Dangerous nurses

ktwlpn, LPN · Mar 22, 2009

IMHO the dangerous ones are the ones that are so busy trying to find fault and write others up that they neglect their own responsibilities.....the gossipy ones scare me.....when one starts in about others before report...I tell them I don't want to hear it, just report please....unless of course it is pertinant to pt. care that I will be dealing with....

Gossip never killed a patient....IMHO the scariest nurse is the one that always believes she is right....

rph3664 · Mar 22, 2009

a patient had a high potassium level and the doctor ordered kayexelate but she did not d/c the k+ and for two days the nurses gave the patient both the potassium and the kayexelate
i have worked with so many lazy, incompetent nurses i have lost count...tptb believe that a warm body with a license is the answer to all their problems

:eek:

Was this on a weekend at a critical access facility with no pharmacy coverage? It wasn't just nursing that dropped the ball here.

I haven't read the entire thread, but we have a lot of nurses at our facility, mostly on the night shift, who speak very marginal English. You can't communicate with a lot of them. They may be technically proficient, but they are dangerous for the reason mentioned in the previous sentence.

1TachyRN, RN · Mar 23, 2009

Gossip never killed a patient....IMHO the scariest nurse is the one that always believes she is right....

Right on to that! Nurses/students that really, truly think they know EVERYTHING scare the bejeebers out of me. You can't teach/talk to them about anything. And thus, they go on their merry way...

aloevera · Mar 23, 2009

Right on to that! Nurses/students that really, truly think they know EVERYTHING scare the bejeebers out of me. You can't teach/talk to them about anything. And thus, they go on their merry way...

How true.....yes, they are the worst, hands down......I had one about a month ago, fresh out of school...I tried to take her under my wing and teach, but she knew it all......I gave up and let her go....

loricatus · Mar 23, 2009

Every one should go the MedCE's right now. There is a ce (Free I Might add) rhat discussess the new format to list bad nurses. And it us very good information
http://www.medcscrape.com

Just fixing the typo:

http://www.medscape.com/nurses

blueshoe · May 22, 2009

I would like some advice please. A very close relative of mine is a nurse with +/- 20 years experience. At one time I know she was an excellent nurse, as I have been her patient and know how deeply she cares about her patients and how much her job means to her. However, in the last several years many things have happened in her personal life that have been incredibly stressful and there is just a lot going on. It has affected her work. She was asked to resign from one job, but I know more than some of her employers and I am concerned -- both for her, her patients and her employers. As a family member of a career nurse who has slipped, can you advise? She is the primary income for her family and her husband refuses to carry insurance, so there is a lot of pressure, but she really does not need to be working... or working as much. Every mistake upsets her more and causes more stress and anguish, but I am really becoming concerned about possible effects on patients at this point. I certainly don't want her to be sued or something like that either. I don't think she could handle that emotionally. Thank you in advance.

lamazeteacher · May 23, 2009

There seems to be a lot going on for this nurse blueshoe knows. Certainly she has personal stress, but if that caused all nurses to make serial serious errors, we'd be having many more of them.

The possibility that other reasons could be at work, such as personality conflicts, lack of support, and discrimination of several varieties. It bears investigation, and giving this poor nurse a "fair shake".

aloevera · May 23, 2009

blueshoe..........I feel for you and your relative....Would she possibly consider moving into the Administrative aspect of nursing? Or a supervisory position?

These would benefit her greatly by her being able to keep her paycheck (with a possible boost) , using her knowledge and experience and getting away from direct patient care.....Is this something that you could talk to her about?

You seem very concerned and I wish you well.........

LilRedRN1973 · May 24, 2009

I have worked with a few "dangerous" nurses and they tend to be the ones who do as little as possible to get through their shift. They don't seem to care much about checking their work and/or have falsely documented care not done. I went to work one night and as I'm getting my patient in order, I notice the IV tubing and the labels. Something struck me as peculiar and it was that the label (designating the fluid contained within the line) had my handwriting on it. I had not taken care of that particular patient in over a week. :no: We were supposed to change IV tubing q 3 days so I knew this tubing had not been changed. But the day of the week label was a brand new one that correlated with the charting done by a nurse on the previous day's shift. So I peeled back the day of the week label and you could see where another had been torn off and the new placed over it. How lazy can you be, folks?? :banghead:

Another nurse I worked with ended up giving a patient 300mg of morphine over her 12 hour shift. We had a patient on a morphine gtt @ 5mg/hr. At some point, someone must have put a high dose syringe in the machine but never took that into consideration on the titration. So instead of getting 5mg/hr, he received 25mg/hr for the 12 hours. During report, the RN told me that his family was so happy he had finally calmed down and wasn't fighting the vent anymore....uh, I wonder why??? :eek:This same patient also ended up having a Versed gtt running @ 30mg/hr because the previous shift nurse said he wouldn't stop trying to rip out his ETT. So she just kept titrating his gtt higher and higher instead of using some critical thinking skills and putting him on a different medication. An hour into my shift, the neuro doc gave me an order for Norcuron PRN (which I thought odd but it worked rather well for this young man) and dc'ed the useless Versed.

