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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tokmom, BSN, RN

4,568 Posts

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

BrandonLPN, LPN

3,358 Posts

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....

Ntheboat2

366 Posts

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.

allnurses Guide

Spidey's mom, ADN, BSN, RN

11,304 Posts

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.

;)

annmariern

288 Posts

Specializes in vascular, med surg, home health , rehab,.

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.

BrandonLPN, LPN

3,358 Posts

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 ;)[/quote']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.

RNfaster

488 Posts

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.

RNfaster

488 Posts

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.

Paco-RN - check this out regarding C diff being airborne...

The Potential for Airborne Dispersal of Clostridium difficile from Symptomatic Patients - "Conclusions. Aerosolization of C. difficile occurs commonly but sporadically in patients with symptomatic CDI."

Airborne Spread of Clostridium difficile.

Ntheboat2

366 Posts

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.

I'm pretty sure when people are speaking of general hand hygiene practices they aren't including the well known exception of C-diff. Obviously.

RNfaster

488 Posts

I'm pretty sure when people are speaking of general hand hygiene practices they aren't including the well known exception of C-diff. Obviously.

Agreed.... this is what I was responding to:

... (obviously, for c-diff, I wash at the sink because the friction is what kills the spores)

Just felt it important to clarify...those C. Diff spores are quite robust...

One other interesting tidbit - some studies have found handwashing preferable to sanitizing in combating norovirus... Hand Sanitizers May Actually Cause Outbreaks Of Norovirus

I try my best to comply with hand hygiene... My poor hands are parched and require loads of hand cream....

I do focused assessments as the situation merits.

I think the OP was trying to get folks thinking and writing. It worked.

I dont like the gel or foam sanitizers. I feel gross after using them. The one my facility uses is very drying and my hands get cracked very fast. Also with all the handwashing talk and cdiff , I see most pts not even wash hands before eating or after using the bathroom. I made a thread on it. I shouldn't have to remind ao3 completely with it adults to do this , but i do. This should have been taught to them as toddlers and it is not some grand secret either. The visitors do what they want . and all of these patients are mostly discharged right back into the community. People are gross.

tokmom, BSN, RN

4,568 Posts

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

Umm, no. This is contract. We are union. WE the nurses have low census hours that WE created to help round out paychecks when census is low. Our staffing on a med/surg floor runs at the maximum of 5, usually 3-4. Pretty darn good, when you throw in 2 CNA and a CN that does all discharges/education and helps on the floor when able and a float nurse.

The nurses have the choice to either stay home and not come to work, and some choose to get some easy hours by doing audits that our organization demands.

I personally support the audits they do. We have a couple of nurses that were reprimanded because they had to be stopped over and over to do simple handwashing.

So no. We don't need these low census nurses on the floor. Our staffing is adequate, thank you.