Do you cut corners in your daily nursing practice? - page 5

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... Read More

  1. Visit  BrandonLPN profile page
    1
    Quote from Ntheboat2
    I think this happens pretty frequently. I remember one specific incident (because it landed me in the office after I exchanged words over it) where a nurse basically told me while I was working as an intern that I should be able to handle a patient transfer without any help because "John, the other intern, is able to do it alone." I said, "Well, John must not be doing it properly because there's NO WAY." Come to find out..."John" was transferring a no weight bearing patient who also had an immobilizer by taking the immobilizer OFF and letting the patient bear weight! Well...gee...why hadn't I thought of that?! It's hard to do things the right way when everyone around you is basically bullying you into doing them the wrong way.
    You were clearly in the right in the situation you descirved there, but be careful saying there's "no way" another nurse can get something done faster or by themselves. Personally, I can transfer many pts myself who require two assist for most other staff. Also I can pass meds quicker than most nurses and I get annoyed when newer and/or slower nurses imply it's because I cut corners. Nope, just faster. On the other hand, I'm slow at changing dressings, and doing an occupied bed change takes me a bit longer too. We're all faster at some things. Don't assume the nurse who finishes faster is cutting corners. Common newbie mistake.
    anotherone likes this.
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  3. Visit  martinalpn profile page
    3
    I am a fairly new nurse and I believe if you practice it wrong then you will do it wrong. Ideally I work hard to follow all the nursing guidelines. l learned to delegate what I can and to be more efficient by having all my needed supplies on hand. I work hard to learn my patients' likes and dislikes makes my day go a whole lot smoother. I try to anticipate their needs and we interupt this broadcast to bring you breaking news. Management has issued a mandate all work must be completed in a timely manner, all 300 duties on all 30 patients. Overtime is not allowed and will not be tolerated and/or you will be replaced, and now back to your regularly scheduled rant. thanks for listening, same rant channel same rant station.
    CloudySue, kabfighter, and sharonp30 like this.
  4. Visit  Jasel profile page
    1
    On average I'm assigned 39 patients for an 8 hour shift. There's only so much I can do.
    sharonp30 likes this.
  5. Visit  FLmed profile page
    1
    Quote from Kooky Korky
    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.
    I can completely empathize with your statement. I'm a type A personality and I'm extremely organized, but management says that I must not be managing my time correctly. All the other nurses get out on time, get their breaks, get their lunches, and find time to sit down. It is impossible to get everything done that management is requiring, and that's why I'm not able to do everything that the other nurses are able to find time for. It is rare that I get out of the hospital by 9:00 o'clock. I never (and I mean never) get breaks. I often don't get lunch either. I'm burning both ends of the candle, but I can say that I'm doing things the way they are supposed to be done. Thanks for the note, fellow sweet nurse!!
    Last edit by FLmed on Dec 9, '12
    Susie2310 likes this.
  6. Visit  FLmed profile page
    3
    Quote from wyogypsy
    Not every cardiac med needs a pulse or BP prior to giving it. If it is a new med, yes. If the dosage has been changed, yes. If the VS are not stable, yes. But millions of people in this world take cardiac meds every day at home without checking their pulse and BP beforehand. Also, it depends on the setting. If they are in acute care they obviously need close monitoring. If they are in LTC and have been there for 3 years and their VS are continually stable and they get weekly vitals, then they do not need them prior to receiving each med.
    I am in the hospital in the acute care setting. I've checked many blood pressures that were under 100 systolic and I held the meds. I was praised by a cardiologist for this. He even asked me where I was educated because in his words, "I've seen a lot of dumb a$$ nurses giving BP meds without checking BP." You have to take in account if patients are in the hospital, they are very sick. They might be taking Xanax or other pain meds that would lower their BP even more. I would rather stay safe and check BP before giving any BP meds. I don't want to have a patient fall or end up doing a bolus when it could have been prevented by simply checking a BP before giving the med. I definitely read what you said and understand where you are coming from. I do educate my patients to check BP at home before taking their meds though. I just think it's responsible to educate them on this.
    Last edit by FLmed on Dec 9, '12
    Susie2310, tokmom, and anotherone like this.
  7. Visit  DoeRN profile page
    0
    Quote from FLmed

    I respectfully disagree. I've checked many blood pressures that were under 100 systolic and I held the meds. I was praised by a cardiologist for this. He even asked me where I was educated because in his words, "I've seen a lot of dumb a$$ nurses giving BP meds without checking BP." You have to take in account if patients are in the hospital, they are very sick. They might be taking Xanax or other pain meds that would lower their BP even more. I would rather stay safe and check BP before giving any BP meds. I don't want to have a patient fall or end up doing a bolus when it could have been prevented by simply checking a BP before giving the med.
    I check them too every single time. I make a note in the comment section of the med I held and in the vitals section. I've been questioned about this too especially since I'm a floater and a lot of people look at me like I'm crazy when I do it. But oh well.

