Worried that experienced nurse may know nothing

Nurses General Nursing

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We have hired a nurse with 10 yrs experience where I work. I orientated her last week (atleast I tried too). During my first med pass all she did was sit at the nurses station and read a book. She kept disappearing and such. I went to her and said, "don't you want to come with me on these rounds so that you can learn who the kids are and about their meds and such and what you can and can not do?" She said, "nah, I'll do it second med pass." :nono: Well during second med pass I caught her on several med errors (now keep in mind, I've only been a nurse 3 months) that involved seriously needed meds. (Seizure)(Narcotic) Well, I found out last night that when she trained with another nurse the night before she did the same thing. Well, tonight she is back and she's on her own. We (the other nurse) are freaking scared to death for our kids. Her comment was "I've been doing this for 10 yrs!" In my opinion, "WHO FREAKING CARES!!!! " She don't know these kids. She's never worked with kids that can go from stable to 'DEAD' in the blink of an eye. No one will be able to watch her tonight. What if she forgets their sz meds again? There are sooooo many things that can go wrong in a heartbeat. I've been there 3 months and I still worry something will happen with my kiddos. Are we justified in being concerned? :uhoh21:

Tell me about it...I hate orientating. I don't even know what I'm doing half the time..

Wow. I thought that you were just a new nurse to that facility, not a new grad. You are orienting with 3 months of nursing experience? Wow. Just wow. Imagine the census of your facility if that info had to be posted for families to read. :crying2:

Specializes in Med-Surg, Trauma, Ortho, Neuro, Cardiac.

Definately sounds like a management problem.

Also you lack of experience in precepting shows. Not that it's a bad thing, becasue heck, you only have 3 months in yourself.

An experienced preceptor such as myself would not have given her a choice. "Put that book down and follow me....NOW. This is what you're going to do, and this is how we do it."

If your management is going to put in the position of precepting new hires, then you've got to get the balls to be firm when you need to be. This is an acquired skill and I am in no need criticizing you at all because you've only three month in and really shouldn't be precepting new hires, especially those with experience.

Absolutely bump it up the chain of command, with documented instances of what went on. She's tying a noose around her own neck and probably won't be there long. Let's hope she does no harm.

Specializes in Obstetrics, M/S, Psych.

EastTXLVN

OK...pretty clear it appears she is not up to snuff, but it also seems this place has more problems than this nurse. This is nothing against you or your ability at all, but the facility should not be putting a 3 mo. nurse in the position of orienting. Understandably you do not and should not be expected to know what you are doing alot of the time, as you are still new to nursing. Unfortunately, their practices leave something to be desired on a few different levels. Is it difficult to keep this place staffed with nurses?

Specializes in Psych.

I've heard it and I've seen it over and over again and I still can't believe it. So MANY people (nurses and others) come to WORK and spend time ON THE CLOCK, not break time, making personal phone calls, reading leisure material, doing jigsaw puzzles. I just don't get it. You are being paid TO WORK, not to play. I just can't understand it. Don't they have any pride or even shame. Clean something, spend some time w/a patient, research a diagnosis or a medication. I am flabbergasted by this behavior. Anyone else?

One question: did you make a few mistakes when you started this job?? Many people do. Could it be that you are overly concerned with this issue? I just can't help but note the title of your thread here, and how exaggerated it is.

Your feelings and fears have little to do with this. Document mistakes when you find them (if you find any more) and trust your manager to deal with things.

I can't help but feel this may be a case of a new nurse eating an experienced nurse..

JMHO.

Right now we only know one side of the story. If the nurse is this complacent and has still managed to be a nurse for 10 yrs. it's a miracle, to say the least.

It also baffles my mind that a new LPN is orientating an experienced RN. I could understand if the LPN was very experienced on the unit and was orientating the new RN...but if what the OP tells us is accurate I think the supervisors are terribly incompetent and I am concerned for the safety of the children.

This whole scenario seems like a bad scene.

You're doing the right thing.

