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.
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.

That is why you wash/gel before you go into the room, right? So anything you touched like the chart, keyboard etc.. is washed or gel'd off your hand once you walk into that room?

And yes, you should wash or gel after touching an IV pump. Do you trust the keyboard of the machine is clean? I don't.

I will whole heartedly admit. I am the patient's best advocate and management's frustration. = / In my experience, especially as a floor nurse. I take time with med. administration, dressing changes, various procedures and so on. I have never been, nor will I ever be an RN "corner cutter". Sure I have had my share of being "called out" on my "time management" skills. (or so called lack there-of). I take full responsibility for being "slow". But thats because I am reading the MAR, making sure what is ordered for my patients by the MD is exactly what they are getting at the time ordered. Even the little 97 yr. old lady that takes pills one at a time and feels the need to blow her nose after every pill, or two. I will be patient... knowing "an ounce of prevention is worth a pound of cure as they old saying goes. Our patients get their meds to manage their specific disease process and the s/s associated with it. Therefore 9/10 times our patients remain stable, or improve. If corners are cut and meds aren't given consistenly. Their condition worsens, then their care becomes more time consuming, their overall needs become greater and the couple of minutes you initially saved. Come back to bite you in the behind. I hope I communicated that in a way that made at least some sense. Same with wound care. A wound not taken care of properly and consistently per MD orders will more than likely cause yourself, or another nurse more work when it becomes infected or, doesn't heal according to plan. I may not go "by the book" at all times. I sure avoid cutting corners though, it makes sense to me. I am the nurse who is last to get my charting done alot of the time, not always. It's okay... I know my patients got good care that day and that I did my best for those entrusted to my care. I will take some guff from mgmt. about my "time mgmt issues.". I know better, the nurse to patient ratio is undeniably out of whack, that's the real ISSUE. I refuse to take it personal when they moan and groan at me about time management.

monkeybug

716 Posts

Specializes in Public Health, L&D, NICU.
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.

Secret shoppers? Are you freakin' kidding me? Once more, some suit trying to turn healthcare into retail. I wash my hands, a lot. Between every patient contact. But often I wash them in the hall because families like to pile crap on the sinks. If it's a family that has made a point of making me wash in front of them, then I happily dribble my soapy germy water in their Coach purses, open cups, make up cases, or whatever else they've piled around. We didn't have gel in the rooms, only in the halls, and I utilized that often, too. Our infection rate, when I worked in the hospital, was very good, too. One of the few areas we got praise regularly. Amazing, since most of us washed in the hall or nurses station.

NJnewRN

112 Posts

The Commuter, I hear you. I feel the same exact way. It's literally like arguing with a brick wall. I get such bad anxiety. I'm afraid that one day something bad is going to happen on my watch and I'm going to be blamed for it. I just can't live with that. So I've managed to stay away now for 9 months. Good luck to you. I would rather push papers that be a floor nurse.

ThePrincessBride, MSN, RN, NP

1 Article; 2,594 Posts

Specializes in Med-Surg, NICU.

I feel like it is impossible to NOT cut corners in this profession. I'm a PCA, and having 10-12 patients, I sometimes have to cut corners. I don't want to, but I'm forced.

tokmom, BSN, RN

4,568 Posts

Specializes in Certified Med/Surg tele, and other stuff.
Secret shoppers? Are you freakin' kidding me? Once more, some suit trying to turn healthcare into retail. I wash my hands, a lot. Between every patient contact. But often I wash them in the hall because families like to pile crap on the sinks. If it's a family that has made a point of making me wash in front of them, then I happily dribble my soapy germy water in their Coach purses, open cups, make up cases, or whatever else they've piled around. We didn't have gel in the rooms, only in the halls, and I utilized that often, too. Our infection rate, when I worked in the hospital, was very good, too. One of the few areas we got praise regularly. Amazing, since most of us washed in the hall or nurses station.

We don't have sinks in the med nurses station or hallways. ONLY in the clean/dirty utility rooms, med rooms and pt rooms. I'm happy for your infection rate. Good for you.

As for the secret shoppers. Yeah, kind of an anal idea, but look at it this way. Wouldn't you want the nurse being busted for never washing her hands? What if she was taking care of your family members? This specific nurse was going from an active MRSA room without washing and was stopped going into an immediate room next door to a surgical pt.

PacoUSA, BSN, RN

3,445 Posts

Specializes in ICU / PCU / Telemetry / Oncology.
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.

This is very interesting, I stand corrected, thank you! No mention of this was ever made to me in school or where I work. C. diff patients are regularly left in double rooms, although isolation precautions are in place, why is this? Also, if airborne, why aren't masks required??

And who says you can't learn anything on allnurses :p

wanderlust99

793 Posts

Specializes in ICU/PACU.

I cut corners daily. Of course that article was written by a manager who probably implemented a dozen additional tasks to her staff causing them to cut corners.

madwife2002, BSN, RN

26 Articles; 4,777 Posts

Specializes in RN, BSN, CHDN.
I cut corners daily. Of course that article was written by a manager who probably implemented a dozen additional tasks to her staff causing them to cut corners.

Yes it is true It is an article written by a manager, who often works side by side with her staff but who also has to make sure corners are not cut, in my place of work there is often good rationale behind what we are expected to do.

I was also a floor nurse until 3 years ago, and where I worked you did not cut corners unless you wanted to lose your job.

nursynurseRN

294 Posts

Specializes in TELEMETRY.

If nurses didn't cut corners then everything we did would never be on time and there would always be overtime...., I think cutting corners on small things is ok, it's the big things we need to worry about not cutting corners.

MsBruiser

558 Posts

Yes it is true It is an article written by a manager, who often works side by side with her staff but who also has to make sure corners are not cut, in my place of work there is often good rationale behind what we are expected to do.

I was also a floor nurse until 3 years ago, and where I worked you did not cut corners unless you wanted to lose your job.

Cut them every way and in every way. You cannot constantly heap more work on someone's plate without taking something away. "Managers" like yourself are the easiest to deal with. Make the charting nice and neat, the patients happy - and the corners will be cut, and cut, and cut. Easy. And then the mangers go their meetings, and run around with their clipboards, and propose more idiotic work - and the corners will continue to be cut over and over and over again. I probably work where you work. Or rather, there are lots of nurses like myself. We keep our mouths shut, the charting complete, and shake our heads and laugh. Yep, no corners cut in your hospital! Wouldn't be a post worthy of this site without a few of these: :no::blink::roflmao::greyalien:;)

madwife2002, BSN, RN

26 Articles; 4,777 Posts

Specializes in RN, BSN, CHDN.

Yep lots of meetings which drive me crazy, but a lot of protocols and procedures which are in place in the recent few years are actually mandated by the government or medicare.

Medicare want to cut payments to health care facilities, by improving care and reducing hospital re-admissions. So they have tightened the rules and if a hospital wants to survive financially then they have no choice but to tighten the care they are providing.

Unfortunately for you and me this all comes down to how we manage our care, reducing infections and decreasing hospital re-admission rates for which we are penalized.

Now you might say we cannot meet these strict requirements and we have to cut corners, but if your floor has repeated re-admissions for hospital acquired infections or an increase in UTI's from catheters then you are going see somebody somewhere coming down like a ton of bricks and investigations will be underway.

At the end of the day I dont know about you but I actually need my job, I work so hard with my staff to focus on what we can do to improve care and reduce infections. Please dont assume that all managers are the same, there are some out there who really care and work hard.