Do you cut corners in your daily nursing practice? - page 5
by madwife2002 23,614 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
- 1Dec 8, '12 by tokmomQuote from BrandonLPNVery true about hand gel. I personally hate the stuff after a few rooms and prefer to wash it off and start again.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)
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.
- 0Dec 8, '12 by MsBruiserQuote from MN-NurseYou are awesome. What a silly, sanctimonious OP....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
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.
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!Last edit by MsBruiser on Dec 8, '12
- 1Dec 8, '12 by lemur00Yeah, 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.
Quote from echoRNC711It 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.
- 2Dec 8, '12 by MunoRNQuote from tokmomI 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.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.
- 0Dec 8, '12 by tokmomQuote from BrandonLPNYou are confused. That's ok. I like you anyway. 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.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?
- 2Dec 8, '12 by BrandonLPNQuote from tokmomFair 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.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.
- 0Dec 8, '12 by Ntheboat2Quote from BrandonLPNExactly...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.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.
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.
- 0Dec 8, '12 by BrandonLPNQuote from tokmomOk, sorry, I thought you meant you gelled and gloved just to touch the sink or something. It was making my head explode. (I'm still not gonna re-wash my hands in front of you, though )You are confused. That's ok. I like you anyway. 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.
- 8Dec 9, '12 by Ntheboat2Quote from Kooky KorkyI 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."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.
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.