HELP! Can you teach an "old" nurse new tricks?

JillR · Dec 12, 2000

Oh Cindy, I can relate. I am having similar problems with one of the RN's that just took a staff nursing position after her managerial job was taken away, in this facilites attemt to save money. I don't think you are going to be able to change her, but if she makes a mess of things and leaves it for you to figure out, the least she could do is put it back when she is done.

This would be a simple and reasonable request.

Good luck.

Jill

RNSue · Dec 12, 2000

CindyLou, I can relate to you AND the RN. I have been playing this game for 23 years and I remember when they started using the med carts, too. They were supposed to be wonderful. Before the carts, we used the Kardex, pill bottles, and little color coded cards on a big blue tray with slots for the cards and places for the plastic med cups. We went into the med room, closed the door and had complete silence and could completely concentrate on what we were doing.All of our supplies were right there. Mistakes were hardly ever made. Then came the cart. We were now out in the hall with patients calling out, co-workers and families interrupting, and all the noise of a busy floor in our ears. The med carts were never stocked right by the pharmacy so we had a choice of pushing it back to the nurse's station to call the pharmacy each time we found something missing or keeping a running list and ending up doing two med passes for every ONE. The individual packaging was a good idea but I didn't like the cart and still don't. We started using the carts when I had been a nurse for less than 3 years. The carts never ended up being the wonderful things they told us they would be. Real soon, they discovered that the individual liquids were too expensive. We couldn't keep the creams and eye drops in the drawers because they had to be exchanged out and the drawer dividers were too much trouble for the pharmacy. The carts never had everything you needed on them. I'm positive the RN you work with is afraid of making a med error by having to change the way she gives her meds. Once you get a "system" and it works for you, you tend to want to stick with it. She is, however being rude by not returning the cart to what it should be for your shift. That continually ticks me off when the prevoius shift doesn't clean and stock the cart. Have you established a rapport with this RN yet? Ask her for advice and get her to tell you some stories from her many years of experience. I'm sure she has many interesting things she could tell you. Ask her to please restore the cart to normal at the end of her shift. I once did private duty for a 93 year old nurse who graduated in 1929 and insisted that we, in addition to our med charting system, do it her way, too. It was hilarious! She had written down the names of all of her meds on a big yellow legal pad and when we gave her a pill, we had to make a mark in the four marks plus a slash equals five format. Each page lasted a month. She had pill bottles stashed all over her house, but knew where each one was. She was sharp as a tack and had been a friend of my grandparents, so I couldn't say much and just went along with it.You're just getting started in the game of nursing and in just a few years you will also experience a change that you wish you didn't have to go along with. The changes in nursing come fast and many, so be prepared. I hope this gives you some perspective, knowing the history of the med cart, and I wish you all the best in your career.

CindyLou · Dec 12, 2000

Thanks for your input. The way you described the Kardex, etc, is exactly the way we had been doing our meds. "The way it has been done for years." I have known this RN all my life and have looked up to her and always wanted to be an RN like her. I understand her fear of change but to be so against this and not even willing to give it a try is what I don't understand. Even after all of us discussing this. And those of us who have used med carts in other hospitals during clinicals, explaining the ease. I do get along with her, but this really upsets me. I never dreamed that she would be so hard headed about changes. As this is only one of the few. Such as unwilling to work with a new male grad RN when he is on the schedule as charge RN!

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Cindy Lou

hollykate · Dec 12, 2000

Hi CindyLou,

It seems that there is not a problem when she is giving meds- But it is a problem, when she doesn't put the stuff back together for the next shift.

I have worked with several nurses who refuse to follow hospital protocol, because, "I was taught differently 20 yrs ago". Things are changing quickly in the medical field and I imagine that nurse has seen a ton of changes very rapidly. AT any rate, she does not need to slow you up at the begining of your shift. If she can't put the cart back together at the end of her shift (Never used a med cart in my life!!! Pyxis.) she needs to learn to use it.

prmenrs, RN · Dec 12, 2000

I agree w/ everything that's been said so far, but I wonder if there isn't something else going on w/ her that's making it harder for her to change, such as a medical condition (menopause is obvious, but depression or medications she needs to take now that she didn't have to before!). Changes at home can be a factor, too. Divorce, kids leaving home, older parents requiring more care, or dying. When things are demanding at home or changing in our own bodies, it's harder to accomodate changes at work for us moldy oldies.

See if you can get her to talk about some of these things, and figure out what's going on.

Good Luck!!!

p.rabbit · Dec 13, 2000

Cindylou,

Aren't we all resistors of change somewhere in our lives? But, usually not in areas where peoples' lives are at risk. Your "old" nurse has some unspoken agenda; my question is, does it put the clientelle at risk and does it disrupt the overall flow of your unit. Caregivers work best, when they work harmoniously. This old gal, is causing some serious disharmony, that may at some point, cause harm to those under your care. You say she doesn't like to take orders from a young man who may be in charge. Maybe she won't go talk to him someday, when she needs a second opinion about a patient, and care is delayed.

You have a dangerous situation brewing here and it would be best to address these issues with your Nurse Manager. He or she is in that position to deal with problems such as these. Do not suffer in silence when lives are in the balance.

Good luck,

p.rabbit