I'm doing my preceptorship for RN on a medical-surgical floor. I've learned so much it's amazing, I have a great preceptor.
But, so many things I've seen the other nurses do are so far from what I've been taught.
The first thing my preceptor taught me is not to believe what the other nurses are charting in their assessments. I thought this was to get me to think for myself and really look at the patient, but I found out that a lot of these assessments are NOT ACCURATE in the least. Not even minor things that can change from day to day, but major, hard-to-miss things that I'm shocked an RN would miss.
THis may seem nit-picking, but:
1. A patient had his IV d/c'd once he was placed on hospice, but some nurses were charting that it was still in days after it was taken out.
2. Another patient had a foley d/c'd, but according to some nurses, had it for days after it was taken out. I received report from a nurse who told me it was in two days after it was d/c'd.
Now, I know it's not a life-threatening situation, but aren't these assessments legal documents?
Some more things I've found:
1. A confused patient was often wandering to other units, his nurse wrote "I belong to ****" on a big piece of tape and taped it to the front of his gown. This was last Thursday. Yesterday, this patient was still wearing the same gown, with the same piece of tape announcing to the world that he was mentally incompentent and being treated like a piece of property.
I wanted to do something, but I'm a student, and am not received well when I have a new idea or want to change something.
2. From what I've seen, patients don't get turned q2 hours, bathed every day, ambulated, or other basic nursing care.
The nurse/patient ratio is 1:6. The tech/patient ratio is 1:13-18+. The patients are often complex, and need a lot of care, but it seems like the level of care is very poor.
Does this shock anyone, or is this pretty much status quo for a med-surg unit?