incompetent nursing - page 2
hi all! im a nursing student and i have a project due regarding incompetent nursing. my question is what makes a incompetent nurse?...some examples would be great!!!!!! and oh yeah im new here and i... Read More
Mar 29, '04Quote from Baby CatcherWow! I have to agree with earle58 blue eyes. That was a bit of an over-reaction. Sometimes you need to step back and think about what you are typing before you respond. Just a friendly suggestion.
I totally agree with you blue eyes, I didn't have a "calling" to nursing. I just decided last year to pursue it because I think it would be a great profession for me, and I also do not think you " over-reacted " Are we not allowed to disagree with each other anymore? That's what makes this forum interesting. Getting to hear everyone's opinion.
Just my 2 cents Brandon
Mar 30, '04I have noticed something lately: Seems to me every time we disagree anymore we start whining and accusing each other of flaming!! I think it's time some of us folks grow a thicker skin and quit being so sensitive. sheesh.Last edit by SmilingBluEyes on Mar 30, '04
Mar 30, '04The term "called" is actually quite culturally based - if I told any of my colleagues that I felt called to nursing they would be asking questions about how soon I would be joining the nunnery - there is no other connotation to the word than the religious one.
Now to get back to the Op's question. Incompetance can be in the eye of the beholder as well.
Imagine if you will a patient who is lying in bed playing what nurses like to call "the dying swan" alternating with "De old plantation master" with you as the nurse in the role of the slave.
Imagine this patient in bed hand to forehead groaning "Oh the pain! the agony! I did not realise that corns could hurt so much!!! Oh How will I stand it!! I'm dying! Nurse! Nurse! Fill my glass - it's empty! Don't just leave it there on the table where I have to reach for it - put it in my hand!!!!"
Now that particular patient probably thinks that all nurses are incompetant and ESPECIALLY that horrible nurse who got her out of bed and made her walk around the ward!!!
Truth is the most competant nurse is the one who is able to give the patient want they need - not what they want and an expert nurse knows the difference.
Nursing is such a broad field with so many many skills required that any nurse will have strengths and weaknesses. I have known some excellent theatre/icu nurses that would be classified as aspergers syndrome thier interpersonal skills are so poor but they are shining lights when in comes to clinical competancy and organisation.
Mar 30, '04Hello:
I would advise you to remember a few things about nursing in general:
Few of us are alturistic enough not to want to make a good living. There is nothing wrong with this. We can care and profit without being inconsistent.
Now comes the problem. We have little or no scientific base with which to serve as a standard within the nursing profession. Ergo we are called the "caring profession". Most of our scientific base consists of what we have adopted and incorperated from the field of medicine. Don't worry about that, it's Biblical. I recall that there was a woman who told Jesus that 'Even the dogs get the crumbs that fall from the master's table'.
We are mainly (so-called) advocates-(don't even go there if you like being paid), care givers, comfort givers, and to sweeten the deal, our duties continue to expand as we are delegated tasks that MDs have decided that they can pass off on us. Examples would be conscious sedation, monitored minor surgical procedures, pharmaceutical titration and the like (for which they are paid). This allows the docs more time to take on more patients, thereby giving us more patients. Makes you feel kind of special, to be so entrusted, doesn't it? Who needs more salary when you can become suddenly so much more talented and able with a mere word from the medical field? (Given, 3 nurses must fly to Chicago for a week to get trained to argue and impliment the proper semantics and inseviced on inservicing the staff; with said insevices mandatory attendance on your own personal time).
In a way I can justify the ones who have designated nursing as an "art and science" as somewhat correct, at least on the science part. (The last art I remember was a wonderful Jackson Pollak consisting of a full Italian dinner including Chianti with my body, beard to shoes, serving as an easel).
I maintain that we are far more a philosophical field than a scientific field, if we take time to examine ourselves honestly at all. Philosophy is philosophy, and therefore opinion, until it becomes proven fact, in which case it becomes science. Ideas and suggestions, i.e. creative thinking, are overwhelmingly un-welcome. "Don't reinvent the wheel" as a physician once told me. I had found a certain sequence I used intraprocedure which worked better for me and had no effect on his part of it.
Unfortunately, we have or take little or no time to know ourselves, our belief system, to cultivate our minds, and no objective standard with which to compare and define competent/incompetent. I understand that we do have corporate "missions", policy and procedure books and a modicum of passed-on science as stated above. Most all of the math the average nurse uses is about 6-7th grade level. I suppose given your question, a "competent" nurse consistently follows policies and procedures, makes no drug errors, checks armbands, and can regurgitate the mission statement to JACHO inspectors upon request.
