What is the most incompetent thing you seen a fellow nurse do? - page 4

by okihusker 14,937 Views | 100 Comments

There were two patients in a double room on a 38 bed tele floor. One was an old fart with a sick heart an the other was a 35 year old male who was in an MVA being observed for a myocardial contusion. The old fart coded and... Read More


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    We simply cannot allow incompetent nurses to continue to give such poor care as I'm reading in this thread. We must document our butts off and get our managers involved or risk liability ourselves. Our nurse practice acts are clear on this (at least MINE is in Texas)

    It doesn't mean we're being 'mean' to another nurse. She might just need some remedial education or assignment to a less critical area for awhile (or forever.) Or she may be the type that never should have been allowed to become a nurse and deserves the license yanked. We can let TPTB decide which.

    But what we CANNOT do is ignore the incompetent nurse.:stone
    Last edit by mattsmom81 on May 31, '02
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    I just don't get it! I am the first person who would say I am totally unqualified to work in ICU or the ER. I cannot understand why they would put new grads there ( This is just my opinion!!) I knew that when I graduated that I was not ready for that type of nursing. I didn't have the skills or the common sense. I was a good nursing student, but not everyone is cut out for that type of nursing. There are people who are working in ICU who are not cut out for it. I think part of being a good nurse is knowing your limitations. Pesronally, I would give myself a stroke if I had to even care for one ICU patient for an hour! I don't know how they can go to work and not care about their actions. I know it happens in all areas of nursing, not just ICU.
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    .
    Last edit by ratchit on Jul 15, '02
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    I worked with the incompetent nurse last night with the nurse I talked about in my previous post, the one who came with the glowing recommendations. She had a patient who has been in and out of the unit for the past six months since open heart surgery with failure. Last night this woman was obviously in distress, agitated, with respiratory rate in the 40s and tachy at 130, pulse ox was 92. I asked her nurse if she had ABGs done recently, or if her MD had been notified, and she told me the lady was in distress because she had diarrhea from C. diff. I could hear the crackles from six fet away. By this time the lady was getting more lethargic, so I got stat AbGs. The lady had a CO2 of 72. I called the doc and got intubation orders immediately. When he made rounds at 0600 he jumped me about why I had left the paltient go so long before I got ABGs. I told him it was not my patient, that I had called him as soon as I realized what was going on. He went to our manager to complain about the nurse, and when she was called into the office, she complained about me interfering wiwth her patient. This woman knows no one trusts her, and knows she is being watched, but still gets defensive and resentful when someone intervenes in a situation like this. She is not allowed to take care of open heart patients, our nephrologist and one of our pulmonologists request that she not care for their patients either. She is still here because a few people continue to support her and because she is a body. This woman has not had had a merit raise in two years, and feels that she is being treated unfairly. When I work with her, I feel like I have four patients instead of two.
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    Nurse who gave ampho B over 30 minutes instead of 4 hours and without any pre-medication.

    Nurse who gave vented patient 100mg Versed/100cc D5w instead of the ordered Flagyl.

    Nurse who put betadine solution into tube feeding bag instead of blue dye - hey the betadine solution bottle had a "blue cover" cover on it.
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    now, if i tell a tale about dumb stuff done in nursing, i would first have to start with myself before i point the finger at another nurse, so here goes....

    when i first started working in sicu, most of the patients weren't alert or oriented, but unconscious. this one patient scared the bejeebees out of me for some reason. to this day, i don't know what it was about her that frightened me so. she always looked like 'death' at death's door or something -- eerie feeling to say the least. well, one morning, i was assigned to her care, and she needed to be suctioned through her trach. okay, i'd done that millions of times since i once worked on an oncology surgical floor where tons of trach patients were. i neared the patient, she made some weird noise, and i found myself going into her trach with suctioning pressure on when the suctioning doesn't take place until after the suction tube is inserted and ready to suction on the way out of the trach. not only did i immediately realize what was happening, so did the nurse in charge for that shift as he looked at me with the biggest eyes as if to say, "duh, what the he** are you doing, lady?" needless to say, i corrected my mistake, finished up with the patient, and went to the nurses lounge to pull myself together.