30 years ago I worked in a nursing home where one of the 3-11 nurses gave all her medications at one med pass and that was around the dinner time. She then sat back and made personal phone calls until the end of the shift. She would scold the aides if they came to her with a patient problem. If she had to give a PRN med she took her time and gave the patient a lot of attitude. The rest of us nurses heard about this time and again from the aides who were looking for someone to do something about this. The DON told us that since this nurse was black and had been working there for more than 7 years there was no way she could get her out of there without the fear of her filing a lawsuit for discrimination. What a bunch of silliness, I thought. This kind of thing just pushed me on to get into positions of authority and learn how to clear deadwood like this out of nursing. You can't be timid about these things. It is a time when you have to be courageous, stand your ground and fight.

I have been hopeful that most of this deadwood has been cleared out of the profession, but it always upsets me to hear it happen. It is so much harder to collect evidence on them when they are working on their own, so you people who are precepting them have a great responsibility. It seems like these lazy nincompoops show up in LTC and residential care facilites a lot more than in the acute hospitals. I think that part of the reason is because there just are not as many staff around as there is in an acute hospital to observe and review what a person is doing. It is so easy to be lazy and get away with just what this nurse is trying to do in LTC. And, the thing of it is that these nincompoops usually have some intelligence. It takes some intelligence and thought to figure out how to get around rules and policies. This lady, however, seems particularly stupid to show her colors to you guys who are orienting her. This obvious defiance makes her all the more dangerous. Doesn't it just make your head reel?

Well, I've said my peace. I've gone back to nursing homes a number of times over my career and feel like I did my part to run off nurses like this, but it takes a lot out you. As I said, the work involved in caring for the patients tires you enough without the added burden of dealing with nurses like this. Whatever you and your co-worker can do to get this lady out of your facility will be a great service to patients every where and to the public.

Remember to put things in writing and save them. Reason: if management doesn't do anything about this lady, you'll have some documentation to sent off with a complaint to the BON. (It's sad, but you have to think that way. It also requires courage to stand up to management if they don't do their part. Somehow, I think you have the right stuff in you to carry this through.)

Keep us updated, won't you?

Ok, I read your post & what stands out in my mind most is the fact that the DON said that since the nurse had been there for 7 years & was black, there was no way to get her out without the nurse filing a lawsuit. THIS DRIVES ME INSANE! I worked at a facility where there was one African American lady who had attitude, treated the clients like you-know-what (yelling at them, using profanity when yelling at them), being punitive with the clients, etc. This supervisor said the same thing about the employee pulling the race card if they tried to terminate her. What about write-ups for behavior, what about documenting behavior such as this. By doing this, there is a paper trail & when the time comes for termination, the documentation is backup.

Unfortunately I shared precepting duties with another RN involving an experienced nurse. This nurse was older than both of us, I think that was an issue with that orientee. She hadn't been on a unit for years, stated that she could not afford the refresher course for RNs, yes she was in bad need of it. She had already spent weeks orientating on day shift prior to starting orientation on days. She had also tried to orientate initially in a speciality area prior to coming to our unit, three had been an issue in this other area involving medication administration, I only heard her side of the story. The sad fact was that this woman had a lot of personal issues going on, near the end I wondered if she kept telling me about her issues to gain my sympathy because she knew she was skating on thin ice. She never asked questions, she didn't know how to prioritize, she made medication errors. She would start things and for some inexplicable reason she would stop and go to another patient and start on something else. Twice I caught her doing this and her response when asked "Why didn't you finish this?" was "I was going to you didn't give me a chance." I talked with her about finishing one thing first before going on to another, mistakes get made when trying to do more than 1 thing at once, it just didn't register. She would call for orders for something like a PCA for a patient and then take 4hrs to start it, despite being asked numerous times whether it was started. With another nurse who had her for the night once, she called after midnight to have IVP analgesic changed on a patient to PO and then later gave that pt the analgesic IVP, no one knew why she felt this person's analgesic needed to be changed to PO, she also gave a patient the wrong insulin in the morning on this shift. In both the PCA and PO analgesic incidents she never discussed with her assigned preceptor about changing these patients medications prior to calling the doctor. I guess she felt she shouldn't have to. We follow an insulin protocol for our diabetes. At HS we only give insulin if blood glucose is over 240, the work sheet we use to record on this sheet includes this information. I made a point of showing this to her and suggesting that she read it prior to giving any insulin. The other nurse precepting this woman stopped her on 2 separate occasions from giving insulin twice to the wrong patient. Both of us orientating this person tried to keep a close eye on her. On her last night with me, she told she had given a person with and NG all of his meds mixed together through his NG, now you do not mix meds when administering through an NG you give each one separate followed by a flush :smackingf . This same patient had feedings scheduled throughout the night and was also on our insulin protocol, according to his HS blood glucose she shouldn't have given him insulin, but she did. Although it was a small dose and would not have harmed the patient, I still notified the doctor and filled out an incident report. I also had a talk with our UM. Thank God she was let go. As bad as I felt for this woman, because yes she needed a job, she should not have been there.

EastTXLVN, keep an eye on this one and document, document, document. Have witnesses to events write their version if possible. If other nurses see this behavior, get on their case to document. Many a complacent nurse has kept their jobs because no one wants to be the bad guy.

Specializes in peds, peds ICU, OB, Cath Lab,home health.
We have hired a nurse with 10 yrs experience where I work. I orientated her last week (atleast I tried too). During my first med pass all she did was sit at the nurses station and read a book. She kept disappearing and such. I went to her and said, "don't you want to come with me on these rounds so that you can learn who the kids are and about their meds and such and what you can and can not do?" She said, "nah, I'll do it second med pass." :nono: Well during second med pass I caught her on several med errors (now keep in mind, I've only been a nurse 3 months) that involved seriously needed meds. (Seizure)(Narcotic) Well, I found out last night that when she trained with another nurse the night before she did the same thing. Well, tonight she is back and she's on her own. We (the other nurse) are freaking scared to death for our kids. Her comment was "I've been doing this for 10 yrs!" In my opinion, "WHO FREAKING CARES!!!! " She don't know these kids. She's never worked with kids that can go from stable to 'DEAD' in the blink of an eye. No one will be able to watch her tonight. What if she forgets their sz meds again? There are sooooo many things that can go wrong in a heartbeat. I've been there 3 months and I still worry something will happen with my kiddos. Are we justified in being concerned? :uhoh21:

Absolutely without a doubt speak with the nurse manager about this! Obviously there needs to be some sort of preceptor program, or much better documentation of new hire orientees - children are too precious and can't exactly fend for themselves. Everyone can make errors, but the ATTITUDE of this "pediatric" nurse seems suspicious...

One question: did you make a few mistakes when you started this job?? Many people do. Could it be that you are overly concerned with this issue? I just can't help but note the title of your thread here, and how exaggerated it is.

Your feelings and fears have little to do with this. Document mistakes when you find them (if you find any more) and trust your manager to deal with things.

I can't help but feel this may be a case of a new nurse eating an experienced nurse..

JMHO.

Oh, come come, mattsmom...we all know that never happens! It's always the "older nurses" who are to blame for everything!

(Thanks, because I was thinking the same thing. Here we go again with another thread about ratting out a fellow nurse. I said it before, I am starting to be afraid of the new nurses out there...seems like there's a bounty on bagging older nurses.)

Oh, come come, mattsmom...we all know that never happens! It's always the "older nurses" who are to blame for everything!

(Thanks, because I was thinking the same thing. Here we go again with another thread about ratting out a fellow nurse. I said it before, I am starting to be afraid of the new nurses out there...seems like there's a bounty on bagging older nurses.)

Actually I always have considered the more experienced nurses a valuable resource, especially when I started nursing. No bounties at my place for bagging older nurses.

One question: did you make a few mistakes when you started this job??

Kind of wondering about the attitude the OP has, also.

Maybe instead of labeling the new nurse "psycho-nurse out to kill the kids", you could try giving her tips, methods you use in med pass that makes it go smoother and error-free.

I don't think you're giving her a chance, JMO.

Right now we only know one side of the story. If the nurse is this complacent and has still managed to be a nurse for 10 yrs. it's a miracle, to say the least.

It also baffles my mind that a new LPN is orientating an experienced RN. I could understand if the LPN was very experienced on the unit and was orientating the new RN...but if what the OP tells us is accurate I think the supervisors are terribly incompetent and I am concerned for the safety of the children.

This whole scenario seems like a bad scene.

Well, I do know the unit like the back of my hand. I've had the same kids almost the whole time i've been there.That's the only reason they wanted her to follow me i'm sure.

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