We are ill trained if at all, concerning the discipline of ethics, which, given our position in the health field should be an ongoing learning process which we put into practice. Psychosocial need intervention is not a moneymaker. This being the case in practice (lofty as our ideals may be), we are left with the follow-ing standards which I do not claim to be an exhaustive list:
1) Don't rock the boat, do as you're told. A little grumbling about how poorly a fellow employee does the same thing or that it isn't your turn is allowable if it doesn't waste time. Usually the phrase "blah blah, blah...my license on the line...blah blah" (fill in your own blanks) can be said ambulatory, thereby maintaining efficiency.
2) Make the patient feel as though the corporate structure they have entered is the greatest place in the world, and great harmony exists between you and your co-workers.
3) Keep in mind that you are replaceable.
4) Follow the chain of command in case of variance.
5) Stroke the MD's ego (remember, he is a customer), stroke the boss's ego and make them look good without taking credit.
6) Don't bother yourself or others with ethical problems. The upper ranks will take care of you. Ethics are something beyond your understanding. Remember that any administrator or MD can resolve any ethical problem on the spot better than Kant, the Pope, Hobbes, Wittgenstein and Descartes with one arm tied beyond their back. Work faster, do more with less, thank God for health care becoming an industry, and smile, smile smile.
After a few years, if you maintain these principles, you will find yourself acclimated to some of the most terrible situations and solutions, knowing that you had no power to solve it or to intervene, and you kept your mouth shut. Then you will be able to like what you see in the mirror, and sleep the sleep of the innocent. Ignore that little voice you keep hearing now and then, it's just your conscience messing with you. Remember, you could always be flipping burgers. =================snake
Mar 30, '04I agree with watersnake, I got into the field because I could stand the sight of blood and I could deal with many different personality's. I used to love nursing, but it's gotten to the point where I look for excuses not to go to work... I don't love the corporate feeling of the hospital.
I just want to make one point... and that is, "can we all just get along".
Apr 22, '04Well your project is probably done, Anyway and incompetent nurse is one who just doesnt give a rats a** anymore. Someone who has a patient passed out on the floor and is busy doing her notes while the rest of the staff has to tend to her collapsed patient. An incompetent nurse also doesnt answer call lights because he/she is too busy talking on the phone to her/his significant other or housing contractor etc.... Another version of an incompetent nurse is one who can perform all the procedures but never gets the big picture and doesnt realize that his/her patient is struggling to breath
(resp 36 on 100% non rebreather mask whose lips are blue and pulse ox is 80%) WHOOPS! How did that happen? I didnt see that before. Another version is the nurse so worried about going from room to room to asses patients in bed number order... to be organized, instead of checking on the sickest patient first.. (WHOOPS! How long has he been like that??!) The patients half dead or near dead now .
Mind you this has been my experience on medsurg with no monitors,, and the ER with monitors....Heck within a minute a competent nurse can tell you to what unit a patient is going to be admitted.
Apr 22, '04Quote from gaylord fawkerHi gaylord!hi all! im a nursing student and i have a project due regarding incompetent nursing. my question is what makes a incompetent nurse?...some examples would be great!!!!!! and oh yeah im new here and i justed wanted to say HI ALL! gaylord......
I dont think you really got the response you were looking for on this one
How about a new project??? Is it a "calling" or something else.....
Apr 22, '04geezzzz....or is it jeezzz....I have to remember to check the dates on the original threads!
Apr 23, '04Okay, a few examples of nurses I worked with (briefly) as they were either counseled out or decided our unit wasn't for them.
1. Pt has trach and NG tube. RN asks another RN where to give the meds.
2. Pt. is on heparin. Pt has huge GI bleed, RN comes to me with a bedpan of about 400cc BRB and asks what she should do next.
3. Pt. is getting a unit of blood, blood finished infusing, RN switches over to NS, off the pump. Doesn't go back to check or tell oncoming RN, goes home. RN, doing her initial rounds, finds her 85 y.o. pt in acute pulmonary edema after receiving a liter of saline.
4. Pt. has central line, RN lets it go dry, doesn't tell anyone, hangs new bag, goes home, line has clotted off.
Apr 26, '04lack of adequate preceptorship, particularly for new nurses due to facilities overly concerned about the bottom dollar or their own ignorance of the importance of it. Personally, I feel it's more the 80/20 rule...20% of the problems are the blame of the individual, and 80% are a result of the system, for which the poor inidividual has no control.