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 Infection Preventionist/ Occ Health.
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.
If a patient is in contact isolation, then gloves and gown must be worn. Period, end of story. Can you guarantee that the nurse will wash her hands WELL and EVERY TIME to kill off all the resistant microbes? BEFORE and after contact with the patient? What if the nurse becomes colonized, blows her nose in the nurses station and then comes and touches the patient without gloves?
The rules exist to protect both the nurse AND the patient. This type of careless and disregard for policy is most likely a contributor to the high rates of MRSA and VRE in many hospitals and LTC facilities. It is pure arrogance when nurses decide for themselves policies to follow and which ones to ignore. They are putting their patients at risk! :angryfire
My father died of a resistant infection, so you will understand why this is a very personal issue for me!
Reading these posts I see a recurring theme. People say they have reported or written someone up and nothing was done. I would add - that you know about. Dicipline of an employee is a private matter between the offending party and his/her supervisor. That goes double if it is one of your bosses.
Sorry, Ruby Vee, but I've gotta agree with student4life.....
I've been treated far too many times as a student like I'm in the way and treated like I'm not welcome. As the next gen of nursing, aren't we the ones who are going to allow the current ones to retire??
And yes, I have "know-it-alls" in my class too, and they raise my hackles from time to time, so I also understand Ruby Vee's frustrations......
And isn't there a way of teaching without dehumanizing someone??
Aren't we all in this together??
Just a thought.
Chickdude1
Yes, I'm sure there are many nurses who want nursing students to learn something and don't "eat" the students everytime they have legitimate questions. But, IMO and from my experiences with the nurses on my clinical rotations, I've seen a lot of deviation from universal precautions and standard procedures by the nurses. No gloves during IV sticks, nurses touching wounds infected with MRSA without gloves, etc. Additionally, the nurses were very, very rude and made it clear that the nursing students were in their way.... In my opinion.
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".
My very first nursing position was on the surgical floor. While not a common practice, the surgeons would have to do debridments on the floor or evacuate hematomas from post-op incisions. For this purpose we keep a supply of 30 ml Lidocaine on the unit for bedside procedures. The only difference between the Lidocaine bottles and the Normal Saline bottles used to flush I.V.s being used on a p.r.n. basis was the color of the writing on the labels...can you guess what happened. When the patient complained to the "experienced" RN he felt funny after his saline lock was flushed, she responded by crying out, "OH MY GOD", and RAN OUT OF THE ROOM LEAVING THE PATIENT WITH ONLY HIS CONFUSED BUT ALARMED FAMILY AT BEDSIDE! Thankfully he made a complete recovery after a visit to the CCU. We all realized that her error could have easily happened to any of us; but to this day I always think of her when drawing up a saline flush and double check the label.
We still laugh about this one, (not really funny of course) those of us who remember her. It was a few years ago in our ICU. Who hasn't had a patient who is determined to rip out tubes no matter what you do. This nurse had an orally intubated patient who got on her last nerve by sitting up and getting his face to his restrained hands so she restrained his head by taping it to the bed with surgical tape. Can you believe that? I saw this same nurse dc a swan ganz catheter on a patient sitting up in a chair prior to obtaining a peripheral line. She is out there working agency somewhere...
I had been out of school for a couple of years (still a pretty "new" nurse in my book) when we had a couple of new RNs join our unit. One of them was scary-she was dangerous. Two incidents come to mind: one I saw and one I was told about. The first one, I was waiting for report from her and she was reporting off to another nurse-this patient had an order for IVF with 40 mEq of potassium, which she had infusing, WIDE OPEN. Our hospital policy was that any medication with an additive-potassium, heparin, pitocin-was to be on an infusion pump. She had it on a dial a flow and it was running on open. We had to put that patient on telemetry and do EKGs q 8 hours, but thankfully he wasn't harmed. She was "reprimanded". The other incident I was told about, but didn't witness: We had a lot of HD patients with Vas Caths-we are not to touch them unless they have a pigtail on them, and then we treat it as a central line port or we try to start a peripheral line. This particular patient had a vas cath without a pigtail and we could not get a line on her, so her doc told us we could use one port of her vas cath for IV antibiotics. We had to "unload" the line before use (withdraw at least 3 cc's of blood due to the fact it was loaded with 10,000 units of heparin) and load it back after we infused the medications with 10,000 units of heparin. The patient knew we were to unload before even flushing before starting the med. Well, one night this particular nurse did not unload-she pushed that 10,000 units on through. The patient told her "you're doing it wrong!" This nurse told her "I'm the nurse...I know what I am doing. You just be quiet." :uhoh21: The patient complained of course and was very upset. Again, this nurse was "reprimanded" and left our facility after that. Thankfully, no harm was done to the lady. But if she is still practicing, I am scared for her patients.
