Do you cut corners in your daily nursing practice? - page 2

by madwife2002 23,155 Views | 109 Comments Senior Moderator

Do you cut corners in your daily nursing practice? Or do you do everything according to the ‘book’. Do you police yourself in your everyday care of a patient, what do I mean by police yourself? I mean always follow the correct... Read More


  1. 29
    Interesting survey. Let's see how I do:

    Do you cut corners in your daily nursing practice? Or do you do everything according to the ‘book’.

    I am the very embodiment of perfection in everything I do. OK, is this a serious question?

    Do you police yourself in your everyday care of a patient, what do I mean by police yourself? I mean always follow the correct procedures no matter how busy you are, and when tempted to deviate never vary because you know it is wrong and that errors do often occur.

    I police myself, whatever that means according to your strangely framed question.

    When you are in a patient room alone, by this I mean no other staff member watching you or a patient who is oblivious. Do you behave as though you were being scrutinized?

    Yes. (Finally a question I understand.)

    Do you manage that patient care the right way, because it is the correct way.

    My way is always the correct way, silly. (See my first response.)

    Do you manage your hygiene, the correct procedure for changing IV fluids, remaining clean/sterile when changing dressings?

    Um...Yes. Yes. Yes. I think you need to do a "fill in the circle" type thing because it is hard to tell when you are done asking a question.

    Do you always wear gloves, do you change your gloves between procedures, do you wash your hands.

    Let's see...No. Yes. Yes. (You don't always have to wear gloves).

    Or do you occasionally forget to wash hands, not follow guidelines for procedures. Cut corners because you think nobody is looking, even though you know it is wrong but do it anyway?

    No. No. No. (I think someone is doing some projecting here.....)

    Do you reflect on your care after every shift? Reflection is old fashioned now, but after every event I do reflect on how I managed that situation, and if I could have done it better.

    No. Jeez how in hades do you reflect on every event?

    Often a corner is cut, nothing bad occurs so the next time you give yourself permission to do it again because you tried it once and it was OK. Soon the corner cutting becomes a habit and you no longer remember that you are cutting corners because it is part of your daily practice.

    Your honor, is there a question here?

    The reason I ask you, is because there are professional health care staff who do cut corners on a regular basis.

    Name names, senator.

    We do see frequent mistakes made because we don’t take our time.

    You got a worm in your pocket?

    Medications mistakes being common

    Sentence fragment.

    So many are made, but I wonder how many are actually happening and caught, and how many are never caught?

    478 are actually happening and caught. 15 are never caught.

    How many of you will go into a room, ask the patient her name, check her name band and then ask what she is allergic to? Every time you give that same patient her medication.

    Whoever does that will eventually get slapped in the face by everyone around him or her.

    Do you tell the patient what medications she is receiving? Do you discuss the side effects or check if the patient actually understands what meds she is receiving and why?

    Sometimes, and always with medications new to the patient.

    Do you watch every patient take the meds you gave them? Or do you give them the pot and walk away?

    Don't bogart that pot, Tonto. Around here we share the pot.

    Remember when you sign the MAR you are saying the 5 R’s are correct, but you are also saying you saw the patient take the meds you gave her?

    Do I remember this? I suppose I remember this.

    How many times have you been into a room and seen a pot of medication sitting on the side!

    Pot doesn't last long in the open around my patients.

    Do you always do a head to toe check, or do you skip some parts of it?

    I often do focused assessments when proper, and I never skip the proper parts of the correct assessments at the perfect times.

    You know that these things I mention occur on a daily basis and often go unchecked until a major disaster occurs.

    You know you wanna leave me, but I refuse to let you go.

    Often causing patients an injury, we have an obligation to provide each patient with high quality care always.

    I don't often cause patients an injury, but when I do, it's Dos Equis.

    Ask yourself when you are tempted to cut a corner, would you approve or condone this if it was your relative or meaningful other?

    Myself is annoyed with me and refusing to answer.

    When a mistake happens, it is often something that could have been avoided but it is something which will live with you for a very long time.

    Sounds like you've been talking to my exes.

    I am not your judge, I am not your conscience and I am only playing devil advocate.

    Whew.

    Please please please do not cut corners because in the long run you may have cost somebody a lot more time, than you spared.

