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

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BrandonLPN, LPN

3,358 Posts

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.
Ok, 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 :) )

Ntheboat2

366 Posts

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 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.

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.
We do not have sinks for staff in every room. I suppose i can gown/glove up for the cdiff , room , de glove, wash my hands in pts br, than re glove.. i wish we had sinks for staff in every room!! i wash them alot at work and they start cracking bad, especially in the winter. hospitai soap is way too dry and rough

wyogypsy, RN

197 Posts

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.

BrandonLPN, LPN

3,358 Posts

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.

N.U.R.S.E.

131 Posts

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.

Jasel, BSN, RN

203 Posts

Specializes in Emergency Room.

On average I'm assigned 39 patients for an 8 hour shift. There's only so much I can do.

FLmed

159 Posts

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!!

FLmed

159 Posts

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.

DoeRN

941 Posts

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.

Mully

3 Articles; 272 Posts

Specializes in SICU.

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!

PacoUSA, BSN, RN

3,445 Posts

Specializes in ICU / PCU / Telemetry / Oncology.

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.