We had another nurse who was given an order to pull a Hemovac from a head trauma patient. She pulled the bolt instead!! :eek: Oh god...if you could have heard the gasps from the other RN's in the unit. This boy had ICP's of > 30-35 and was touch and go. He didn't fare well and I never did find out what happened to him in the end. I also worked with an RN who received a patient from another facility via helicopter. Upon arrival to the unit, this patient had a peripheral in the hand with Dilantin running. Not only did this nurse not do anything about the IV and Dilantin being infused, but she neglected to check it for the remainder of her shift. Needless to say, when the next shift came on, this patient's hand was completely infiltrated and turning black. She ended needing an amputation up the elbow as a result of the infiltration and that particular RN ended up being charge several months later....

All that being said, I became one of those dangerous nurses when I ended up addicted to my pain medication. I look back at the last 3 months that I worked while active in my addiction and feel like so many amends are to be had. I went from a conscientious, reliable, focused, and caring RN to one who was a train wreck. I lost track of charting and relied much too heavily on my coworkers to help me in my patient care. Meds were given late and patients were not attended to they way they needed to be. It was dangerous and unfair to my patients, their families, and my co-workers. :no: I never thought I would end up a nurse who came to work impaired, but I did. I'm being given the chance to make amends to at least one of my former co-workers as my old charge nurse is now the APN in our clinic. She was rightfully surprised to see me at work d/t my surrendering my license after leaving the unit where her and I had worked together. But I see it as somewhat of a sign from God...I'm being given the chance to show her the nurse I truly am and not one who places her patients, her co-workers, and herself in jeopardy. I cringe when I think back to my previous work performance and the guilt that consumes is terrifying. It made me realize how terribly powerful addiction can be and how it took over my entire being, down to what I cared about and who I was as a person, a mother, and an RN. I have been to hell and back; it's not a place I care to visit anytime soon.

There are many things that make up dangerous nurses.....apathy, inexperience, overconfidence, substance abuse, and just plain bad apples to name a few. I've been both and much prefer being a clear-headed, responsible nurse who is able to perform her duties to the best of her ability while being a positive part of the nursing team and giving my patients the care they deserve. And I only wish that someone in my unit had reported me or any suspicions they may have had. I might have entered into recovery sooner and not continued placing patients at risk. I don't know if it would have fallen on deaf ears as I know many incident reports are filed away and not given much thought. But I can this....if I end up working a shift with an RN who behaves in the way that I did, I will either speak to him/her directly about my concerns or report it. I had no business taking care of patients and neither does anyone else who is behaving in that manner.

ECKPowers · May 24, 2009

Again, my only experience is as a patient. So I offer my two cents worth with my own grain of salt. LOL

In laymans terms, medicine is a constantly evoloving entity. Practices that were acceptable and demanded ten years ago may not be the same practices that are acceptable now.

Doctors and nurses CANNOT ever know all diseases, disorders, sicknesses, etc. That's why there are specialities.

"Dangerous" nurses or doctors, to me, would be those that ignore the evolution of the health care field.

Being a nurse does not require empathy, compassion, caring, or sympathy. A nurses job requires applied skills and learned treatments from education. A nurse doesn't have to treat someone with empathy to fully perform their job.

Ellean55 · May 24, 2009

This is a really interesting topic. How do we define dangerous and incompetent?Is it a combination of

* Lack of knowledge/outdated practice

* Lack of Experience/outdated experience

* Poor clincal supervision/preceptorship (newly qualified nurses)

* Inappropariate clinical area in relation to job experience

* Lack training experiences in areas such as medical/surgical etc

* Poor/lack of mentorship upon being qualified and experienced?

I think its important to asses if a nurse is willfully dangerous/incompetent or is it a combination of their own lack of knowledge ? If so what support is there for nurses who may be underperforming, or whose practice is causing concern?? Okay here are two scenarios I would like to present:

A graduate nurse has just qualified and managed to get a job in the ICU. On interview they excelled with their knowledge, etc. However one year into the job you and other colleagues begin to notice that she is making errors (although not dangerous), but causing some concern. Now as their clinical supervisor what would you do bearing in mind they are coming towards the end of a preceptorship programme?

Second scenario - A nurse who has 15 years experience working in Medical/surgical nursing. During this time this nurse has taken a career break in order to raise a family and build a home etc. They returned to the profession 3 years ago, but there have been new developments in medical/surgical nursing. Although she has a lot of experience - you notice that some of her practices - although not serious - are causing alarming concern. It reaches a point where some of your colleagues are reluctant to work with this practitioner. Your colleagues come to you (you are the manager), what are you going to do?

aloevera · May 24, 2009

life is good 1973........Bravo to you for seeing the light and recovering from your addiction......I work on the CD unit at times (float) and believe me, we get MANY nurses in our facility......it scares me to think of how many are working without seeking help !!!!!!!! Yes, we must take care of each other and Please, if you suspect this behavior...go straight to the person first and give them the chance to be a responsible nurse.....we all have been at one time or wouldn't have made it thru school !!!!!!!! it is easy to fall down the path of addiction, some people have addictive personalities, whether it be food, sex or drugs....

Good Luck to you.......and happy nursing.......