    WHY DIDN'T YOU JUST SAY THAT TO BEGIN WITH??? SHEESH!
    canoehead, monkeybug, fashionistaRN, and 26 others like this.
  2. 0
    Part of nursing, nowadays and especially in LTC where I work, is knowing how to cut corners safely. Occasionally you have a patient who says, "I'm sorry, I just can't take any more of these pills right now, can you just leave them and I'll take them in a few minutes?" As long as it's not controlled, and they are A&O, I'll do it. There are people who are fully capable of operating their own HHN. I'll prepare it for them, and they'll do it when they're ready. I don't always pop in with meds and the most convenient time for the pt.

    It's impossible to wash in and out of every single room every single time. If I wash when leaving one room and go right into the next room without touching anything, my hands are still clean. I always wear gloves when indicated.

    Sterile procedures are one thing you can't cut corners on. If you do, you're risking serious infection.

    Floor nurses where I work are only required to do focused assessments, the Charges do the head to toes. But if I saw a bruise or scab yesterday and it was fine, there's not going to be any real change in it today.

    Safety checks on meds become habit after a while, and I can do them in my sleep (and I have in dreams!). It takes me zero extra time because it's so ingrained.

    I try to work by the book as much as I can. But it is IMPOSSIBLE to do so 100% of the time for anyone. If you are someone who works completely by the book all the time, I can guarantee you are off the book because your meds are late and you're waking people up in the middle of the night for their afternoon dressing changes.
  3. 4
    LMAO!!! Thanks for the laugh!
    The questions are crazy but the intention of the questioner is good I suppose. I'd say there are 3 types of nurses, the first one cuts corners to save pts' lives and her/himself, the 2nd one cuts corners to update their statuses of FB, and the 3rd one cuts corners to cut corners.
    gonzo1, janhetherington, Fink, and 1 other like this.
  4. 3
    I figured cutting corners was part of the package deal when it comes to nursing judgement; and policies were put in place as guidelines to help promote good nursing judgement. Eh, what do I know.
    Orange Tree, KitkatPRN, and brownbook like this.
  5. 2
    This is too long to answer correctly, but yes, there are days I cut corners. I might give quick d/c instrxns on meds, but I always put in information for them to read at home. In the fantasy world, I would do teach back for every single med.

    We scan our meds, and no, I don't always check for allergies with the pt. It's written on top of the emar and I can see it there.

    The handwashing thing I do every single time and I'm shocked at those that are answering they do not. I will even gel in and out, to silence a pump. I will wash/gel before going into a room to touch a pt, even if I just came out of a room next door and washed/gel'd. I might know I washed my hands, but the pt that I'm going to touch in the other room doesn't know that I did.
    Think about it. Another nurse comes out their room and goes into yours to silence a pump. That particular nurse might not have washed their hands and haven't done it all day. God knows what is on their fingers! They come in your room and touch your pump. You, thinking your hands are clean, touch the same buttons. Since you only touched one spot on the pump, and nothing else, you walk away and don't clean your hands. See where this is going?
    Last edit by tokmom on Dec 8, '12
    nightnurse28 and anotherone like this.
  6. 4
    I remember a shift last spring where I had time to do everything "by the book", good times. Other than that occasional shift, most of Hospital Nursing is the art of cutting corners as responsibly as possible, if there is such a thing. Nurses earn their keep by figuring out how to squeeze 16 hours worth of work into 12.
  7. 6
    Quote from MN-Nurse
    Interesting survey. Let's see how I do:

    Do you cut corners in your daily nursing practice? Or do you do everything according to the ‘book’.

    I am the very embodiment of perfection in everything I do. OK, is this a serious question?

    Do you police yourself in your everyday care of a patient, what do I mean by police yourself? I mean always follow the correct procedures no matter how busy you are, and when tempted to deviate never vary because you know it is wrong and that errors do often occur.

    I police myself, whatever that means according to your strangely framed question.

    When you are in a patient room alone, by this I mean no other staff member watching you or a patient who is oblivious. Do you behave as though you were being scrutinized?

    Yes. (Finally a question I understand.)

    Do you manage that patient care the right way, because it is the correct way.

    My way is always the correct way, silly. (See my first response.)

    Do you manage your hygiene, the correct procedure for changing IV fluids, remaining clean/sterile when changing dressings?

    Um...Yes. Yes. Yes. I think you need to do a "fill in the circle" type thing because it is hard to tell when you are done asking a question.

