Dangerous nurses

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Have any of you ever worked with a nurse you would classify as dangerous ---- dangerous as a nurse and as a person?

Specializes in ICU/Critical Care.

Ruby Vee's thread about the new grad she worked with is a big lesson in what a dangerous nurse is. Doesn't take constructive criticism well, dismissive, has to constantly be reeducated, doesn't understand the seriousness of her mistakes. Not all new grads are like this. In fact, I have a couple of new grads in the ICU with me and they rock. But Ruby's new grad, very scary.

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Specializes in ED, ICU, PACU.
This is a really interesting topic. How do we define dangerous and incompetent?Is it a combination of

* Lack of knowledge/outdated practice

* Lack of Experience/outdated experience

* Poor clincal supervision/preceptorship (newly qualified nurses)

* Inappropariate clinical area in relation to job experience

* Lack training experiences in areas such as medical/surgical etc

* Poor/lack of mentorship upon being qualified and experienced?

I think its important to asses if a nurse is willfully dangerous/incompetent or is it a combination of their own lack of knowledge ? If so what support is there for nurses who may be underperforming, or whose practice is causing concern?? Okay here are two scenarios I would like to present:

A graduate nurse has just qualified and managed to get a job in the ICU. On interview they excelled with their knowledge, etc. However one year into the job you and other colleagues begin to notice that she is making errors (although not dangerous), but causing some concern. Now as their clinical supervisor what would you do bearing in mind they are coming towards the end of a preceptorship programme?

Second scenario - A nurse who has 15 years experience working in Medical/surgical nursing. During this time this nurse has taken a career break in order to raise a family and build a home etc. They returned to the profession 3 years ago, but there have been new developments in medical/surgical nursing. Although she has a lot of experience - you notice that some of her practices - although not serious - are causing alarming concern. It reaches a point where some of your colleagues are reluctant to work with this practitioner. Your colleagues come to you (you are the manager), what are you going to do?

I think I can sum up what constitutes a dangerous nurse:

Dangerous Nurse = Sentinal event just waiting to happen.

Thinking of it in that simplified manner helps me to separate the inexperienced/naive/underdeveloped... from the ones that are going to cause serious harm to a patient if not stopped. A truly dangerous nurse is one that does not have the capacity to realize they are in need of learning something, although they may have been told; nor, are they able to grow. If the nurse can never admit to ever making a mistake (blaming another, in some way, does not count) , you have the cardinal sign of a dangerous nurse, IMHO.

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I think is also important to assess the quality of nursing training. I gather some nursing schools are going to be better than others. I will give another example. When I worked on a particular unit there was this newly qualified nurse. She was the most arrogant, know it all practitioner I had ever met. She was rude and patronising to other members of staff. I tried to help but to no avail. Anway one day she made an error which put a patients life at risk. Needless to say she was severely reprimanded. Had she not behaved the way she did previously she may not have been treated so harshly. I got another job shortly after, but my friend said she is a completely different person now - (she hardly says a word, she does her job and asks if she is unsure of anything and LISTENS). If fact I did feel a bit sorry for her. But folks some nurses have to learn the "hard" way.

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Specializes in ICU, Telemetry.

There's 2 on our floor. One thinks it's okay to increase a heparin drip when the APTT's > 250. One will have an order for PO narcotics that she will give IV without an order. Both reported. Both still there. Both function as preceptors and charge nurses.

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Not being familiar with Aspart (only aspartane), does that mean that doctors are "dangerous" too? What a shock!

(to be taken as a sardonic comment)

Insulin aspart is a semisynthetic short acting insulin, sold under the brand name Novolog. It's probably been out for about 5 years.

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Just wanted to add also, for me I always reflect upon my own practice. I always ask myself is there anything that I do that might be considered dangerous or incompetent? I think its also important for every nurse to examine their own practice before questioning their colleagues. I also think as a nurse you never stop learning and thats the beauty of our job. I am always hungry for new knowledge, skills and experience. Hence I improve myself by undertaking further training and education.

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Arrogant nurses could be the dangerous ones.Once up on the time while I was in NS I was administering a med and on the MAR it said to contact the resident on call (pediatric ward) before giving this med and I went to find the nurse responsible for this peds patient to find out who was the resident on call (especially since there was no MD name in the MAR ) and when I finally had I chance to ask her she replied "Why do you need to consult the doctor,I never do":eek:

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Specializes in cardiac.

Overly confident nurses scare me the most. When a nurse stops questioning things......I don't know...kinda makes me a little nervous for the pt.

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Specializes in Gerontological, cardiac, med-surg, peds.

To keep this thread going, please "play nice." Follow the terms of the TOS. Vigorous debate is encouraged, but do not attack the poster or post off-topic stuff. All such posts have been and will be deleted. Thank you and carry on.

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Also I think its important for clinical areas to specify if they want EXPERIENCE or are prepared to accept newly qualified graduates. Normaly specialities such as ITU (intensive care unit nursing) offer students preceptorship. Here you are given a mentor who is with you at least 6 months to a year. Hopefully this type of preceptorship offers alot of support because the nature of this type of nursing cannot afford know it alls and arrogant nurses. It needs the right type of attitude.

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Specializes in OB, HH, ADMIN, IC, ED, QI.
Insulin aspart is a semisynthetic short acting insulin, sold under the brand name Novolog. It's probably been out for about 5 years.

Thank you so much for the information. Of course! :grn:

I didn't know that Novolog is Aspart......

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Specializes in Med-Surg, Oncology, telemetry/stepdown.

I work with a person who I consider to be a dangerous nurse. Her approach to patient care is lazy and...hands off at best. I have come across numerous things she has done that have worried me..heparin gtts allowed to run dry for half a shift, drawn up subq heparin needles left at the bedside of a confused patient because she "got distracted before i had a chance to give it to him", beds left high up in the air when a patient is confused,fall risk, and admitted to our floor for a fall in the first place! I could go on and on with the things she does every week. She just doesn't seem to care.

oh another thing that happened last night, (not exactly dangerous but this was my face when I saw her :eek:!) she was sitting at the nurse's station as usual, chitchatting with a respiratory therapist..I am charting when I hear her logging into our VoiceCare system on speaker phone..She says to the RT "wait until you hear all the stuff that is wrong with this guy!" and proceeds to play,loudly on speakerphone, the patient's name,DOB, admitting diagnoses and past medical history. I was like are you ******* kidding me? Maybe not such a huge deal, but I thought it was so wrong!

We have filed incident reports and gone to our patient care manager numerous times about this girl, and yet NOTHING has been done about her. 2 patients have ended up in the unit as a result of her negligent care..and here is the kicker..everytime she is confronted about anything (chatting on the cell phone while removing and administering meds), she claims that other nurses are targeting her because......wait for it....because she is so pretty and we are all jealous!!!!!!!!!!OMG..she has no accountability for her actions, and it is dangerous and uncomfortable to work with her. The PCM has made the excuse for her that she is a young nurse, which doesn't fly with us..( she has worked at this hospital for almost 2 years...I just graduated from school this past May, and when we are both working, I am put in charge! Still she does not get it!)...ugh I am just disgusted and feel like nothing will be done until she kills someone..Recently in a mtg with another nurse and our PCM, she claimed that she had a legal right to sue for HARRASSMENT if action is taken against her...

sorry for the length of this vent..been building up for 6 months!:nurse:

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