    Now as far as the hand washing I gel in and out. And if I'm going to the next room. I get some gel from the previous room, hold it in my hands and go to the next room while in rubbing it in.

    If I have a c-diff patient then I wash my hands afterwards.
  8. Visit  Mully profile page
    4
    What a bunch of buzzards! Squack, squack, squack.

    Good job OP for making everybody think! Granted I think you might be one of those nurses that's just a little too by the book, but I'd rather have one like you than one that's a little too by the break room.

    The great thing about being a nurse - we are critical thinkers (not robots). We have the ability to say, "I know how it should be done according to the book, yet I also can assess that for this particular patient at this particular time, it is not necessary." If one thinks I'm going to make the patient say their birthday every time I see them in my 12 hour shift because I supposedly am not able to remember what they look like, one would be mad. Does that leave me prone to error in some wild situation where I might mistake some other person for my patient? Maybe. But making such a rule would be like reducing the speed limit to 10 mph so there are no crashes. It's just not logical. We do things how we do them and we do our best.

    But you betta be washin yo hands!
  9. Visit  PacoUSA profile page
    2
    Yep, I readily admit to cutting corners. Because I have to. Do I gown up every time I enter the room of a C. diff patient? No, not if I don't expect to come in contact with their bodily fluids (like if I am bringing them a pitcher of water and leaving right away). But I still do wear gloves and I do wash my hands with soap and water. I don't think this is a severe corner cutting, as last I heard C. diff is not airborne.
    turnforthenurseRN and wooh like this.
  10. Visit  FLmed profile page
    1
    Quote from Mully
    What a bunch of buzzards! Squack, squack, squack.

    Good job OP for making everybody think! Granted I think you might be one of those nurses that's just a little too by the book, but I'd rather have one like you than one that's a little too by the break room.

    The great thing about being a nurse - we are critical thinkers (not robots). We have the ability to say, "I know how it should be done according to the book, yet I also can assess that for this particular patient at this particular time, it is not necessary." If one thinks I'm going to make the patient say their birthday every time I see them in my 12 hour shift because I supposedly am not able to remember what they look like, one would be mad. Does that leave me prone to error in some wild situation where I might mistake some other person for my patient? Maybe. But making such a rule would be like reducing the speed limit to 10 mph so there are no crashes. It's just not logical. We do things how we do them and we do our best.

    But you betta be washin yo hands!
    Great post!!!
    Mully likes this.
  11. Visit  janhetherington profile page
    4
    How in the world do you not cut corners?? I am a perfectionist; it has slowed me down all my life. But NOBODY can follow all the rules in a typical shift. Another thing about all that hand-washing; if you don't get them perfectly dry (who has the time), then you have trouble getting the gloves on for the next patient. Since nobody can handle the patient loads we get, staff get cynical and get slacker and slacker until they hurt someone or break some huge rule and get caught, then they're fired. How about some reality in the mix, management?
    anotherone, turnforthenurseRN, wooh, and 1 other like this.
  12. Visit  wooh profile page
    3
    Quote from Paco-RN
    last I heard C. diff is not airborne.
    But you might touch something and not know it! You never know when you'll be in a patient room and lose control of your bodily functions, and you have to be wearing full isolation gear just in case!!!!!!!
  13. Visit  Fink profile page
    4
    Throwing stones at others when you are also guilty? Really, who has not shaved an occasional corner? We nurse under the gun constantly. Things are time stamped in some charting systems. Being late on meds, even routine, is not acceptable! Time and performance equal revenue these days...your facilities paycheck and yours. The higher "ups" will not tolerate any lags in your performance. You will be terminated if you can not keep up. You do what you have to do to care for ALL your patient and what you have to do to keep your job and your sanity. I function on the priority of tasks and the acuity of my patients. The one that continually rings the call light for pillow fluffing and pulling the covers up when they have two good hands does not equate with the one on life support, multiple pressors, and chest tubes down the hall! I call us the"Stepford Nurses". Maybe we need a headset and a pair of skates! Oh, and "would you like fries with that"?
    Last edit by Fink on Dec 9, '12
    echoRNC711, anotherone, martinalpn, and 1 other like this.
  14. Visit  Fink profile page
    0
    Sorry about the typos! I am learning to use a tablet with with a virtual keyboard. Technology is very important..LOL!


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