Incompetent nurses - page 4

I didn't know whether to list this as vent or concern, so I guess I'll just let it all out. I have been an RN for about 3 years and was a street medic for 7 years before that. I feel like I might be... Read More

  1. by   UM Review RN
    Quote from medicrnguy
    Actually I was never a monitor tech. I have some friends that work in there though.
    So you're telling us all about incompetent RNs based on whose observations? These friends? Or your own?

    Quote from medicrnguy
    I have received a lot of criticism of my opinion, but I asked for suggestions. Everyone does have the right to an opinion whether you agree with it or not. I figured if I got all this out in an open forum, those that do practice nursing the way I described can perhaps change their behavior and save a couple of lives in the process. It seems many of you who practice nursing the complete opposite as I have described, got offended. If you don't act like this why take it personal?
    I'm not offended. All I know is, if I had colleagues who behaved like that, I'd have reported it. You never told us whether or not you reported the problems and you never told us what happened when/if you did report the problems, whether you're still working in that situation or not.

    I have a problem believing that your post was trying to solve a problem. As an RN. you should've taken it up the chain of command on behalf of the patients. I would've been writing the incidents up to Risk Management until my fingers fell off.

    Did you do anything at all to make sure that this problem doesn't happen again?
  2. by   Cattitude
    I'm not offended at all by the OP's post. I think it says a lot about his story and personal experiences.

    I know that I take suggestions from others very seriously. Especially when they know more than I.

    I have also worked many, many nights with no CNA and no clerk. I know how to give all my pt's bed baths and order all their tests too!
  3. by   medicrnguy
    Quote from Angie O'Plasty, RN
    So you're telling us all about incompetent RNs based on whose observations? These friends? Or your own?



    I'm not offended. All I know is, if I had colleagues who behaved like that, I'd have reported it. You never told us whether or not you reported the problems and you never told us what happened when/if you did report the problems, whether you're still working in that situation or not.

    I have a problem believing that your post was trying to solve a problem. As an RN. you should've taken it up the chain of command on behalf of the patients. I would've been writing the incidents up to Risk Management until my fingers fell off.

    Did you do anything at all to make sure that this problem doesn't happen again?

    All three of these incidents happened within the last year. It's ironic that all of these incidents happened on the same unit. Impovement reports were sent to risk management. The way I understand it is that prior to sending the reports, the manager has to make a statement of how he/she will insure that this will never happen again. If it is acceptable to Risk Management, then nothing more is done, not even a follow up. I believe all three incidents could have been prevented with some cooperation with other ancillary services.
  4. by   UM Review RN
    Quote from medicrnguy
    All three of these incidents happened within the last year. It's ironic that all of these incidents happened on the same unit. Impovement reports were sent to risk management. The way I understand it is that prior to sending the reports, the manager has to make a statement of how he/she will insure that this will never happen again. If it is acceptable to Risk Management, then nothing more is done, not even a follow up. I believe all three incidents could have been prevented with some cooperation with other ancillary services.
    I'm sure Risk Management would appreciate hearing what you have to say about the situation.

    But saying that it's "ironic" that these incidents all happened on the same unit is almost the same as saying that there's no connection between the nurses' ignorance of what constituted an emergency and that's not what you said in your first post at all.

    What you want here is for RM to connect the dots and realize that these nurses are apparently lacking in training, if that's what you really mean by "incompetence," and it's costing lives.

    After all, RM's goal is to minimize errors, especially those that lead to sentinel events such as you've described. Again, I would be using these cases to illustrate the nurses' need for further training and pushing for more education.

    Also, you allude that the incidents could've been prevented by having help from "other ancillary services." As in which ancillary services? How could they have helped?

    Only the RN has the power to call the doc and in all of the cases you cite, the docs would've been notified immediately and a Rapid Response would've been called had any of them happened on my tele unit.
  5. by   UM Review RN
    P.S. All of those incidents are why the nurses at our hospital fight having remote tele tooth and nail. We want to be able to look at the monitors ourselves, not just have the rhythms called to us from 3 floors away.
  6. by   UM Review RN
    Oh and one more thing. In your second scenario, you have the nurse turning UP the lido on what is obviously a contraindication for the med. Never could've happened on our unit. We don't titrate.

    That's one reason why.
  7. by   vamedic4
    Quote from Lotte
    I'm wondering why the OP became an RN ?
    Uh, because despite the enormous amount of responsibility that a field medic has, he gets paid peanuts for all of his time and training. It's a wonder why anyone would want to put themselves through the trouble if they knew the economics of it all. I certainly wouldn't do it again.
    I think it was just a venomous vent on the OPs part. Some people felt the sting more than others, perhaps because it generalized some RNs into an incompetent group of people who couldn't find their behinds with both hands and a road map. Don't take offense if it doesn't apply to you, it's simple. I'm certain we can all bring up situations in our past when incompetence reigned supreme, and common sense was an afterthought. And it truly doesn't matter whether the OP was posting about RNs or EMTs or dog catchers, this is HIS experience...not ours.
    Regardless, the OP is entitled to his opinions, and I respect that. We don't know what the OP has been through. Extremely biased? I think not. The OP is an RN, after all. And he's not a new RN, either. Perhaps some of you would feel the same way he did if you were a family member of one of the afforementioned patients? I'm sure of it. What's the saying? Don't judge me unless you've walked a mile in my shoes? This applies on both sides of the dime. Food for thought.

    vamedic4
  8. by   cardiacRN2006
    Quote from vamedic4
    Don't take offense if it doesn't apply to you, it's simple.


