rigidity of nursing school style?

i've been a nurse for 32+ years and think i still do things the way i was taught 99% of the time. one area which i'm not good at is wearing gloves. i was taught to start iv's w/o gloves on and it is very difficult for me with gloves. i cut the second finger tip of the glove off so i can feel. i then use my third gloved finger to hold the intercath down while i attach the j-loop. i never take short cuts when giving meds. that's just too important not to give it my full attention and do it the correct way.

[color=#a0522d]the nurse in your post should be reported :twocents: imho

Virgo_RN, BSN, RN · Apr 15, 2008

"There's the nursing school way, then there's the REAL world.". I can't tell you how many times I have heard that, both in clinical as a student and in practice out on the floor. I have seen experienced RNs pre-chart medications, but I do not do this myself. For me, documenting in the MAR is one of my safety checks. Also, you never know what might happen in that room prior to actually giving the meds. The patient might refuse them, or the entire cup might get spilled on the floor. This happened to me the other night. The cup of pills contained two Ativan tablets, and I had to search high and low to find them both so that I could waste them and take new ones out of the Pyxis. By the time I actually gave the meds, it was a different time than what I would have charted in the MAR had I pre-charted.

imanedrn · Apr 17, 2008

So I was at a convalescent home for my geriatric clinical rotation this week. The nurse told me that she already signed all the meds out for the night but that she had not given them yet so I could still pass the meds for my client. She laughed and said thats not what they teach you in nursing school, but this is real nursing. She is right...its one of the things we were taught in our first weeks of classes...do not sign as given until YOU GIVE IT!!!
What other things have you seen other nurses do that you learned the opposite in nursing school? Those of you that have fallen pray, how long were you an actual RN before you started straying from the rigidity of nursing school style?

Just because a nurse does it in "real" nursing does NOT make it acceptable. She is actually committing a CRIME by doing this. She has falsified documentation! Why jeoparidize your license and your pt's safety for a little bit of ease. :no:

Whatever you do, do NOT follow her example. Yes, there are certain things in school that are not done in real life 100%, however, pt safety should ALWAYS be #1. This violates pt safety 100%, however, not to mention being ILLEGAL!

I hope you realize this.

NewEnglandRN, RN · Apr 18, 2008

I hate it when I need to waste a med and the second RN does not even look at what I am doing. Personally, if I am going to be co-signing in the Pyxis that > witnessed a med waste, you can be sure I am going to check the med and watch the waste.

jj1986 · Apr 18, 2008

How about hangin the vanc b4 the trough is drawn? Yes, I've seen it done.

SCDOHJohnRN · Apr 20, 2008

You were smart to refuse. :up: Nurses like her are the reason Nursing Homes in the US have a bad name! :madface:

HeartsOpenWide, RN · Apr 20, 2008

Just because a nurse does it in "real" nursing does NOT make it acceptable. She is actually committing a CRIME by doing this. She has falsified documentation! Why jeoparidize your license and your pt's safety for a little bit of ease.
Whatever you do, do NOT follow her example. Yes, there are certain things in school that are not done in real life 100%, however, pt safety should ALWAYS be #1. This violates pt safety 100%, however, not to mention being ILLEGAL!
I hope you realize this.

I totally realize what she was doing was wrong. We talked about that and some other things (I.E. nurse explained to me that she was giving her resident Lasix at night because if she gave it during the day she would be having to change the depends five times a day......she stated that the resident "wore a diaper at night anyways" and that the resident slept through the night--indicating to me the poor older woman had to sleep in her pee all night long! Hello, skin break down!) I plan to stick to my guns when I graduate (I worked as an MA --I know measly MA--but I never slacked on the things that I learned in school then either). I just wanted to be prepaired for what else I may potentially see when I become a RN

sunny261 · Apr 20, 2008

HeartsOpen Wide:

Do not fall into the belief that this is the way REAL nurses work. Just like in other jobs there are good and bad workers. Your are following someone who is sloppy and could potentially lose their license or even worse kill someone. Don't let one crummy one ruin what can be a rewarding career/way of life. She is among the few nurses who are not commited to her profession...good thing I'm not there with her.... :madface:

CABG patch kid, BSN, RN · Apr 22, 2008

I totally realize what she was doing was wrong. We talked about that and some other things (I.E. nurse explained to me that she was giving her resident Lasix at night because if she gave it during the day she would be having to change the depends five times a day......she stated that the resident "wore a diaper at night anyways" and that the resident slept through the night--indicating to me the poor older woman had to sleep in her pee all night long! Hello, skin break down!) I plan to stick to my guns when I graduate (I worked as an MA --I know measly MA--but I never slacked on the things that I learned in school then either). I just wanted to be prepaired for what else I may potentially see when I become a RN

Good for you for questioning it, you sound like you're going to be a great nurse!! :yeah:

al7139, ASN, RN · Apr 25, 2008

Hi,

I am a new grad with 11 months on the job. As a student we are taught the steps for a procedure or giving meds, etc. As a student, just giving a patient a Tylenol takes forever, let alone putting in an IV catheter!

Since I have been in the "real world" of nursing, I have observed both good and bad in nursing.

I see that the nurses who take short cuts, and are not careful are the ones who don't last. Those who are diligent in their work are the ones who keep their jobs. In school we were taught to always pay attention, to the 6 rights, abnormal labs, how to do a procedure.

I do pay close attention to med admin. My patients may get irritated when I ask for ID checks, but, when I explain why I am asking their name, dob, ss#, etc, they understand that I am looking out for their safety. In procedures like IV's, the step by step of school has been replaced by a confidence that only means that I am getting proficient at the skill, not that I am skipping steps when I do it.

Amy