    Do you always wear gloves, do you change your gloves between procedures, do you wash your hands.

    Let's see...No. Yes. Yes. (You don't always have to wear gloves).

    Or do you occasionally forget to wash hands, not follow guidelines for procedures. Cut corners because you think nobody is looking, even though you know it is wrong but do it anyway?

    No. No. No. (I think someone is doing some projecting here.....)

    Do you reflect on your care after every shift? Reflection is old fashioned now, but after every event I do reflect on how I managed that situation, and if I could have done it better.

    No. Jeez how in hades do you reflect on every event?

    Often a corner is cut, nothing bad occurs so the next time you give yourself permission to do it again because you tried it once and it was OK. Soon the corner cutting becomes a habit and you no longer remember that you are cutting corners because it is part of your daily practice.

    Your honor, is there a question here?

    The reason I ask you, is because there are professional health care staff who do cut corners on a regular basis.

    Name names, senator.

    We do see frequent mistakes made because we don’t take our time.

    You got a worm in your pocket?

    Medications mistakes being common

    Sentence fragment.

    So many are made, but I wonder how many are actually happening and caught, and how many are never caught?

    478 are actually happening and caught. 15 are never caught.

    How many of you will go into a room, ask the patient her name, check her name band and then ask what she is allergic to? Every time you give that same patient her medication.

    Whoever does that will eventually get slapped in the face by everyone around him or her.

    Do you tell the patient what medications she is receiving? Do you discuss the side effects or check if the patient actually understands what meds she is receiving and why?

    Sometimes, and always with medications new to the patient.

    Do you watch every patient take the meds you gave them? Or do you give them the pot and walk away?

    Don't bogart that pot, Tonto. Around here we share the pot.

    Remember when you sign the MAR you are saying the 5 R’s are correct, but you are also saying you saw the patient take the meds you gave her?

    Do I remember this? I suppose I remember this.

    How many times have you been into a room and seen a pot of medication sitting on the side!

    Pot doesn't last long in the open around my patients.

    Do you always do a head to toe check, or do you skip some parts of it?

    I often do focused assessments when proper, and I never skip the proper parts of the correct assessments at the perfect times.

    You know that these things I mention occur on a daily basis and often go unchecked until a major disaster occurs.

    You know you wanna leave me, but I refuse to let you go.

    Often causing patients an injury, we have an obligation to provide each patient with high quality care always.

    I don't often cause patients an injury, but when I do, it's Dos Equis.

    Ask yourself when you are tempted to cut a corner, would you approve or condone this if it was your relative or meaningful other?

    Myself is annoyed with me and refusing to answer.

    When a mistake happens, it is often something that could have been avoided but it is something which will live with you for a very long time.

    Sounds like you've been talking to my exes.

    I am not your judge, I am not your conscience and I am only playing devil advocate.

    Whew.

    Please please please do not cut corners because in the long run you may have cost somebody a lot more time, than you spared.

    WHY DIDN'T YOU JUST SAY THAT TO BEGIN WITH??? SHEESH!
    YOU ARE AWESOME. I literally LOL'd for 10 minutes after reading this!
    NutmeggeRN, SleeepyRN, MN-Nurse, and 3 others like this.
  8. 11
    Quote from MunoRN
    I remember a shift last spring where I had time to do everything "by the book", good times.
    I remember a shift a few years ago, I think about 7, that I was able to do the most exquisite documentation. I was kind of sad nobody sued, I really wanted to see it up on the big screen.
    SleeepyRN, mazy, sharonp30, and 8 others like this.
  9. 1
    Quote from wooh
    I remember a shift a few years ago, I think about 7, that I was able to do the most exquisite documentation. I was kind of sad nobody sued, I really wanted to see it up on the big screen.

    LOL, that is so true. I had one troublesome pt that I charted with amazing detail. Nothing happened, thankfully, but the prosecuting attorney would have had a difficult time picking it apart.
    As much as I did not want to be named in a lawsuit, I was a bit disappointed it went to the archives without anyone looking at it.
    wooh likes this.
  10. 0
    Quote from wooh
    I remember a shift a few years ago, I think about 7, that I was able to do the most exquisite documentation. I was kind of sad nobody sued, I really wanted to see it up on the big screen.
    LOL love it!


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