Do you cut corners in your daily nursing practice?

Nurses are overworked and some will cut corners to manage all their day to day activities. Are the corners that get cut saving time or are they costing the patients dearly? Do we know when we are cutting corners in our practice or has it become a habit or routine that we no longer acknowledge it? Nurses General Nursing Article

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 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.

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?

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

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

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

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?

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.

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.

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

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

Medications mistakes being common

So many are made, but I wonder how many are actually happening and caught, and how many 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.

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?

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

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?

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

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

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

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

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

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.

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

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

Specializes in cardiac CVRU/ICU/cardiac rehab/case management.

OK blood starting to curdle....I feel a vent coming.

Let's try something novel, the truth. I have worked on 2 continents nursing for the last couple of decades and I assure you every nurse has cut corners somewhere. Promoting this myth of perfection serves no one. It is not only dishonest to paint the picture of the nurse who is perfect every time it is quite frankly a disservice to the profession. It is attitudes like this that make nurses not fess up when they err when the climate portrays and expects perfection.

Just look at the poor new nurses. What are we thinking. Not perfect...there's the door. God I would be petrified to be a new nurse in this climate. Zero tolerance. Its just brutal. No one and I mean no one can tell me they do it right everyday.

So let me start the ball rolling. Forget to wash my hands, yes. Made medication errors yes. Told the pt, yes. Felt the wrath for making that mistake,yes. Next error I got the Dr. to write an order that covered me and I am not ashamed of it. Do I reflect,yes. If it is a stupid rule like the script hospitals have us say, no. I work under my own honor. I do the best that I can. I treat people how I wish to be treated.

It sets me on fire that a climate has been created not to tell the truth. If I don't do my work I am honest. If I didn't do a dressinsg I admit it. If I don't want to do the next admission I say it. I say what's the truth "I am tired , or I'm feeling lazy, or I'm just too grumpy today "I don't care whose looking because what you see is what you get, a real person. Instead of all this perfection let's try trust. Work on establishing trust that the pt knows you are giving everything you have got.That we begin trusting each other. That management create an environment where trust is valued over making things look good. Lets give the care rather than writing stacks of paper on what we are meant to do. I do not believe that people are doing head to toe assessment because I have seen enough on pts to tell you they weren't looked at . Furthermore nurses on med surg have looked at me ga ga at even the thought of doing it. Your really lucky if the nurse is listening to pt lungs when they are admitted for CHF. Don't take my word ask your pt. Again,lets try some honesty. It is done in units but not on the floors. If anyone tells me "oh no,not me" .Then you are the exception

We would have less law suits and paperwork if we actually valued forming a trusting relationships with pts. Why, because we miss the most basic thing we don't take the time to listen. People who feel heard ,validated forgive us the mistake of not washing our hands or forgetting an alcohol prep. Why, because they feel cared for.I simply can't take this holier than thou attitude. I absolutely think that when we harm pt,correct it, even sue but trying to make people perfect is just denying our basic humanness We are flawed. So lets just start focusing more on making an environment where people feel safe to tell the truth, room to learn, safe to be yourself without a camera hanging over you. Lets start with the basics give the best care you can. Forgive yourself when you don't and try for bettter tomorrow.

Yes to many things. I also have occasionally yelled at my kids, driven over the speed limit, parked over the 1hr limit, not eaten 5 servings of fruit/veg daily and other innumeralble things.

I admit to imperfection sometimes.

I don't always wash my hands when I take off gloves. I'll pull them off and throw them in any trash can I can find while I'm running to do the next task. Washing before putting on gloves and then after is a bit overkill IMO...especially if you're going to wash again before you go into another room. Technically, if you do things the "right way" and the rooms are 3 feet apart then you would take off your gloves, wash your hands, wait for them to dry, and then wash them AGAIN because the last time counted as the washing that was supposed to be done after removing gloves and not the washing before entering a patient's room, yes? That's just goofy.

Specializes in RN, BSN, CHDN.

My article was designed to get you thinking, it is not about persecution of the nurse.

I can feel your blood boiling, but you have to think about how easy it is to make a mistake

As nurses we are poor communicators and we have poor managers or hierarchy, the expectations from companies we work for, are that we can manage and cope.

If we all stood together, vocalized our disgust and inability to manage, we might be able to make changes

Unfortunately there are expectations and governing bodies are checking our care and are quick to judge.

New changes from medicare and medicaid, mean payment for performance, money is taken away instead of given so we will see more stringent measures in place. These government bodies think if they hold money back that it will force health care facilities to improve their care, but I do not believe this will happen. It will just cut jobs and those left behind will have to work harder with less resources

I want to live in a world where we are free to practice without worry or looking over our shoulder but sadly I do not live in this world.

