What are the huge "DO NOT EVER DO" things that new nurses need to know about? calling - page 4
I am graduating in a few days, and off to be a new registered nurse. I would love to hear from experienced nurses about the "BIG" things that they need to remember or the things they try to avoid.... Read More
May 8, '07Never allow a co-worker or doctor to treat you as anything less than a professional. Never allow a doctor to demean you. Not only is it hard on you but you are just setting up the next nurse the doc gets peved with to be treated badly.
Remember that docs (some) only treat nurses badly becuase nurses have been tolerating it.
May 8, '07Quote from ponytailman-Good advice also never falsify a report or take meds from someone else's medication slot if you do not have any.Never document that you gave a pill or did a dressing change knowing that you didn't. Never call or talk to the MD without being prepared or having the information in front of you. And never assume something was done, afterall when you assume it often makes an ass out of u and me.
-Never talk about your patients in the cafeteria or elevator (just because you do not use a name does not necessarily mean you are not in violation of HIPPAA). If someone can tell who you are talking about then you are in Violation and can be fired. ALWAYS think HIPPAA before giving answers to friends or family of a patient about their condition as well.
May 8, '07For peds nurses, never dismiss what the parents are telling you about their child.
Most moms and dads, especially those of chronic kiddos, know their child's routine better than you do. Remember, they take care of their child 365 days a year and you've known the kiddo for a few hours. If they say that a behavior is abnormal or their child "doesn't look right", follow up with more specific questions. It might be nothing, but it could be that they're picking up on their child's deterioration earlier than you ever would.
If your order doesn't jive with what they do at home and they're questioning you, take the time to investigate. Page the MD to get orders changed if necessary.
May 8, '07The golden rule always applies. NEVER ask someone to do a task that you can do yourself. Never treat another person/pt/staff member/doctor any way that you would not want to be treated yourself.
May 8, '07Say thank you at least hourly, and I'm sorry at least daily.
If you are angry with someone, do what they ask anyway if it doesn't affect patient care, then address the issue later when the smoke has cleared. (This has saved my job a few times).
IV push is the most dangerous way to give a med, don't do it if you are at all unsure. Call the pharmacy, talk with another nurse, call the doc, and make it a group effort.
May 8, '07Quote from pmfb-rn[font="comic sans ms"]i beg to differ with you. i doubt very much that the only reason anyone treats nurses badly is that the nurses have been tolerating it. if the person didn't have the tendency to treat nurses badly, he wouldn't know whether or not they would tolerate it!remember that docs (some) only treat nurses badly becuase nurses have been tolerating it.
May 8, '07I am a new grad in the ER and I have learned (the hard way) to always have all of your pt information and facts togeather before approaching a doctor for a medication order. They are not just going to write you an order without information so be prepared to answer their questions.
May 8, '07Don't be unfriendly to anyone on your new unit. I've noticed that some of our new people get chummy with their preceptors and the most experienced nurses and are downright rude to other less experienced folks. You never know who'll help you when you're in a bind and you don't want to alienate anyone.
If you need help, ASK! Don't get overwhelmed alone.
May 8, '071. Be polite and respectful to EVERYONE on the unit. Remember, you are the newbie. Everyone on the unit has an important job to do. Introduce yourself to everyone. Say please and thank you.
2. Check and double check your medications and orders.
3. Always make sure your patient is ok. Check your patients right after report, and frequently throughout the day.
4.Be a patient advocate. Speak up for them, act as if they are your family member. You are caring for the sick, weak and vulnerable. You are their voice.
5. Ask questions, don't be afraid. Don't ever think you know it all, because every day is a learning experience even for nurses with 20 years under their belt.
6. A sense of humor goes a long way.
7. Be honest and truthful. Be reliable. Once you get a bad reputation it is very hard to turn it around.
8. Try not to gossip. Hospitals are the worst gossip mills.
9. If an experienced nurse offers her help, advice, tricks, etc. always listen carefully and thank the nurse for her time. Even if you don't follow the advice, or accept the help, consider it for the future. Don't say "i know i know" or come off like a know it all.
