Do you cut corners in your daily nursing practice? - page 7

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  Kooky Korky profile page
    0
    Quote from Michigangirl
    We have a new-grad nurse on our busy med-surg floor who doesn't cut any corners. She does the most thorough assessments, creates awesome care plans, and loves to educate her patients. And her technique is flawless... I could give lots of examples; once I even saw her scrubbing a brand new heparin vial for 30 seconds before drawing out the medication into the needle.

    Unfortunately, she can barely handle more than 4 patients. She doesn't have time to reconcile the medical administration sheets (we are required to audit all of the orders in the chart every night for the day shift). Once she got a new admission and didn't have time to do even one assessment during the remaining 8 hours of her shift - nothing was documented but the vital signs. Sometimes she even forgets to check on her patients.

    She is either going to burn out, kill someone, or learn what corners she can safely cut.
    Is anyone helping her to realize what she needs to change in order to carry a full patient load?
  2. Visit  Kooky Korky profile page
    4
    Quote from tokmom
    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.
    Wish you could get those "secret shoppers" to pitch in and actually do some work!
    FineAgain, SleeepyRN, BrandonLPN, and 1 other like this.
  3. Visit  NightOwl0624 profile page
    0
    Quote from Kooky Korky
    Is anyone helping her to realize what she needs to change in order to carry a full patient load?
    She had a very extended orientation. Now that she's on her own, it's a real problem. I think she has trouble multi-tasking and prioritizing, and may be a little OCD. But she is really stuck on the nursing school way of doing things. Managers are aware, and insist she is doing just fine.
  4. Visit  spinksi profile page
    0
    Why can't you just use the hand sanitizer provided on most walls instead of washing your hands when you are in a rush? JUST WONDERING, mkay? I'm not a nurse yet.

    As in - use sanitizer if you haven't contacted the patient but have gone into another room to touch a button on the IV monitor?
    Last edit by spinksi on Dec 9, '12 : Reason: clarification
  5. Visit  roseonye profile page
    2
    yes i do. especially when i have 40 pts and i am alone on weekends
    wooh and BrandonLPN like this.
  6. Visit  tokmom profile page
    0
    Quote from Kooky Korky
    Wish you could get those "secret shoppers" to pitch in and actually do some work!
    They do work. They are not management, but nurses. We have low census hours and if you get called off you can come in and do many projects. This can be one of them. Don't come down on them. They are only doing what they are told to do, and quite frankly, some nurses need education on simple handwashing.
  7. Visit  tokmom profile page
    0
    Quote from Michigangirl
    She had a very extended orientation. Now that she's on her own, it's a real problem. I think she has trouble multi-tasking and prioritizing, and may be a little OCD. But she is really stuck on the nursing school way of doing things. Managers are aware, and insist she is doing just fine.
    If your username wasn't michigangirl, I would swear you worked in my hospital.
  8. Visit  BrandonLPN profile page
    6
    Quote from tokmom
    They do work. They are not management, but nurses. We have low census hours and if you get called off you can come in and do many projects. This can be one of them. Don't come down on them. They are only doing what they are told to do, and
    quite frankly, some nurses need education on simple handwashing.
    I dont blame the nurses, i blame the people implementing such nonsense. If hospitals are going to pay extra money for nurses to come in and work, they should just put them on the floor in an assignment. God forbid there actually be an extra nurse on the floor once in a while... Sounds like more imaginary jobs thunk up by more clueless people whose jobs, by all rights, shouldn't exist in the first place....
    monkeybug, anotherone, martinalpn, and 3 others like this.
  9. Visit  Ntheboat2 profile page
    5
    Quote from BrandonLPN
    I dont blame the nurses, i blame the people implementing such nonsense. If hospitals are going to pay extra money for nurses to come in and work, they should just put them on the floor in an assignment. God forbid there actually be an extra nurse on the floor once in a while... Sounds like more imaginary jobs thunk up by more clueless people whose jobs, by all rights, shouldn't exist in the first place....
    Seriously...if someone is not doing things the right way...like washing their hands...on a regular basis then it needs to be pointed out TO THEM. I don't like the fact that the best nurse on the floor could be written up just because they stepped into a room, remembered they forgot to grab something, and were "caught" not washing their hands leaving a room...even though they didn't touch anything. While on the other hand...someone who is a repeat offender gets away with it because they weren't working the day the hygiene police stopped by. It's just one more of those passive aggressive policies nursing is famous for. God forbid managers actually approach someone who is doing wrong individually when they can just threaten everybody big brother style.
    FineAgain, monkeybug, anotherone, and 2 others like this.
  10. Visit  Spidey's mom profile page
    2
    Our rooms have the gel dispensers inside the room as you walk in. And there are sinks in every room.

    I think revisiting this issue about cutting corners is simply a good way to step back and look at our behavior. Not to say we all must be perfect.

    We have an inservice on boundary issues about once a year - not to point out that we are bad people but to remind us to pay attention to the hair on the back of our neck raising when we do something that might be crossing a boundary.

    This seems like a good thread to hash out this idea of cutting corners.

    I was interested to read WHICH corners were cut.

    I always wash or gel my hands between patients - I'm one of those folks who uses the antibacterial wipes on shopping carts and keeps gel in my car. I wash all the fruits and veggies I purchase.

    As someone said . . when you program that IV pump, you can't be sure the person who touched it before you washed their hands after wiping their tush.

    NRSKarenRN and tokmom like this.
  11. Visit  annmariern profile page
    2
    This drives me insane; The OP is a manager; well my manager has added a new job function this week, ortho tech to assist PT ambulating pts, oh yes, I am already unable to do the ridiculous job description we already had, I have taken over as UC, pharmacy tech, my pts have to be discharged in 1 hour and I have to have meds out on time, I won't even go on, as its so ridiculous. Protest, sure, they say we are doing it anyway. Of course we cut corners, do we want to? No. Do we have to to survive, hell yes.
    monkeybug and janhetherington like this.
  12. Visit  BrandonLPN profile page
    3
    Quote from Spidey's mom
    I always wash or gel my hands between patients - I'm one of those folks who uses the antibacterial wipes on shopping carts and keeps gel in my car. I wash all the fruits and veggies I purchase. As someone said . . when you program that IV pump, you can't be sure the person who touched it before you washed their hands after wiping their tush
    I use hand sanitizer every time I exit a room, and after touching a resident. It's a good habit to get into. But saying we "need" to wash our hands because we don't know who touched that IV pump is taking it too far. We don't know who touched that chart. Or that keyboard. Or that doorknob. Or that elevator button. If we follow that line of thought to it's logical conclusion, some "study" will dictate it's "best practice" to wash before touching a chart or table or chair or telephone. And then some policy will dictate that we all sanitize our hands in between *every* single action like OCD crazy people.
    SleeepyRN, wooh, and TheCommuter like this.
  13. Visit  RNfaster profile page
    2
    Brandon - friction doesn't kill C diff spores, it's just more likely to remove the spores from your hands and send them down the drain. Here's another interesting item: "Commonly used hospital cleaning agents, such as quaternary ammonium–based (and other surfactant-based) detergents, are not sporicidal and may in fact encourage sporulation." Measures to Control and Prevent Clostridium difficile Infection

    One other thing... one of the things I tell my patients on admission to the unit is that if they or their families/friends have any questions or concerns to feel free to say something to any of us. I give them an example: if you think we missed washing our hands, say something. I tell them that speaking up is an important factor in patient safety. And I have sanitized my hands again in front of the patient in response to a voiced concern.
    Last edit by RNfaster on Dec 9, '12
    tokmom and madwife2002 like this.

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