All of us at one time or another have seen or heard of a nurse doing the most idiotic or blatantly stupid thing that goes against our grain of "good nursing". What's the worst you've ever heard? Here's one for you:
At a LTC where I worked, (this was LONG ago...) we had one nurse on 3-11 shift that all the other nurses kept complaining about because it was "common knowledge" that she always gave her 4 pm meds with her 8 pm meds. Of course, I never actually saw this happen and rarely ever worked with this woman. However, no one else would dare to approach this nurse as she had worked there "forever", and always got her way with whatever she wanted. She would leave the building and not clock out for her breaks, and spend a couple of hours at Walmart then return to work. I was told once that a family member approached her about a resident who thought was having a heart attack and this nurse told them "I'm not her nurse, you need to inform someone else"....this while she sat at the nurses desk filing her nails. Anyhow, one evening our DON just "happened" to check this nurses med cart...and guess what. Supposedly, all the 8pm meds had already been given (or at least they weren't in the med cards) Needless to say, she doesn't work there anymore. Actually, I believe she retired!!!
I don't understand how some nurses can be so PLAINLY unprofessional - not even attempt to hide it! EDIT: Just a reminder, this is what I had heard, not what I had witnessed. Had I witnessed anything close to this you better believe I would be on the phone with someone...and fast!!!
Specializes in Med/Surge, Psych, LTC, Home Health.
Nurse with 23 years experience had patient swallow Motrin 800 mg with a nasogastric tube in place!
Can't you do this as long as the suction is turned off? I know I've given patients with NG tubes PO meds and just had to turn the suction off/clamp the tube for 30 minutes or so.
STUPID THINGS I'VE DONE:
I'd like to think that I've never done anything as blatantly ignorant and unsafe as some of the things that I've read so far in this thread! Worst thing that I've done, and this is pretty bad... is "lose it" in front of a patient or family member. The last example that I can think of (it's happened a couple of times, unfortunately) is when I had to give a baby a shot of Rocephin... this happened a few months ago... and the mom was upset, almost in HYSTERICS, because the baby was going to have to be stuck again. I drew up the med, went to give it with a 25 gauge needle in the top of his thigh.. and the needle went in a bit further than I had meant for it to, and the mom went nuts. Then to top it all off, while trying to push the med in the needle came OFF of the syringe, and the medicine squirted all over the place. OH! That was it! I calmly left the room without saying anything, but then kinda, well, REALLY lost it right there at the nurse's station, and I could hear the mom carrying on in the room. Oh, it was awful. I'm still learning to keep my cool.
WORST THING I'VE SEEN A NURSE DO:
Hmmmm, I've actually worked with some pretty good nurses over the years, because I can't think of too many things that I personally have witnessed. I guess one example that stands out is... once while I was still working as a CNA, I was helping take care of a gentleman who had developed TERRIBLE pain in his left side, under his rib cage. The nurse that was taking care of him was giving him the pain meds that were ordered, but they weren't helping. She just kept mostly, verbally, passing off his pain as "in his head", somatic pain, or something. The next night, he threw a PE and went to the ICU, and then died. I just feel like that nurse should have done more. She mostly ignored him. He wasn't someone who had a history of psychiatric illness or drug abuse or anything.
maybe i'm just cranky from working night shift, but something about the tone of your last post just grated.
i've had mostly good experiences with students, and would love to have more contact with them. but there are a few -- and your last post struck me this way -- who think that after so many hours of lecture and textbooks, they know everything. and it's very, very hard to teach someone who thinks they already know everything. some of those students have been hired to work in our unit, and as "experienced" nurses of 2 or 3 years, they still think they know everything, and consequently miss out on a lot of educational opportunities.
if you think you see an experienced nurse making a mistake, perhaps you could ask why she's doing it that way instead of the way you learned. you might learn something new -- or you might tactfully be reminding her that she's missed a step.
ruby
before we get too much off the original topic of this thread,
1. i already said that i called the nurse out for not wearing gloves. telling her she did not have gloves on when she had blood all over her hands after an messy iv stick was as tactfull as i could get. that was what i had in mind when i was replying to this thread. blatant no-no's by nurses.