I had an incident myself. It is common sense if you are hanging an IVPB to get air out of the line isn't it? Well, I was in the hospital for a severe post-op infection and on numerous IV antibiotics. There were 2 antibiotics that were infused at the same time as they were compatible-which was ok with me. One night, one of the nurses came in and hung the one on the pump and the other was going on by gravity (sort of) to a distal port. I was talking with my husband and waiting on her to prime the line, connect and go on as I was about to go to sleep-she never checked the line for air. I noticed this 5 inch long piece of air and mention it-she said she didn't see it. So she does her thing and as soon as she leaves, I go to the bathroom and unhook it and prime it myself. I never reported it, but was scared to death anytime she was on duty and it was time for my IVPBs.
I would have primed it right in front of her! Either that, or go to the nurses station and act stupid, "Um, just wondering if this is normal?"
I had a PRN nurse working the unit with me. We had a patient with orders for Lantus 95 units HS. She comes to me and says, "we're out of Lantus, can I give him Regular insulin instead?" Mind you, this was a nurse with several years' experience!
Once I regained my power of speech, I told her "Er...no. I want him alive."
Well, this one's not scary like some of the others, but still...
I once worked with an RN supervisor who, let's just say had some issues. One evening, we had a resident (pt.), who needed some blood drawn for lab. This nurse gets the phlebotomy tray and heads to the room to collect the sample. I went along. She gets her supplies out and attempts stick #1, which misses. Lays the used needle on the pt.'s bed, where she is sitting to do the procedure. Stick #2, also a wash. Needle goes on the bed. At this point, I offered to try, but she declined. Stick #3- no luck. Needle joins the first two. Finally, on the 4th attempt, she hits an actual vein and collects the needed specimen. Now, you may think this would be the end of the story, but,no. She starts to pick up her discarded supplies from the bed , then yells out "Ouch!" What's wrong ? She accidentally sat on one of the used needles and was stuck in the butt. No injuries, but proceeded to perform her own drug test ( which ,yes, I told her couldn't possibly be legal), fill out her incident report , and go home. The DON came in the next AM, found the report, and came quickly to our unit for a better explanation than what was written in the report. I told her this story, and after she recovered from the shock, she called the nurse to come back to the facility for a repeat drug screen ,and goodness only knows what kind of counseling. As far as I know, that was the end of it. The pt did ask me later if " that nurse was still learning". I told her I certainly hoped so.
A nurse in ICU here gave 150 units of insulin SubQ. This patient was on an insulin drip so I have no clue why she would give any insulin subq, let alone 150 units. When you have to draw up more than one syringe, thats reason to question yourself. That incident created a new protocol....2 nurses have to check off insulin before its administered. The patient did make it, thank GOD.
ICRN2008, BSN, RN
897 Posts
If a patient is in contact isolation, then gloves and gown must be worn. Period, end of story. Can you guarantee that the nurse will wash her hands WELL and EVERY TIME to kill off all the resistant microbes? BEFORE and after contact with the patient? What if the nurse becomes colonized, blows her nose in the nurses station and then comes and touches the patient without gloves?
The rules exist to protect both the nurse AND the patient. This type of careless and disregard for policy is most likely a contributor to the high rates of MRSA and VRE in many hospitals and LTC facilities. It is pure arrogance when nurses decide for themselves policies to follow and which ones to ignore. They are putting their patients at risk! :angryfire
My father died of a resistant infection, so you will understand why this is a very personal issue for me!