Nurses that just "pass the buck".

Extremely frustrated today and just need to vent.

We have several nurses (probably at least 50%) that just pass the buck and I just don't get it. Example.. I was doing a 5 day MDS today, my first real detailed look thru a new resident chart. One of the MANY things that were wrong was an order for Zinc Oxide 220mg po BID. (Hmmmm! Me thinks that butt paste would taste pretty yucky and be damn difficult to swallow!) So I go look at the med sheet which also states Zinc Oxide. I then ask the nurse who had this resident to help me look in the med cart and see exactly what pharmacy sent. Hmmm, the med cart has got Zinc Sulfate - which makes lots more sense. This medication (the zinc oxide) has been signed for 16 different shifts! NO ONE QUESTIONED WHY THE MED SHEET AND ACTUAL DRUG didn't match. Come one, isn't this pharmacy 101?

Now on top of all of this, one of our state survey tags was on medication error rates. We have done numerous group and 1:1 inservices on proper medication administration and error prevention. This particular day shift nurse is just back from a one day suspension for medication errors. We are expecting our resurvey any day and this is just one of many, many, many examples of how so many of our nurses just won't "buy in" that we are obligated to get it right. I see no chance in hell of our passing resurvey.

So.. how do ya all get your nurses to take accountability? We are inservicing, 1:1 direct audit and education, suspension as a last ditch effort.. but still doesn't seem to help. So frustrating

How about nurses who give patients pain creme for their shoulder or aspirin for their headache and the next day when they are off and the relief nurse is on and I as a CNA not viewing the MAR on a daily basis is assuming this resident has some kind of doctor signed order for this creme or whatever and comes up to the nurse and tells her the resident is requesting it and finding out that there is no order and the patient has been getting this medication for months!!!! Or how about signing for a medication that isnt in the cart!!!