Incompetent nurses - page 9
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
Oct 24, '07Wow.....sounds like you've had a couple of scary nights there, medicrnguy.
It CAN be scary at night when you look around ye old hospital and notice that the level of experience is not all you would like for it to be. I've noticed, however, that it is usually just that - inexperience - as opposed to out-and-out imcompetence. About the only folks I think of as incompetent are the ones who insist that they know what they are doing when in fact they don't have the slightest idea and no clue as to their own ignorance.
Unfortunately, we do have a few of those, and I would even venture to say that most of us have occupied that space a few times in our careers - hopefully, with less disastrous results than the ones you mentioned. I will remember to my dying day the first time I gave meds through an NG tube as a new grad. The patient was three days older than dirt and had aspirated barium a few days prior. His son, a handsome guy of about 40 (I was 22!) was sitting there in the room, just watching. I was very proud of myself for remembering that I needed to keep the pt. in a sitting position and check for tube placement before I gave the meds. (I had read that in one of my textbooks. So smart!)
Sooo....I whipped out my trusty 60 cc syringe, explained what I was going to do to dear old Dad, and tried to aspirate stomach contents from the tube. No luck. I tried again, and listened for bowel sounds and all of the other things that I had been taught to do (like a trained chimp). No go. After 5-10 minutes of this, I excused myself and scurried along to my preceptor, who was moving to Alaska that same week, no doubt to get away from preceptees like me. I explained the situation, and she advised me to inject a little air into the tubing to dislodge it from the stomach wall.
I strode back into the room, smiled beatifically at cutie-pie, and laid out my plan and theory. The patient, of course, did nothing, because he was pretty much gorked, which was better than being terrified of having me as his nurse. I pushed in some air, and attempted to aspirate, but still nothing came out. I had kept up a non-stop blather about various reasons why the tube might not be working when Adonis decided to put me out out my (and his, no doubt!) misery.
"I don't mean to tell you your job", he said, as he reached over and pulled the cap off of my 60 cc syringe.
I kind of slithered out of the room....after I gave the meds....after I FINALLY aspirated some stomach contents.
Hey, my intentions were good, my theories were good, my outcomes were (Thank you, God!), good as well. My level of experience was nil, and I was just to damned inexperienced to know what I didn't know. I find that's usually the reason when we're called in the middle of the night (ICU does rapid response where I work) to assess a struggling pt., and we find that's it's med related. or something was given that shouldn't have been, or that somrthing is up and the nurse doesn't know what to do and they're afraid. They're good nurses, but none of us as all of the answers all of the time. At least they've usually taken the cap off the syringe!
I know from experience that it can be easy sometimes to dismiss other nurses as being less than competent. I also know that I have stood in that same place, that hindsight is 20-20, and that my crystal ball hardly ever works right at 3 am.
Nursing is more than strips and drips, which is fortunate, because I got almost none of that in school. About the only things I remember are neuro assessment, washing a bedridden pt's hair, and lying about seeing my roommate's tonsils when the instructor asked me about them. (You should have seen my face....) Sounds like paramedics get a very thorough grounding in all of that, which has to happen if you're going to be a first responder.
Despite our apparent lack of grounding in basic EKG assessment, the learning curve in nursing is steep, and it never stops. I've been a nurse for 20 years, and I can't imagine doing anything else. You're there for the best and worst moments of people's lives, and you have a front row seat to the best and worst that the human experience has to offer. I have my "incompetent" moments along with everyone else, and I hate it when I screw up. That being said, I do my best, take responsibility for my mistakes, and extend the same grace to myself that I would extend to others. It's the only way I'll suvive another 20 years as a nurse.
Oct 24, '07I remember a few paramedica who were attending the same university as I was, in order to get their degree and qualify to take their licensing exam. They thought pretty highly of themselves too. I have often wondered why they go on to get nursing degrees when they think so little of us.
Oct 25, '07I don't think all paramedics take a dim view of nurses. From what I was told by one whom I worked with, nurses often make more than paramedics, that's why he changed to nursing. He was a rather incompetant, not very confident fellow, so I also suspect he may have had difficulty being accepted by the other guys.