Specializes in Certified Med/Surg tele, and other stuff.
I don't always wash my hands when I take off gloves. I'll pull them off and throw them in any trash can I can find while I'm running to do the next task. Washing before putting on gloves and then after is a bit overkill IMO...especially if you're going to wash again before you go into another room. Technically, if you do things the "right way" and the rooms are 3 feet apart then you would take off your gloves, wash your hands, wait for them to dry, and then wash them AGAIN because the last time counted as the washing that was supposed to be done after removing gloves and not the washing before entering a patient's room, yes? That's just goofy.

Put yourself in the other pt's room that is three feet away. A nurse walks in the room and doesn't wash her hands. Are you going to A) Ask her to wash her hands because you, the patient, did not see it?

B) Assume she did and say nothing? C) Say nothing because you don't want to offend her?

Nobody is touching me without washing once they enter the room. I don't care if the washed their hands 3 feet away. If it's not done in front of me, nobody is touching myself or my kids.

Right....so you're going to throw your gloves into the trash and then wash your hands outside the door and stand there while they dry so you can walk in the room and immediately wash them again?

Or...you're going to throw your gloves away and then wash them outside the door/as you walk into the room? Or throw your gloves away and use the dispenser inside the room? Either way...it's the same thing.

I've not seen a person yet who throws their gloves away, washes their hands while they stand outside the room and then walks into the room where they'll immediately be washed again.

Great article and I can appreciate this so much. I have taken a vow to do no intentional harm to my patients. If I didn't remain sterile for a Foley catheter procedure and that patient got an infection, I would never be able to forgive myself. So, yes, I do things by the book. I'm very disheartened when I see nurses cutting corners. The reason it's so upsetting to me is because some of the things they are doing are dangerous. I have observed many nurses giving cardiac medications without checking pulse or blood pressure. I actually won't go into more detail on some of the things I've seen. In the beginning, I was wondering why those nurses always got out on time and got to sit down during their shift to document. My manager says that I need to work on time management, but I'm doing things the right way. I can look in the mirror at the end of every shift and know that I have given my all to my patients. Not only was it quality care but it was coupled with compassion too.

Funny you should say that because I do ask myself when I'm tempted to cut a corner. The answer though is, yes, I still cut corners.

Just one example: At my workplace, we are required to chart two head-to-toes per shift. I do a full hands-on assessment at the beginning of shift, but the second one? Well, if I can't figure out if anything has changed in six hours when I've been in that room at a minimum of three times, my assessment skills and powers of observation suck.

Wow -- you have to chart two head to toe assessments? Wow- I feel for you!

Of course I cut corners, only way to survive as an RN.

I cannot give you all of your medication information when I discharge you. I give the main points, but there is something to be said for self-awareness. It is also the patient's responsibility to read directions.

Sometimes I don't finish the fluid bolus on a DC'd patient so I can clear the room for another sick one.

Using nursing judgment, critical thinking skills and autonomy are our greatest tools. In a perfect world we could do everything by the book, but in reality, we are all overworked and understaffed.

I have been a RN for almost 5 months, and I can honestly say that I've never cut corners. What you have written here makes a lot of sense though. Perhaps I might need to look at my current practice and reevaluate things. I'm sooo incredibly burned out right now.

I used to wonder why my co-workers at a certain job ALWAYS got smoke breaks, meal breaks, and left on time, while I was always getting off late and never breaking for more than 15 or 20 minutes, while charting.

It's because I was charting, checking VS and I/O that were supposed to be put in the chart by aides, restocking the med and tx carts, and doing my dressings.

The other nurses weren't bothering to chart! Or make sure the aides did their charting!

Newbie FLmed, bless your heart.

Specializes in Certified Med/Surg tele, and other stuff.
Right....so you're going to throw your gloves into the trash and then wash your hands outside the door and stand there while they dry so you can walk in the room and immediately wash them again?

Or...you're going to throw your gloves away and then wash them outside the door/as you walk into the room? Or throw your gloves away and use the dispenser inside the room? Either way...it's the same thing.

I've not seen a person yet who throws their gloves away, washes their hands while they stand outside the room and then walks into the room where they'll immediately be washed again.

Color me a bit confused, but our sinks are in the room and I use paper towels. I usually gel in, and will put on gloves. Once done with gloves, I throw them away, turn on the faucet, wash hands, take the paper towel and dry my hands. I then take the towel to turn off the faucet. I toss the paper towel and walk out of the room. I then go into another room and repeat my process in front of the pt. That is our PnP and anything less gets a write up.

Put yourself in the other pt's room that is three feet away. A nurse walks in the room and doesn't wash her hands. Are you going to A) Ask her to wash her hands because you, the patient, did not see it? B) Assume she did and say nothing? C) Say nothing because you don't want to offend her? Nobody is touching me without washing once they enter the room. I don't care if the washed their hands 3 feet away. If it's not done in front of me, nobody is touching myself or my kids.
Whatever. If I just washed my hands in the hallway (where I do 90% of my hand washing) I am NOT gonna wash them again in front of just because you're an OCD case. Sorry, but you're SOL on this one.