2. i always ask when i dont understand the way a nurse is performing a technique. there are alot of things that nurses do that are different than textbook but are perfectly legit. i dont think i know it all!! i guess students need not reply to this thread since we might be deemed "know it alls"
i'm sorry if my post rubbed you the wrong way. my original opinion still stands though, just because it was my experience. i see your point and where you are coming from. no hard feelings...ok???? :chair:
I look at EVERY med I pull from the med station or cart, because despite every precaution, I have seen pharmacy load look-alikes or just plain load incorrectly. We're all human though. Now if I listed every error I made in the last 2-3 weeks, I'd fill the rest of the page.....guess I'll add 'em all to the Knowledge File
The worst thing I have seen so far was when I was still in nursing school. I was working as a nurse tech at a LTC facility. I have been a CNA and was trained by the state for years to give po meds in goupr homes for years prior to this. I also had special training to give insulin injections. Anyways......we had this older gentleman, a brittle diabetic and dementia and a nurse who was forced to stay over 3 hours.....See where I am going here. I was in his room assisting him to the bathroom when the RN came in to give him his insulin on the blood sugar level I had reported to her. This was at 5 pm. This nurse left at six. She had charted the blood sugar I told her but did not chart the insulin. The new nurse that came on was new to the place and did not know me that well...but that is beside the point for the next part of this story....I told her "you need to call so and so, I saw her give the injection myself" she said if it's not charted its not done. At ten pm a very good cna came running up to me and said so and so is not waking up when i call his name. I had told her to keep a close eye on him. Well Thank God she did. I ran to his bedside did a sternal rub and got no response and she ran to get the machine to check the blood sugar. It was 10. I live in America so this is not a Canadian number ladies and Gents. The RN's were no where to be found. Obviously we could not give him jouice to drink so I broke into the bed room and got the gel to use in his mouth. Luckily with small amounts given at a time I was able to get him to come around. Twenty five minutes later the RN's show back up. I am not sure where they were. This was a sub/acute with vents and LTC facility. I was scared I would lose my job and my chance of ever getting a liscnece when the DON found out I gave this med without my lisc. Well the RN who had the pt was fired on the spot and I was given an accomidation for my efforts.
This was just unbelievealbe to me that these RN's could just all walk away and tell no one where they were. And that she did not listen to me when I told her that the pt ahd already gotten the insulin and to contact that other RN for verification. I hope she at least got in some sort of trouble with the state for neglect.
I was a patient in the hospital and the nurses found out that I was a nurse also. One night a nurse came in to see if I was awake. She told me the IV on one of her residents got behind and what should she do? I am sure she wanted to save face with her fellow employees and supervisor but I don't think asking your patient for advice is the way to go.
Another time I was working for an IV company and was called to an LTC to restart an IV that had infiltrated. When I got there I was told that they had not stopped the pump or pulled the IV. I was horrified when I saw the resident. From her fingertips all the way up, the arm was at least 3 times the normal size and purple. I stopped the pump and pulled the IV then raised the sleeve of the patient gown to see how far up this infiltration went. The tourniquet was still in place. When I started investigating I found out the tourniquet had been on for 24 hours! Quite obviously this little lady was not getting very good care.
Another time I was called to a different facility about 9pm to restart an infiltrated IV. I found the (agency) nurse sprawled behind the desk eating and reading a book. She informed me that she hadn't checked any of her IVs yet. She called because the CNA told her it was infiltrated. She never moved from the chair or put down the book while I was there. I got her name and the next day I called the DON at the facility and told her what happened.
maybe i'm just cranky from working night shift, but something about the tone of your last post just grated.
i've had mostly good experiences with students, and would love to have more contact with them. but there are a few -- and your last post struck me this way -- who think that after so many hours of lecture and textbooks, they know everything. and it's very, very hard to teach someone who thinks they already know everything. some of those students have been hired to work in our unit, and as "experienced" nurses of 2 or 3 years, they still think they know everything, and consequently miss out on a lot of educational opportunities.
if you think you see an experienced nurse making a mistake, perhaps you could ask why she's doing it that way instead of the way you learned. you might learn something new -- or you might tactfully be reminding her that she's missed a step.
ruby
when i was a nurse extern i used to work nicu quite a bit. i loved the enviroment there. most of the nurses loved to teach. there was this one nurse who i refused to work with. i would do jsut what you suggested. i would say i have never seen it done that way could you explain to me why you do it that way. and she would say dont ask me why just do it. i am sorry that is not teaching. if that were the case then monkey's would be nurses. there is thought and theory behind what we do. tell me why you are doing something that way. what makes it better the the other ways, why do you find it works. anything. some are just not meant to teach. some are. some like it and some hate it. to each their own. but if you don't like to teach tell you manager that so you will not be assigned to work with ppl who need to be taught.
stepping off my soap box.......in my honest opnion.
In the unit I formerly dialyzed in (and this is one of the MANY reasons I switched units!), a patient had died because the nurse who initiated his treatment had grabbed a syringe of lidocaine instead of heparin-- his heart stopped in the unit and the ambulance people were unable to get it started again. At the time, both lidocaine and heparin bottles had purple and white labels and were easy to mix up-- but the fault for the patient death should also be shared by whatever nurse put that bottle of lidocaine on the heparin shelf.
That unit had multiple instances of mix-ups like this... thankfully a unit opened up in my own city and I was able to transfer. Dialysis is scary enough-- wondering if I was going to be alive in 4 hours was definitely too much to handle!
