A message to new grads: NEVER....

[UM Review RN]

* un-spike the old IVF's with 100 mls left in the bag while it's still hanging

* say the word "quiet" in reference to your hopes for the shift

* say you've never had a patient ________ before

* take your stethoscope off till you're in your car and on the way home

* plan on going to that inservice/staff meeting/whatever during your shift

Experienced nurses, share your wisdom. What are some other things that new grads should NEVER do?

[Stitchie]

Never say "Because the doctor ordered it".

Use your rationale, and let patients/parents know that they have a choice to refuse treatment that they believe is unnecessary/unwarranted/unwanted.

Never blow off the person who comes to triage and says "I feel like I'm having an heart attack/going to die". They are, and they will!

[Thunderwolf, MSN, RN]

Never forget that pain can be expressed in myriad of ways

Never say you are sorry for being "only an LPN" to an RN or "only an RN" to a doc or "only a nurse" to a patient

Never forget to wash your hands before and after seeing a patient

Never leave IVs dry for the next shift...they will hunt you down

Never gossip...it reflects on you

Never take an assignment that is beyond your skills...ask for help or reassignment

Never stop asking questions

Never stop building your knowledge base or stop critical thinking

Never let small kids sit or lay on the floor while visiting

Never assume

Never give a new patient a tray without checking the orders first

Never plant yourself at the desk all the time...get out and help

--------

Always say thank you when someone helps you

Always knock before entering into a patient's room

Always be mindful that you reflect your profession on the floor

Always ask who that strange person is looking at a patient's chart that you are not familiar with...it could be someone's lawyer...know your docs!

Always remember that you are human and can only do so much by yourself

Always look at your paycheck, comparing what it says and what you actually worked

Always be prepared for something to go wrong

Always count on another ER admit

[weetziebat]

Never take shortcuts and not check the IV site under the dressing. Amazing how much fluid can infiltrate and the pump never alarms.

Never try to cut a dressing off if patient has tubes. Invariably you'll wind up cutting the tubing.

Never fail to question a doctor if you don't agree with their order. They also make mistakes.

Never leave a med at the bedside, even if the patient is sitting up and promises to take it right away. Wait till they actually swallow it.

Never put someone down cause they ask questions. Far better to ask than to try to repair the damage afterwards.

[ladybird1292]

Love this thread, I'm still a student but I will take notes and remember :) Thank you to all those nurses who willingly share their knowledge, both on this site and those I have met in person

[talaxandra]

So much excellent advice - I'm sitting here nodding and 'mm-hmm'ing under my breath!

I can't think of anything else to add, but I'm sure that I'll nod and 'mm-hmm' over all the posts that follow mine :)

[riern]

Never accept what your charge nurse, supervisor or even doc say if you don't think it's right. Ask them questions and get them to explain the rationale to you. Discuss why you don't agree.....listen to your gut.

Never push dilantin(or any other drug) without double checking the current fluids...don't take someone elses word for ANYTHING.

Never get in too big of a hurry to really look at and assess your patients...you may miss something that could save a life.

Never leave a patient lying in urine or feces and tell them the CNA will be in soon. Change them yourself........part of nursing is cleaning behinds!

Never ever cut the tubing of a foley catheter to remove it.....the urologist will be very angry when he has to take the patient to surgery to remove the balloon. Use a syringe to remove the water!

If you didn't/did do it even if your wrong.......always be honest. The truth will come out in the end anyways.

Always knock before entering your patients room.

Always be as honest with your patient and their family as possible. Give them a pencil and some paper and encourage them to make a list of questions for the doctor.

Always give your patients a smile and your undivided attention while in their room.

Always take the time to help your CNA with the difficult total care patients.

Make friends with the unit sec and the CNA's.... they are 2 very valuable people on your unit.

Always treat your patients the way you would want someone to care for you, your parents, your children, your husband, etc.... you never know when you or someone you love may be on the other side one day.

Always make rounds with your doctors if possible, at least talk to them about your patients before they leave the floor. It's rather unprofessional to ask the patient what the doc said.......not to mention the patient may leave out something very important.

In the mist of a hectic, anything that can go wrong has gone wrong day, take 10minutes and stop, take a deep breath and remember the top 5 reasons you became a nurse to begin with.

There will be days that being the greeter at Walmart looks good.......LOL... but they will pass.

Rie

[ReinventingMyselfAgain, MSN, RN]

never leave a patient lying in urine or feces and tell them the cna will be in soon. change them yourself........part of nursing is cleaning behinds!

always take the time to help your cna with the difficult total care patients.

make friends with the unit sec and the cna's.... they are 2 very valuable people on your unit.

while i don't disagree with these, i urge you do them with caution. i don't mean to sound disgruntled (but i am :chuckle ). don't let them take advantage of you! they will sit there and watch you change every wet/soiled pt. if you let them. they are also well aware of the fact that you are 'new', and want to do everything you can to help your patients. many nurses told me this as a new nurse. depending on where you work, you need to make a choice- either be their friend, or keep it professional (so they will do their job). it is very hard, once you've established that 'friendly' relationship, to change that.

please remember this: you can do the cna's job (and the unit sec as well), but they cannot do your job!!! i'm just a little sick of hunting them down, and doing everything for my patients, while they sit on the phone.

[UM Review RN, ASN, RN]

ALWAYS check the patient's O2 tubing: is it connected? what's the rate? because *Things Happen.*

ALWAYS tape your Chest Tube Drainage system to something stable so it doesn't get knocked over--like the floor.

ALWAYS make sure your Chest Tube connections are taped securely.

ALWAYS have an occlusive dressing and a set of really large clamps taped to the wall for a chest tube patient.

ALWAYS keep an ambu bag nearby for the patient who desats fast. Nice to have it handy--because *Things Happen.* You just slap it on and go to town while someone else gets the crash cart.

[thebrneyedangel]

NEVER ... TRUST EVERYTHING YOU HEAR IN REPORT .. ALWAYS CHECK YOUR CHARTS.

The nurse your getting report from has had a long shift. They are human and forget things.

Some don't even have a clue. Always trust your critical thinking skills and when you do not know find the answer use any and all resources.

Never Leave the floor without letting someone know.(Having to page a nurse back to the floor via hospital loud speaker really stinks)

[CardioTrans, BSN, RN]

Thought of some more......

Always treat the PATIENT....... not the MONITOR

Always make sure you cover the patient if you have to do a bath or anything personal to them..... even if they are sedated.......

Always, always, always check and double check your IV fluids and rates....

Always check the vent settings with the chart........

Always have an obturator taped to a patients bed in case they cough their trach out.........

[begalli]

Always, always, always check and double check your IV fluids and rates....

AND concentrations and the volume that's left to be infused. Nothing worse than responding to a pump alarm to find out your bag has run dry (especially vasopressors and propofol!).

[jnette, ASN, EMT-I]

Never say "I can't"... because sooner or later you will most certainly HAVE to.

Never put off a potty call... you'll most surely get tied up with sth. else for another hour or two. :stone