Do you ALWAYS do the right thing?

Define "right." But probably the answer is still a big ol' "no". Of course everything's always clearer through the retrospectoscope.

And even if you think you did everything right, somebody coming up behind can probably find a fault with it. I followed up a nurse just tonight that I greatly respect, just got her RN III or IV. And found a mistake she made, nothing major, but not right none the less.

Out of curiousity, what were you supposed to call the doctor about?

I would have been annoyed at the unit manager as well. Its always nice to be told to your face what you did wrong instead of hearing it 2nd or 3rd hand. It rarely happens though.

@ 2shihtsus-I'd be happy to PM you. I don't feel right posting publicly. You never know

For the life of me I don't understand why they do that. If it is worth bringing up at all, it is worth bringing up to the guilty party. Otherwise the conversation is inappropriate.

This has come up for me personally recently. So the question I pose is, how many times should you bring something up to them (the same issue), before you take it up the ladder?

I am an LPN working in the state of Indiana. To my knowledge, scope of practice entails a hierarchy where we are accountable to our RN supervisors (which God knows are not always available). That being said, if an LPN is practicing nursing, and a situation arises where the patient's safety or health is in question, the order of operations is to first seek out the RN for advice, and second, call the MD in charge. BUT, of course, there's a million caveats to this process. Was the patient becoming critical, did an appropriate nursing measure effectively address the issue, was the patient alert and oriented enough to provide satisfactory and MEMORABLE feedback, and finally, was the RN, who is our supervisor, consulted regarding the change in condition? Nursing is a very, very difficult field, regardless of whether LPN/RN/CNA/NP or any other position which entails caring about another individual's health. We do not always do everything "Right"--especially considering that the field seems to be becoming more about CYA than caring for the individual at all levels-physical,emotional,social,mental,spiritual.

I work semi-autonomously in the field of home health care, which is absolutely a double-edged sword. I have the luxury of providing 1:1 care, and who could ask for a better ratio then that? However, it is not a "clinical setting", to say the least. I must use my soundness of reasoning, fine-tuned problem solving skills, and the whole compendium of tools which God has given me to use in this field.

My main hope and aspiration, other than to be a good mother, wife, daughter, is to "first, do no harm."

Hope all turned out well.

As it would so happen just this morning, I read about a license suspension in Fla for a nursing supervisor in LTC for failing to transport a resident via 911 per MD order. There were several hours of delay for a private ambulance transport and the resident expired on arrival to the ED.

A perfect example of how an outcome may or may not have been inevitable, but delay in appropriate actions is the coup de gras.

Yes. If "coup de gras" is being used contextually as "the blow that terminates", then that is correct. Expediency of action is paramount in the medical field, even if said expediency involves a forced quickness of sound judgement. Unfortunately, rapidity at multi-tasking often comes only after repeat exposure, or more often, years of experience in the medical field. The human condition is vast, and not easily evaluated from strict empiricism.

Experience has taught me the hard way, but it has taught me. And for that, I am grateful.

i am a night supervisor at a snf. i guess there was an issue last night i should have called the md about. instead of telling me directly, the unit manager told the 3-11 supervisor in passing, which upsets me. if there was a problem, i wish they would have talked to me about it. anyway, i'm now beating myself up about it. i don't handle my own mistakes well.

i'm not sure precisely what you mean. if you mean, do i always try to do the right thing, the answer is yes. if i know, or can figure out what the right thing is, and if it's possible, that's what i do. sometimes it's easy to do the right thing -- it's easy to see what the right thing is and easy to do it. sometimes it's easy to see what the right thing is, but not so easy to do it. i try to do it anyway. or at least, the least wrong thing. and sometimes, it's difficult or impossible to tell what the right thing is . . . but i try anyway.

if you mean do i ever make mistakes, the answer is yes. i've made some doozies. anyone who tells you they don't make mistakes is a liar.

you don't give any details about your situation, and i'm not going to second guess what you did or not do. i will say this: usually, the right thing is to talk to the person who made the mistake before (or instead of) talking to anyone else. sometimes, however, the patient care situation is such that the mistake needs to be passed on to the next shift so that they can continue to deal with the ramifications. in such cases, it's polite to try to withhold the name of the one who erred and just deal with the consequences, but in a small workplace that's not always possible.

learn to stop beating yourself up over the small stuff. there's plenty of big stuff in life to beat yourself up over!

I've learned when in doubt call the assess, notify, and document. I don't always do the right thing but I do make every effort to.

i'm not sure precisely what you mean. if you mean, do i always try to do the right thing, the answer is yes. if i know, or can figure out what the right thing is, and if it's possible, that's what i do. sometimes it's easy to do the right thing -- it's easy to see what the right thing is and easy to do it. sometimes it's easy to see what the right thing is, but not so easy to do it. i try to do it anyway. or at least, the least wrong thing. and sometimes, it's difficult or impossible to tell what the right thing is . . . but i try anyway.

if you mean do i ever make mistakes, the answer is yes. i've made some doozies. anyone who tells you they don't make mistakes is a liar.

you don't give any details about your situation, and i'm not going to second guess what you did or not do. i will say this: usually, the right thing is to talk to the person who made the mistake before (or instead of) talking to anyone else. sometimes, however, the patient care situation is such that the mistake needs to be passed on to the next shift so that they can continue to deal with the ramifications. in such cases, it's polite to try to withhold the name of the one who erred and just deal with the consequences, but in a small workplace that's not always possible.

learn to stop beating yourself up over the small stuff. there's plenty of big stuff in life to beat yourself up over!

great answer from the always awesome ruby vee!

the right thing can be colored by perspective - so, caution is called for in some instances. and hindsight is a punishing ***** - it is never wrong - even when i am. so, as much as possible - yes, i try to live in the land of the right thing. and when the "right" thing become murky - i try to chose the lesser of all the "wrongs".

as for other "right things" - as nurses we will always have to make choices. we have infinite demands on a finite system. i make exhaustive efforts to do the "right thing" and i am certain that i am in good company with that directive. critical thinking and clinical acumen comes at a price - and that price is that mistakes were likely made and lessons learned. the key is to always resolve to go forward - better today than yesterday, better tomorrow than today.

as for the right thing in interpersonal situations, i try and try to live by the golden rule - do unto others as you have done to you. before i act - i ask ---- these important questions:

* is my involvement necessary?

* do i have all the "facts"?

also, in any interaction - am i being true? am i choosing advocacy and professionalism? am i being kind?

we travel a rough road at times. sometimes, the map is impossible to read, the gps breaks, the compass shifts from true north and cloudy skies keep the sun and stars from assisting us - - - in short, at times you are on your own. i choose to make the trip with few regrets. it is tough out there. i think it is important to support others on the journey. being blessed with others "going your way" makes getting there possible. join in.

practice safe!

:angel: