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.

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.

Yikes.

Specializes in Certified Med/Surg tele, and other stuff.
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.

Is it OCD or is it keeping yourself, as a patient, safe, from God knows what?

Come to my hospital and you would be out the door in less than a month. It's taken seriously. Very seriously. There are secret shoppers watching nurses come and go. I prefer not to be written up and the pt's actually say they like seeing people wash their hands. We also boast a zero infection rate.

Is it OCD or is it keeping yourself, as a patient, safe, from God knows what?Come to my hospital and you would be out the door in less than a month. It's taken seriously. Very seriously. There are secret shoppers watching nurses come and go. I prefer not to be written up and the pt's actually say they like seeing people wash their hands. We also boast a zero infection rate.
Well, maybe I'm confused. If I sanitize my hands with the dispenser right outside the room, that's not good enough? I have to wash again in front of you? And I have to glove on and glove off just to touch the faucet? Or am I misunderstanding?

Well, if it's that's important for the pt to see me wash my hands, I guess they better park themselves in a spot where they can see me do it at the dispenser in the hall. Cause that's where I'm gonna do it.

BTW, research shows that the hand

sanitizer kills more germs than soap and water. (obviously, for c-diff, I wash at the sink because the friction is what kills the spores)

You are awesome!

Specializes in Certified Med/Surg tele, and other stuff.
Well, if it's that's important for the pt to see me wash my hands, I guess they better park themselves in a spot where they can see me do it at the dispenser in the hall. Cause that's where I'm gonna do it.

BTW, research shows that the hand

sanitizer kills more germs than soap and water. (obviously, for c-diff, I wash at the sink because the friction is what kills the spores)

Very true about hand gel. I personally hate the stuff after a few rooms and prefer to wash it off and start again.

Our dispensers are in the room, so the pt's can readily see nurses etc..gel in or out.

If I heard the dispenser outside the door and saw the nurse rubbing it in their hands, I would not expect you to wash them. But as a pt, I want to see some sort of wet stuff on your hands. Either water or gel. ;)

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. What a silly, sanctimonious OP....

Specializes in Palliative.

Yeah, there's been a fair amount of research here showing that "no fault" reporting means that people do a lot more reporting of themselves, and more errors are prevented. And fewer report others out of spite or manipulation. "Accountability" too often means treating professionals like children who get spankins when they make a mistake. It should mean being able to admit those mistakes and work on them together.

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.

Specializes in Critical Care.
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.

I commend your attention to your safety, I agree that an observant patient is a good patient, but I think your routine isn't quite correct. There's a reason why the term "hand washing" has been changed to "hand hygiene"; too much hand washing can actually increase infection transmission, which is why the rule is to gel in and gel out, not gel in and wash out. Hand washing should be reserved for soiled hands. Too much handwashing creates micro-fissures, which you may not even notice, but they can harbor bacteria and make gelling/washing less effective.

Specializes in Certified Med/Surg tele, and other stuff.
Well, maybe I'm confused. If I sanitize my hands with the dispenser right outside the room, that's not good enough? I have to wash again in front of you? And I have to glove on and glove off just to touch the faucet? Or am I misunderstanding?

You are confused. That's ok. I like you anyway. :cheeky: No you don't glove on and off to touch the faucet. You take the gloves off, wash hands, take the paper towel, and turn off the faucet. The gloves were off before you touched the sink. That is our PnP.

Very true about hand gel. I personally hate the stuff after a few rooms and prefer to wash it off and start again. Our dispensers are in the room, so the pt's can readily see nurses etc..gel in or out. If I heard the dispenser outside the door and saw the nurse rubbing it in their hands, I would not expect you to wash them. But as a pt, I want to see some sort of wet stuff on your hands. Either water or gel. ;)
Fair enough. The very idea of someone telling me to wash my hands again when I know I just did it got me all riled up. And I've never worked somewhere that had dispensers IN the rooms, so there you go. What you described smacked too much of the whole "customer service" mentality, which always gets my goat. :)
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.

Exactly...most of our handwashing is done "in the hallway" which is really at the dispenser right outside of the patient's room. So, if you dispense some gel in the hallway....you're probably still going to be washing your hands/rubbing the gel as you're walking into the room. That's why I said if I walk out of room 1 and wash my hands...I'm not going to immediately wash them again before going in room 2 when I haven't touched anything in between.

Technically, if you forgot your ink pen right outside the door then you should wash your hands, step out to get your pen, put it in your pocket, wash your hands again before going back into the room, etc. It's not realistic and it doesn't happen.