Witnessing mistakes

wv_nurse 2003 · Sep 27, 2003

Do I understand that you are in your second semester of nursing school? I don't know the "mistakes" you've witnessed....but I do work with nursing students. "Mistakes" to a student can include a wide variety of things that are taught a specific way in school....but aren't "real world". My example---remember how you learned to do a bedbath in nursing school? (that bath blanket and a towel under the extremity.....).

Of course--you could also be witnessing true "mistakes" that constitute negligence or even malpractice. Talk over the things you've observed with your instructor. Not as a "tattletale" but as a genuinely concerned student. Just becareful not to jump to conclusions .....

Best of luck to you!

acuteobrn · Sep 27, 2003

There is one major thing that I learned in school: That what you learn in school is "textbook". Like WV nurse noted above, there are many things that are taught text book, and practiced quite differently in the "real world" Doesn't mean that they are wrong, just done differently, somethings really through me off in school, like pushing IV lasix, you can shoot it in when they have all the monitors on (CVP, A Line, EKG) especially when you are in critical situations, things are done quite differently than you learned in school and you don't have time to set everything up "textbook" ie, a bed bath, it would take you all day to perform it that way, never mind all the other things you have to do. I don't doubt that you may have witnessed things that are not quite right, I myself did in school. But definately talk to your instructor, and do it right away if your name is on this chart even though you are practicing under the RN precepting you and your clinical instructor, if you see something speak up tactfully. This way you will learn the "real world" tricks of the trade and will learn from the mistakes of others. Good luck to you!!!

Nrs. LaLa-Land · Sep 27, 2003

I agree with the last 2 posts...as a 4th semester student I have seen so many "no-no's" that I thought were compeletly wrong according to what I have learned in school...but after a while I just realized that everyone is different and is taught differently....

school teaches you the ideal thing to do in the ideal situation...reality is not ideal...

Bevi · Sep 27, 2003

"It makes me wonder how many people do end up dying...not because of their physical condition, but because of these errors I've been watching nurses make. "

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Hi Jenn....

Are you seeing truly life-threatening-for-REAL mistakes occur? Cause if so, aren't you sort of bound to telling someone? you know---"do no harm"...?

Could keeping ones mouth shut about life threatening errors be considered "doing harm"? ....Probably, yes.

just some food for thought....

We're all being taught that the first consideration should be the Pt., not our butts.

So if LIFE THREATENING mistakes are occurring.. perhaps you should speak to the floor manager... or to one of your instructors.

I guess it would be your responsibility to do that regardless of the consequence or backlash to you.

now.......

If these errors are NOT truly life threatening errors... then, my advice would be to lay low.

You will see lots of things done in ways that *you* wouldn't do them ...and lots of things being done, that *you* weren't/aren't being taught...

but remember..

you're a newbie. You don't want to be targeted and you don't want to be seen as a trouble maker by nurses who are teaching you and ultimately report to your clinical instructors(who are most likely nurses) who can "make" or "break" you.

again... i stress this lay-low approach only if the "mistakes" you are seeing are NOT life threatening.

good luck.

acuteobrn · Sep 27, 2003

In one way I agree w/ Bevi, not wanting to be too outspoken, cuz Bevi is right in saying that they can make or break you...very true.

However, if you are seeing things done differently, ask talk to the nurse in a respectful manor, some are willing to help you out and teach you real world nursing. Others might be offended, it does matter how you approach them. One issue comes to mind that was not life threatening, but does increase the risk of a patient. I was being precepted by a nurse who was kinda lazy about things, spent a lot of time on break, well I mentioned that I thought my patients IV infiltrated, she looked at it said it could wait until after lunch, if I recall correctly she was getting IVPB antibiotics, and I just couldn't let that go, so I questioned it, she said "whatever" and went to lunch. I asked the RN who was covering her and sure enough infiltrated, I may have only been in second semester clinicals, but when the patient says it hurts like hell, looks like hell, I am going to believe them. Remember it doesn't have to be life threatening to cause harm to the patient's health.

SO approach it gently and respectfully asking to learn and most will be helpful, some not, just goes with the learning experience. And if your clinical instructor is doing what they should, they should be helping you and recognize you are using your thinking cap...just my thoughts...

I myself am quite outspoken, gets me into trouble sometimes, but I am also a patient advocate...sometimes the two go hand in hand, depends how you handle it and how you look at it remember not all will receive the outspoken ones well. but I live by my gut instincts assessment skills and knowledge, and if I am the one in the wrong I am more than willing to admit it and learn from it. I guess it depends on personality....anyhow this is how I look at things, may not be right to some, but I am still learning and growing as a person, just like those who make a mistake.

Ortho_RN · Sep 27, 2003

I agree I have seen things. but most of it is just "real world" nursing..

Jennerizer, ASN, RN · Sep 28, 2003

Thanks for the advice. I have told my clinical instructor the majority of things I have witnessed & she has agreed that they are big no-no's. I definitely do not want to be a tattletale, but we're not talking simple stuff like bed baths or dressing changes. It just amazes me how nonchalant it all seems to be. It's really opened my eyes because I always thought that if you were in the hospital, you were in good hands. Now I'm seeing that it isn't necessarily true.

Rapheal · Sep 28, 2003

Jennerizer it is good that you are aware of what is going on in clinicals. It is a good idea to form your nursing standards during this time and decide that you will do things differently than what you have observed.

I was told that every nurse will make mistakes. The defining part of your career will be how BIG your mistake was. I like some others dread making a BIG mistake. But I know it can happen and I have seen it happen. Nursing is tough. Good luck in school and your career.

patti101 · Sep 29, 2003

I always tell my instructor what I witness when it concerns my client, that's the only one I am focused on...i.e. witness the RN TRY to flush an IV access lock, half of it squirts back out from the pressure, & and the other ml she just doesn't even try, she peels off the old tegaderm & cleans client up with an alcohol swab, puts on a new tegaderm, states, "good as new", okay what little she did was because my client was complaining of PAIN, site was hard & cool to the touch...She also stated that she didn't want to start another IV, client 's HX , X sticks I couldn't without my instructor at the bedside with me....I didn't know what to chart as in covering my ......she also dropped meds on the floor & was seen scooping them ( caps) back up & administering them to client...I report EVERYTHING to my instructor, have to to be your client advocate! MOST nurses are NOT like this example, the BAD ones really stand out...

acuteobrn · Sep 29, 2003

JEN and PATTIE:

I appluad you two for having the guts to stand up!!!! You two are going to make excellent patient advocates as RNs!!!

It is not easy to say something especially when you may feel like the low man on the totum pool. But this experience will become invaluable, may save a life and may make it easier to deal w/ MDs that are in need of a little RN guidance.

So good for you!!!!!