Specializes in med-surg 18 months, respiratory 3.5 year.
This happened while I was a student last year. I had a pt w/ a G-tube as one of my clinical pts, and I watched his primary nurse crush up the meds to put in the tube. My instructor was not with me at the time. The primary nurse then proceeds to mix the meds with apple sauce. I still wasn't sure how wrong this was, because I had been to several different hospitals for clinical, and each one did things a little differently. My first thought was, "How can the pt taste the applesauce anyway?" So I watched this RN put the applesauce with meds in the G-tube and flush it. When I told my instructor about it she told me that it was never proper to put applesauce down a G-tube.
So far the dumbest thing I have done personally involves chocolate mousse and a 40 yr old female pt who was a S/P CVA quad, whose mother was very involved and had asked me to order the chocolate mousse for her daughter. I told her that chocolate was listed under the pts allergies. The mother swore up and down that pt was not allergic to chocolate, and that it shouldn't be listed as an allergy. So the mousse comes up to the floor and since pt is a feed, I fed her the whole cup of it. It was the only thing that she ate that night. Pt was very picky eater. Not one hour after pt had eaten, she had broken out in a rash over her entire trunk.:imbar
Moral of story is: How do you know when pts are lying to you? Their lips are moving..........
Speaking for myself only. No, I do not think I know everything, but I do know nurses are supposed to wear gloves to avoid contact with blood. I saw many nurses who just weren't. And yes, I called them on it. I just wanted to clarify that point. I didnt mean to generalize "all nurses", and I think I did say "many".
The nurses you were working with knewthe rules too, and they were putting themselves at risk NOT their patients, so long as they washed their hands after patient contact. They were very likely less enthusiastic about teaching after you hadtold them about all they were doing wrong. I can't say I would be any different.
The nurses you were working with knewthe rules too, and they were putting themselves at risk NOT their patients, so long as they washed their hands after patient contact. They were very likely less enthusiastic about teaching after you hadtold them about all they were doing wrong. I can't say I would be any different.
I see what youre saying. She was putting herself at risk. However, if it was me who got blood all over my hands, I would bet that an incident report would have been filed and I would have failed the rotation or something like that. It was my understanding that we must protect ourselves as well as the patients. So, it is your opinion that I should not have said she should have had gloves on? Wow. ok.
In the unit I formerly dialyzed in (and this is one of the MANY reasons I switched units!), a patient had died because the nurse who initiated his treatment had grabbed a syringe of lidocaine instead of heparin-- his heart stopped in the unit and the ambulance people were unable to get it started again. At the time, both lidocaine and heparin bottles had purple and white labels and were easy to mix up-- but the fault for the patient death should also be shared by whatever nurse put that bottle of lidocaine on the heparin shelf.
That unit had multiple instances of mix-ups like this... thankfully a unit opened up in my own city and I was able to transfer. Dialysis is scary enough-- wondering if I was going to be alive in 4 hours was definitely too much to handle!
NurseCard, ADN
2,850 Posts
Can't you do this as long as the suction is turned off? I know I've given patients with NG tubes PO meds and just had to turn the suction off/clamp the tube for 30 minutes or so.
STUPID THINGS I'VE DONE:
I'd like to think that I've never done anything as blatantly ignorant and unsafe as some of the things that I've read so far in this thread! Worst thing that I've done, and this is pretty bad... is "lose it" in front of a patient or family member. The last example that I can think of (it's happened a couple of times, unfortunately) is when I had to give a baby a shot of Rocephin... this happened a few months ago... and the mom was upset, almost in HYSTERICS, because the baby was going to have to be stuck again. I drew up the med, went to give it with a 25 gauge needle in the top of his thigh.. and the needle went in a bit further than I had meant for it to, and the mom went nuts. Then to top it all off, while trying to push the med in the needle came OFF of the syringe, and the medicine squirted all over the place. OH! That was it! I calmly left the room without saying anything, but then kinda, well, REALLY lost it right there at the nurse's station, and I could hear the mom carrying on in the room. Oh, it was awful.
I'm still learning to keep my cool.
WORST THING I'VE SEEN A NURSE DO:
Hmmmm, I've actually worked with some pretty good nurses over the years, because I can't think of too many things that I personally have witnessed. I guess one example that stands out is... once while I was still working as a CNA, I was helping take care of a gentleman who had developed TERRIBLE pain in his left side, under his rib cage. The nurse that was taking care of him was giving him the pain meds that were ordered, but they weren't helping. She just kept mostly, verbally, passing off his pain as "in his head", somatic pain, or something. The next night, he threw a PE and went to the ICU, and then died. I just feel like that nurse should have done more. She mostly ignored him. He wasn't someone who had a history of psychiatric illness or drug abuse or anything.