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.

i think there are times when you have to. It never makes you feel good to cut corners or not be able to get to something, but in my last job at a SNF I had 40 patients (given that half of them were ICF). they all had at least one treatment that needed to be done; lotion, topical creams, small dressing changes, large dressing changes and all of that. out of those 40 patients 13 were diabetic and i had to check all of their blood sugars in my 8 hours shift twice and administer insulin to about 10 of them. I also had a trach patinet that had trach care once a shift and suctioning 3 times a shift, he was also a tube feed and we had one other pt who was a tube feed as well. on top of that i did the large dressing changes and treatments and i did all my charting. If everything went perfect i could get it all done. If something happened, like a patient fell, or someone coded or needed to be sent to the ED or the house dr came in and wrote 20 orders for different patients or patients were on IV fluids then i was screwed. at that point i would have to cut corners or "skip" certain things..... mostly it would be things like anti-itch cream or barrier cream (which its required that a nurse to apply if it contains zinc) or the small things. I never skipped the big things like dressings, meds, or such, but sometimes i wasnt even able to chart on all my patients that i needed to chart on! i felt guilty about that all the time, but in the end we are put in the position that we have no other choice! i could ask for help 1000 times and never get it, i could try to stay 3 hrs past shift but still couldn't finish

To answer the question though, where direct writing is still required, in trying to get everything done, or as the shift gets later and later, my handwriting goes more and more down the toilet. Yes I see some nurses print or write with perfect penmanship. I envy that, but as long as the writing is legible enough to hold up in court, I feel like other things are of greater priority. Plus, unless I write very slowly, I cannot print like some of these nurses. Lord knows I have tried. I'd be there forever.

IDK, I think it's kind of tough to cut corners in intensive care units. They are very anal-retentive environments, and mostly there is a reason for that. Now if the crap really hits the fan, well, the hygienic aspects may become core only--it depends. I hate to miss that too; b/c if you have ever been a patient, you know how much it makes you feel better to be as clean as possible--although nothing beats a good shower.

I have had times when drainage canisters were not empty--only b/c we only had to dump them a zillion times already, and other things of higher priority got in the way. Guess what? Mostly other critical care nurses will still @#$%^ at you about it, even it was a war zone. Depends upon the nurse-person, but I kid you not.

When you work on the floor, well, you can't always be as anal as you can in the unit. There are just too many patients with too many needs, and you can only divide yourself so far before you risk jeopardizing higher priority functions.

Mostly what I find is the documentation isn't as nice and pretty. Like I said. . .if it's legible, that is what counts the most.

Specializes in LTC and School Health.
I have been a RN for almost 5 months, and I can honestly say that I've never cut corners. What you have written here makes a lot of sense though. Perhaps I might need to look at my current practice and reevaluate things. I'm sooo incredibly burned out right now.

In my first five months, I didn't either.

Thank you for this reminders, it helps that we need to read this more to better serve our patients.

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.

Specializes in Home Health, MS, Oncology, Case Manageme.

I am leaving my current position of direct care because I am finding myself cutting corners. I don't want to be that kind of nurse. My excuse is that I am burned out from patient care. As soon as I recognized I was starting bad habits, I started looking for a desk job. I found one and hopefully now I can sleep at night.

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?

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!

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.

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?

yes i do. especially when i have 40 pts and i am alone on weekends

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