incompetent nursing

aurora_borealis · Apr 23, 2004

Okay, 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.

BlueTang · Apr 27, 2004

lack 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.

mattsmom81 · Apr 28, 2004

My best example of professional incompetence is failing to know what you don't know, not asking for help, accepting an assignment over your head and risking your patient. I run into this all the time, unfortunately. Its one reason I left this last job...I was tired of getting train wrecks dumped on me at shift change by nurses like this...nurses who also became hostile and defensive when I asked them why they felt this was OK....

If they don't want to BE ICU nurses they don't need to be WORKING in ICU, IMO. We have a professional responsibility to learn basics of our unit/work of choice; to NOT do so is incompetent in my book.

CHATSDALE · Apr 28, 2004

THE CHOOSING VS CHOSEN ISSUE DOES NOT ANSWER ORIGINAL QUESTION

I HAVE WORKED WITH NURSES WHO GAVE THE IMPRESSION THAT THEY WERE KNOWLEDGEABLE WHEN IN FACT THEY WERE BLUFFING I HAVE SEEN FAMILY MEMBERS SWALLOW IT HOOK LINE AND SINKER BUT EVERYBODY ON THE FLOOR FROM CNA s TO CHARGE NURSE KNEW THE TRUTH USUALLY THEY WOULD GET AWAY WITH UNTIL THEY COMMITTED A PROVABLE OFFENSE AND THEN THEY WOULD BE ALLOWED TO RESIGN AND GO TO ANOTHER FACILITY TO START ALL OVER AGAIN

WHAT IS THE ANSWER MAYBE THERE ISN'T ANY

gwenith, BSN, RN · Apr 28, 2004

Ah! Yes! The cocky little newbie that either will not ask direction or wont TAKE direction - because "I have never seen anything like that happen!"

One of the reasons I do not do shift charge is simply because I got soooo sick and tired of this. If you don't know ASK! There is no such thing as a "dumb" question. (with the sole exception being the RN in the middle of a chaotic ICU asking "Can I plug this pump into that wall socket?" )

I would rather be asked the most BASIC question than find the ventolin being given via face mask to a trachy patient. Bottom line there are nurses who will always find themselves in over thier heads not because of design but because the cards fell that way.

Having said all of that I am only too well aware there is also the nurse that will NEVER tolerate any inquiry and meets all questions with the response "You should know THAT! How come you don't know!!!!" These people are dangerous to others - they can foster a culture of "do not ask" - I have seen it happen and the results were a disaster.