Need Advice Regarding an Incompetent Nurse

[littleroxy79]

i don't understand why the bad nurses still have jobs. i work with this one nurse who is pretty much incompetent. she has been a nurse for a long time, but she can't seem to get basic nursing down. she asks questions that a new RN would ask. she gets offended when she's wrong and you tell her she's wrong. last night i worked with her and i was verifying her insulin. first, she came up to me and just flashed her syringe in my face. i saw that it wasn't the correct dose and i said it wasn't the 2 units she said it was. she huffed and stormed away. i told her she could get someone else to verify it because it was wrong. this was after i had verified 2 other things with her and one of the other 2 was wrong also. she said i was inappropriate because i told her it was wrong in front of her peers and a doctor. what did i say? her whole attitude and the way she talks to her co-workers and patients are rude. she has had many complaints on her, but nothing has really happened. she got mad at another nurse because she lost a pain med and had to take a urine test. of course security was called and pharmacy was notified, but she blamed it on the charge nurse. the only thing she has happen to her is that she had to talk with the nurse over critical care. these patients we take care of are critical patients. i worry that they are not cared for, but i can't take care of her patients and my own. it's just irritating...does anyone else have this problem? or is just me and our unit?

[onarie]

First, I'm sorry that you are having to work with a nurse that you are so uncomfortable with. I am a new ANM on my floor and am learning some of the whys that you are asking. What I have learned so far is that if a nurse has been someplace for an extended period of time, it is going to take lots of documentation and proof that things need to be changed. If the things you mentioned are only being talked about among the staff, there really is not anything your nurse manager can do regarding the nurse. What would help your nurse manager is for you, and the other staff that you work with, to document (and turn in) the concerns and complaints that you have with this co-worker. Medication error is a huge concern and you need to make sure that the nurse manager is aware of the situation. I have already been put in the position of having to document, almost daily, the concerns that I have had about a particular staff member. The documentation needs to have specifics in it - including patient's names, room numbers, medications that were involved, times and dates - that sort of information.

I hope this sheds some light on the situation for you. Please talk with your nurse manager about the situation and see what she/he needs from you to help take care of the situation.

[littleroxy79]

the sad thing is that she has ALOT of write ups. but it seems like nothing is done. it's not like she has been just working there a year. it's been 3 years. you would think she had her organization skills down. she's always running around like a chicken with her head cut off. she says rude things to us like we are lazy and we don't do anything because we're sitting down. but, we are done with our stuff. we have tried to help her, but she gets an attitude when we help her, so it's like we don't even want to help her. it's a losing battle.

[TazziRN, RN]

Document, document, document!!! You were right to refuse to verify the wrong dosage, keep that up. As for the write-ups and them not going anywhere, you can go higher up the chain in the interest of pt safety.

[littleroxy79]

she has been reprimanded by the head of critical care, but i don't know what the outcome has been because she's still here. she made a comment to us that she has a stack of paperwork on her. i just don't know what to do, but document. i love where i work and i love my coworkers but when she works, she just makes the whole unit crazy.

[anne74]

Maybe she has untreated ADD? There was a nurse like that on my former unit. And as for the rudeness, she's probably aware that she's not a solid nurse and she's not very happy with herself - therefore she projects it onto others.

I wonder if your manager could have a talk with her to find out why she's having all this trouble after 3 yrs. Maybe it is ADD?

[CHATSDALE]

bad situation but you can't let it slide

as mentioned you must document, personally hand them to nm, keep copies

when something is wrong let her know that you don't agree with her and why

be very careful about signing behind her or checking anything that you can be held responsible

the real problem is that when she goes, they will let her resign and she will go somewhere else and be some other pts problem

[littleroxy79]

sometimes i think it's ADD or she's crazy. she just laughs randomly at nothing. i think sometimes she does things or says things just for someone to say something so she can get defensive. she is the only person like this. i have never met anyone else in my life like her. everywhere i go when i get pulled to another floor, they know her too. she acts like that everywhere she goes.

[TazziRN, RN]

If the nurses on the shift all get together , you can do an intervention with her and the NM and HR. "We are very concerned about her behavior and practices and we will no longer verify for her" etc.

[littleroxy79]

yea, i'll try that

[ICURNinIL]

I totally agree with Tazzi, document EVERYTHING. We have some of the same issues at work with a few people. We actually fired one that had worked there for 18 years after making up accu checks and documenting meds that she really didn't give.

Make sure NOT to cosign or witness meds with her unless you observe her wasting and actually GIVING the amount that she documented she gave!

I've worked with RN's that were my night charge gals who have actually injected themselves with their patients drugs. I've worked agency before where another agency RN was stealing narcs from the Pixis after looking at staff members ID's and passwords, then removing drugs under the staff member's ID. They had to put a "nannycam" in the med room to catch her, but she was caught on tape and busted.

It's amazing that people are like that and you have to document to try and get them removed from caring for patients, but it's the patient's that potentially are suffering, so it must be done!!

[Daytonite, BSN, RN]

You need to document these things that you have personal knowledge of that she does with you no matter how insignificant they may seem. The written evidence will all add up in her personnel file. A quick little write up of "xxx came to me to double check the insulin she had drawn up to give patient, xxx. The dose should have been ___. She had ___ in the syringe." When she gets mad about something I would add "She became angry, raised her voice, and became rude with me over this." Date, sign it and give it to the manager. I'd probably keep copies for myself just in case some blow up does occur and the powers start pointing fingers at the staff and blaming you guys for not reporting her. I would also tell her to cut the attitude or quit bothering me. And, if she keeps up that kind of behavior I'd probably tell her that I was writing her up as well. After all, you are doing her a favor by verifying her work and there's no reason for her to behave that way to you. Eventually, she's going to make a big error and all these little documentations are going to add up to "Here's the door. Bye." There must be some reason that management hasn't booted her sorry butt out the door yet. I'd hate to think that it was because they didn't care. More likely it's because they don't have any proof of what she does. They can't see what goes on with her from minute to minute like you do--so, help them out and document.

It wasn't critical care, but I was working in a nursing home where an RN who worked on my days off wasn't giving medications, was making up blood sugar results and disappearing for long periods of time during the night. I was on the DON about this all the time. When nothing was done at first, I started collecting and documenting evidence. I started counting pills and copying down the blood sugar results stored in the glucometer and giving this information to the DON. Finally, she had the pharmacy services come in before and after a shift this idiot was to work and totally inventory the medicine cart she would be using that night. Lo and behold! She had barely given one medication and had made up all the glucometer readings! They still didn't fire her. I stormed into the DONs office and told her I was reporting this chick to the state board of nursing. The nurse never showed up for her next work shift after the DON told her about the pharmacy audit of her medicine cart. She was gone. I still reported her to the BON because I didn't think the DON was going to do it.