    Sorry, if I came on a paramedic's board, and threw up a long winded, hateful post about medics and listed reasons why I am better than them, then you had better believe that people will be offended.


    I dont' buy the whole-don't worry about it if it's not about you crap. The OP's post was nonsense, and probably mostly made up in an effort to stir up resentment.


    Oh, and just because he put up a 'name' and 'credentials' after it, doesn't mean he's either or both. Remember, this is an anonymous website.


    Still sticking by my original post-this guy's a troll.
  9. by   brissie
    I was a FF/Paramedic before I became an RN and I took a pay cut.....
  10. by   Ariesbsn
    OK, true story that happened when I worked on Thursday. I was in the ED and had a pt come in because his defibrillator fired. At 2314 the tech room called to tell me that the pt's defibrillator had fired again. I checked the time frame that they were referencing, saw something different, odd even, and then went in to talk to the pt. He stated that no, he didn't feel the pacer fire. I reviewed the strip and the situation with a more seasoned nurse. We decided it wasn't anything to report to the doc.

    A couple of hours later, I took the patient up to his room and was in the process of disconnecting the monitor leads. When I got to the red lead, the electrode was not on the lower left side of his chest. I followed the wire and found that the wire and electrode were in his pants. I gave a gentle pull on the lead and met resistance. Since he was getting into bed anyhow, he took off his jeans. The electrode and wire were in his underpants and the electrode was attached to his penis!

    Apparently, it wasn't his defibrillator that fired earlier. Somehow, when he was going to the bathroom, things got rearranged. I still am chuckling about it. The nurse I reviewed the strip with passed pop through her nose when I told her.

    My question to the OP is, do you know all sides of what happened in your examples? Maybe the nurses weren't incompetent, just inexperienced and relying on the advice of a seasoned nurse. Maybe they thought they were doing the right thing. Maybe in the past, the monitor room people have not been that accurate with their interpretations. Don't judge the nurses, help them overcome their knowledge deficit.
  11. by   bigreddog1934
    i think you guys are being a bit hard on this prodigy. he was the first laugh i had tonight after getting home from the er. show appreciation where needed.
  12. by   ddoosier
    UGHHHH!! Find a different profession or pursue counseling.
  13. by   jojotoo
    Quote from medicrnguy
    I will admit I did come off harsh. The statement of having RN's block traffic was uncalled for. Consider this statement withdrawn.

    Keith, I thought your post was very well written and had many valid points.

    I am a seasoned ER RN with quite a bit of trauma experience. But I have not had first responder training. If I was first on scene, then I would be better than a lay person. If EMS was there first, then I would defer to their judgement, including me directing traffic, if that's what was needed.

    The problem with nursing school and new nurses, is that you only get a tiny bit of exposure to many, many disease proccesses, procedures, medications, teaching strategies, etc. Nursing has come a long way in the past 40 years. There are many specialized areas that need specialized knowledge. Even the "simple" area of med/surg is now a specialized floor.

    I graduated in 1991 and did not receive ANY teaching in regards to arrhythmias. It wasn't until I was a practicing RN that I took a class and ACLS. Even now, my knowledge is sufficient for the "down and dirty" rhythms that I need to know in the ER. But I doubt that I could read the subtle rhythms that a non-licensed monitor tech can.

    What's the answer to this problem? Not more general nursing school or an advanced degree. I think we need longer internships or orientation that teaches and tests for knowledge that is specifically unit based. I think we need more required annual CEUs to renew our nursing licenses. (My home state doesn't require ANY!)

    How many nurses do we all know, that once they get their license - well, that's it. No more studying. No more questions. No more learning. We've all worked with "experienced" nurses that when asked for the rationale behind a procedure say, "That's the way we've always done it." At one time they may have known the reason, but now everything is done by rote. Just because someone has been a nurse for twenty years doesn't mean that they have twenty years of experience. Maybe they've had ONE year of experience twenty times. (That's not original, so I can't take credit for it.)

    Keith, the other issue that you addressed was respect (or the lack of respect) shown by RNs to ancillary personnel. You have a point. But I don't think that this is a problem with only RNs. I think this is a pervasive problem throughout our society right now. I see this everyday, from the way we all speak to each other (MD, RN, LVN, CNA, P-EMT, EMT,etc) (management to staff)(patients to staff)(children to parents/ teachers), the way we drive (road rage, running red lights, giving the finger to somebody, cutting somebody off in traffic), the devaluation of certain members of our society (the elderly, the unborn, religious conservatives - whether they be Christian, Jew, Moslem, or any other denomination), just the general lack of common courtesy or "home training" as my Mom would put it.

    This problem I don't have an answer for, except maybe a little less of me, me, me, and a little more of "How can I make the next guy's load a little lighter?" And yes, I also need to work on that one myself.

    Sorry if I got off track here.

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