    now, i know i was just orienting to sicu at that time for the very first time ever, but i had been a nurse for almost eight years at that point in time, and had never never never done something that stupid, especially when suctioning a patient. i sat in the nurses lounge shivering, asking myself, what the heck was my problem, and wondering if my personal problems at that time were really getting to me as bad as others said they were...only i refused to see it. stressed-out nurses need to take some time off, so i did. nothing serious happened to that patient, but i still felt like a real heel because she started jerking her body for air when i went in to suction her the wrong way. the charge nurse came into the nurses lounge and gave me a big hug, and said, "we've all been there, or we'll all do something we don't think we can live with, but from my own experience, i can tell you, you'll survive this, so don't be too hard on yourself." great guy, that charge nurse! after a few weeks off, i went back to work refreshed, but not into sicu. i refused to try that area again. i needed bodies that talked, that were alive, and that didn't give me the hee-bee-jee-bees all the time. so, that's my dumb nursing story. what's yours???
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    I have been an RN for over 16 years and have certainly seen a whole slew of mistakes! One problem I do see though, is how nurses are extremely hard on one another for a mistake. I once saw a seasoned RN in Peds ICU where I worked just verbally abuse another new nurse. I don't even remember what his mistake was now (it was very minor though), but I remember at the time thinking that it was uncalled for! I think we need to remember that we weren't born with this knowledge, it came to us through education, hard work and experience. We need to help the new and inexperienced nurses and watch over them, but not berate them. Remember--we ALL have made a mistake sometime in our nursing career!
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    A few of the things described on this thread are indeed 'dumb mistakes' and of course we all made a few of those. We can start another thread on that, Renee, and we probably should to offset this one. We all make mistakes.

    However, there IS a difference between a 'harmless' dumb mistake and a 'harmful' dumb mistake. There is also a difference between a new hire preceptee giving poor care who is teachable and willing to learn, vs the nurse who doesn't GIVE
    A CHIT that she's giving poor care or endangering her patients, or doesn't care she's always stressing her coworkers because she doesn't know what is going on and doesn't care to learn.....get my drift??

    MANY of these stories speak of dangerous incompetent care...where patients can and are harmed and even KILLED by an incompetent person. We can't take this stuff lightly today, because hospitals indeed DO have the attitude "just put a warm body on duty".

    JMHO. And no, I am NOT a *****y old nurse...I give everyone a fair shot....and I'm nice to work with. We can only do so much, though.

    RNinICU, I know exactly where you're coming from!! If I ever get back to my ICU I will NOT do charge again, as I am exhausted from pulling the weight of people who have no business being in an ICU setting. I will just be responsible for 'my own little group' and be happy as a clam! :roll
    Last edit by mattsmom81 on Jun 4, '02
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    Pt codes, gets intubated. Nurse is bagging the hell out of her but O2 sat just won't go up, put her on the vent and sat increases? The ambu bag was attached to the air line instead of the O2. Pt had severe neuro deficits afterward and eventually died.

    I was charge in CCU back in the dark ages...1987. We had a shortage of nurses at the time and the hospital actually got some agency nurses to pick up the slack. The one they sent was supposed to have all this ICU experience so I gave her a pt on the vent gettting feedings via an NG tube. She came and asked me which was the NG and which was the ET. I told her to sit right here and don't move. Called the supervisor and sent her home!

    Pt on an insulin drip, getting tube feedings. Pt got meds via the tube at 2400. Nurse forgot to hook the feeding back up. Pt had a seizure, d-stick was 19!!!!!!!!!!!!!!
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    Lilgirl, I have had agency nurses too who have come in for a 4 hour orientation with claims of years of critical care experience. I take them at their word until they show zero recognition of an A line wave on the monitor, or don't know what to do with VTach (they think it's artifact), etc.

    We have to be really careful with agency on their first visit to us, IMO,...I asess them very closely during their initial 4 hour orientation and DNR them right on the spot if they're coming in lying to me.

    I've worked with some top notch agency nurses. I work agency myself on occasion. I do not misrepresent my skills, and I expect other agency staff to do the same. If they're gonna call themselves critical care nurses they better be able to demonstrate to me that they ARE critical care nurses.

    ::stepping off soapbox now::


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