Professionalism...

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    do you work with any nurses that seem to lack professional accountability and responsibility? Are you seeing a disturbing trend toward this?? This has been a discussion in one of my online classes and I wanted to get some feedback from members here.

    Here's an example....I worked with a nurse that walked out of a code...on HER patient! Her excuse was..."you guys could handle it"! My opinion....professional abandonment. She was fired for this but according to my NM, the reason she was fired didn't sink in. She saw no problem with walking out of that code...."I don't see what the big deal is....there were other people there." She wasn't a "newbie", had been an RN for a couple of years and this wasn't our first issue with her. She had always lacked personal self-direction....wouldn't answer call lights, never did anything without being TOLD to first, etc and had her probationary period extended because of it.

    Have any of you worked with other nurses that have walked out of codes, refused to admit to medication errors, falsified charting, etc?? How is this handled at your facility? What do you think is the underlying cause? Is it a lack of education in nursing school? A lack of personal responsibility? I'm just trying to gain some insight into this...and please...no BSN vs ASN debate....the nurse I was talking about was a BSN and had graduated at the top of her class.
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    Along with being fired, should be reported to BON for patient abandonment.

    Definitely seen decrease in professionalism across ALL professions, more acutely in past 10 yrs. I especially rankle when I here comments like "ANA/AMA standards don't apply to me, I'm not a member".


    One of the tenets of professionalism is personal and professional accountability. Nursing and healthcare is so much more than learning a concept to pass a test. If personal integrity not important to parents, next generation isn't going to think so either. Trying to cram so much info into students heads these days, think this aspect is glossed over....certainly minimized by "is this going to be on the test" mentality some student bb members espouse.
    Last edit by NRSKarenRN on Nov 21, '06
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    Thanks for your reply NRSKaren! She was reported to the BON and her license was suspended then revoked after a hearing. A co-worker ran into her several months later...still no personal responsibility. It was OUR fault she lost her license.
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    I agree with NRSKarenRN about the decrease in professionalism across all professions. Personally I think this is a societal issue which is becoming more rampant. People (generally as a whole) are becoming more self centered and investing less energy trying to uphold a higher standard. I see this everywhere, from the video clerk giving me a snotty attitude, to some of the doc's I've seen for illnesses. Somewhere, somehow, I think the "customer is always right" mentality has been swiched to "I don't feel like it right now, so you are just going to have to deal". Unfortunately I feel that this is a pervasive problem and one that won't be reinstilled into a person just because they went to nursing school. <Just my opinion, not to be interpreted as fact or anyone's reality besides mine>
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    Even if she did not feel confident to run the code herself, she could have grabbed the board and charted meds, etc.
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    I see some isolated incidents here and there, but haven't really noticed any trends or an decrease in professional accountability.

    What that nurse did was deplorable, but is it right to extrapolate (sp?) out of this that nurses are becoming less accountable than in past years?
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    The only newest one I have come into contact with is my job as of late. Now, I love my new job (hate the hours but working on that) and I love the day shift/swing shift nurses I work with...we are such a great team, and I don't want to leave it! However...

    The noc shift seems to have something against me. They have been writing me up for tiny mistakes and accusing me of not being professional. For instance...I wrote a discription of a dressing, but accidentily wrote it on the line below under tubing..oops, but I put 'shadow drainage yellow/brown dime sized' (hints like a dressing description to me..not a tube) and they accused me of not even assessing the patient! They said I was dangerously unprofessional! WHAT???? All they needed to do was ask me and I would have cleared that up and fixed it..but no...wrote me up and got my manager upset! I mean please!!!!!! Too bad I changed the dressing to a clean one to see if the area where a tube once was was draining or I could have shown them what I meant. GRRRRRRR~!

    SO basically I have gone into work with a new write up like these or even bold faced lies (which I was able to prove myself twice now!) every day, and trying to be proactive and team oriented with this shift...well...I just got dx with my first ulcer...so you tell me how it is effecting me! I think it is harrassment and am currently doing research for workplace harrassment so I do this by the book.

    The day/swing shift nurses are dumbfounded by all this, and are totally on my side...the noc...guys I can't even look them in the face without holding back sarcasm and being ticked! THIS I call unprofessional...here I am trying hard to be proactive and work this all out, but they are honestly against me and not giving me a chance at all since I am new, and I got the opportunity to be promoted fast (where as they did not).

    I think it is the catty behavior towards a team memember that is the worse probelms with the professionalism in nursing! A professional will see it is benificial to talk to the other RN and if needed write them up, but these guys just won't talk..they write me up...UNPROFESSIONAL!
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    I have noticed that a lot of nurses who aren't cut out for mgmt are being promoted to managerial positions.

    I just finished a travel contract with one such unit manager. She wore short t-shirts to work and all her back and arm tattoos were always showing. She said the "f" word every time she spoke to me, as in "I have too much f---ing work to do!"
    She spent about 4 hours out of every 8 hr day (no exageration) outside smoking, and often the techs would wander outside and join her. This would leave the other techs and me to cover everyone's work for long periods of time.
    She disclosed inappropriate things about her personal life.
    When I wrote up a tech for blatant insubordination and endangering a pt, she tore up the write-up. She did not tell me this-another tech did! when I asked her about it, she confirmed it.
    She was hardly ever even at the unit, and no one could find her. She would say things like "I'll be in Monday to help you give all the flu-shots" then no call, no show on me.

    Last year, I worked at a dialysis unit where the faciliy mgr was not even a nurse! She was a PCT with a BA in humanities. She had no concept of a nurse's accountability or liability. She would always back the techs in every situation. She was a nice person and intelligent, but basically clueless.
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    I agree that there's a general lessening of responsibility (and also of basic courtesy) in society generally but where I work, in a small private psych hospital, it's the older RNs who are most guilty of unprofesssional behaviour. And when I say older, I mean anywhere from 60 to one RN who is over 80. No disrespect to anyone older out there, but these particular nurses have their own entrenched subculture where all sorts of things frowned on in the wider world of nursing are considered perfectly OK. E.g. predispensing of meds is very prevalent. They even do it right in front of the nurse manager (also older) while having a lovely chat about where they might go for their vacation etc. Another thing they do is disappear from their post regularly to wonder off to catch up with their colleagues for yet more extended chit chat. One of them feels quite comfortable about leaving all the keys (inc. all the drug keys and keys to offices) right on the front desk near the main entrance, where anyone could walk in and snatch them, while she is off somewhere ringing old pals on her cellphone. They won't wear the call/duress units so it's often impossible to find them. Because of all the time they waste (and because work is their main social environment) they hang around for hours after their shift, getting in the way of the next shift and driving everyone nuts. They all think of themselves as dedicated and caring and pride themselves on never taking a break, whereas to many of us it looks like they're on one long break all shift. I've never come across people who are so self-justified in their extremely slack and to put it bluntly, selfish behaviour. It's like they've retired already but are still showing up to be with their friends and collect a full salary.
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    BTW..I forgot to mention that leaving a code is WRONG unless you have been dismissed by the code leader for some reason. There is always something to do during a code...historian, gofer, assist with IV placement or have equipment ready for those doing tasks...you name it. The only time I was excused from a pt code (my pt) was to consult the family and help out with other patients for the nurses that were doing the code (the code team was there and the room was FULL of folks..a few of us needed to leave, and I am not a memeber of the code team so I helped out till I was dismissed..and even then I was near the door and helped get things they needed and to help call ICU for a bed and such).


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