10. Get enough sleep before your shift, eat a nutritious meal and be at work on time and ready to work. Make sure you take breaks and plan fun things to do on your days off.
That's all I can think of now, you have gotten a lot of good advice here. Good luck!Last edit by Agent99 on May 8, '07
May 8, '07If I see a vital sign that is bad enough that I have to call a doctor or give a special PRN med for (like for a high blood pressure) I ALWAYS double check it myself. Even if it's a temp. Many times I rechecked it and it was normal... or it was way worse by the time I was told of the vital sign and when I get to the room. Especially for blood pressures. A lot of times the CNA's are taking so many and they might not have the right cuff size. Find a good cuff size to fit and recheck it yourself... manually. Sometimes those machine vital sign takers aren't corrent. Many times it has said something like 60/30 and you check it manually and it's 100/60, for example. I swear once I got the vital sign sheet back from the CNA and almost everyone had a fever. Something is wrong here. Even though she told me she double checked with a seperate thermometer. I rechecked and only one had a fever. Remember if they were drinking something hot or cold it will effect an oral temperature. Many times the O2 sat monitor won't pick up a patient's true O2 sat. You'll get 60% and the patient says they are fine. Try the other hand, different fingers, give it some time. If you really think the patient is OK and all else fails you can try to see if respiratory therapy has some other kind of o2 sat detector, like that goes over the head or an ear. Or you'll have to call the MD for an ABG to see what their O2 sat is.
Remember if a patient doesn't look right to you, as a new graduate you should ask another nurse to look at the patient for you if you are unsure. We call ICU sometimes to look at patients for us when we're not sure. If a patient is going downhill and the doctor is only giving you crap orders, call him again. First ask the supervisor to look at the patient or an ICU nurse and tell the MD that the patient has been assessed by so and so and feel that this patient needs to be transfered to ICU or whatever. Remind him again of the assessment findings. I think every nurse has been in a situation where the doctor isn't understanding the severity of a patient's condition. Of course, if the patient is DNR or on comfort measures only, then it may affect the aggresiveness of the treatment so keep that in mind. I've had a doctor just order morphine to keep a DNR patient comfortable as it was clear he was dying. It was appropriate for that situation. Be sure to call family when a patient's status is going downhill. I always call the doctor first though, so I know what to tell the family about what is happening.
May 8, '07As an LVN Intern I have already come across errors the nurses are making @ the facility.So just for FYI... if you have a med. cart and keys to it... never leave them anywhere except in your OWN pocket, or somewhere you will NOT LOOSE them... seems simple enough, but trust me... errors happen to the best of us. Also, if a patient has dyspahgia, why crush K+/ Order liquid... duh! And if a treatemtn needs done, i.e. dressing change, no shortcuts... dont just apply gauze and lots of tape... take the time to do it correctly... geriatric patients have thin, thin skin... a lot of tape coming off will make more abrasions which could lead to more wounds, more dressings, making the patient more uncomfortable. Above all... patient PRIVACY no matter if it's a simple medication w a glass of water or an insulin injection... how would you feel in that patients shoes if your nurse is in too much of a hurry... youd feel like a number rather than a human being...
Of course, this is why I plan to get my RN and BSN... Im more fit for supervisor positions ... very meticulous and I put myself on the other end... Hopefully these tid bits help a lil'.
May 8, '07[QUOTE=HeartJulz; Also, if a patient has dyspahgia, why crush K+/ Order liquid... duh! ]
If a patient has dysphagia, why are you giving thin liquids??
They are the hardest to swallow, and the most likely to be aspirated.
Have Speech Therapy eval the patient's swallowing. Ours will start a pt. out with thick liquid or applesauce consistency before advancing to thin liquids.