New Grad on our floor continues to make mistakes

[swimmingfever00]

Hi let me preface by saying that I am not a perfect nurse and I don't proclaim to be one. I have been a tele nurse for two years now and made my fair share of mistakes. However, there is a colleague on my unit that works night shift and I work days. He frequently gives me report on patients and he's been a nurse for 10 months. In the past, he's left chest tubes clamped when the order was for intermittent suction, given patient's PRN medications for the wrong reasons (valium to help a patient sleep when it was for etoh withdrawal, doesn't check blood sugars or fill out paperwork for patients going to dialysis at change of shift). In his word's it's "day shifts problem".

This morning he told me in report that his patient had no output from the NG tube overnight, which was placed for gastric decompression to treat a small bowel obstruction. Okay he told the provider (good) and a routine CXR was ordered on day shift to determine proper placement of the tube. At bedside shift report I found that the suction was at the wrong setting (at 20 mmHg instead of 75mmHg) and the NG tube was clamped. He never unclamped it when the pt arrived on the floor from the ED 8 hours ago! Once the settings were adjusted correctly be me there was output. I told the nurse outside the room that he did not have it set up correctly, and he just shrugged and walked away. I told management and filed an incident report. The poor patient was having intense abdominal pain all night, which the patient felt relief once the NG tube was draining.

Management told me that he was a new nurse and this was a learning experience because he never had taken care of a pt with an NG tube before. Why didn't he ask another nurse to look at the setup if he was unsure? I know it's Nurse's Week and I'm trying to not be salty over this. Our unit empowers nurses, which I believe in as well. But the nurse holds no accountability for himself whatsoever and me and my colleagues are tired of his frequent mistakes and management defending him. When he doesn't seem to care at all. Management can't find anyone else dumb enough to be willing to care for 8 pts on nights, which is why I think he is still employed. Sorry I just had to vent. Happy Nurse's Week y'all!

[CalicoKitty, BSN, MSN, RN]

Sometimes with new nurses, when doing the hand-off, I like to do the assessments of stuff like NGT and chest tubes during the shift change. This way, I can teach the new nurse while checking to make sure things are done right. It really should be part of the hand-off, like double checking PCA pumps. But, really going through the motions can teach new nurses, hopefully, in a non-punitive way (though, sometimes it's hard to keep my what-was-going-through-your-head feelings to myself and off my facial expressions). I'd go crazy with 8 patients.

[swimmingfever00]

That is an excellent point and that is what my nurse manager suggested doing as well! Taking care of 8 patients itself is difficult and to be a new grad doesn't make it any easier. Some things are bound to be overlooked with that many patients. So I can't put all the blame on him.

[guest52816]

42 minutes ago, swimmingfever00 said:

Hi let me preface by saying that I am not a perfect nurse and I don't proclaim to be one. I have been a tele nurse for two years now and made my fair share of mistakes. However, there is a colleague on my unit that works night shift and I work days. He frequently gives me report on patients and he's been a nurse for 10 months. In the past, he's left chest tubes clamped when the order was for intermittent suction, given patient's PRN medications for the wrong reasons (valium to help a patient sleep when it was for etoh withdrawal, doesn't check blood sugars or fill out paperwork for patients going to dialysis at change of shift). In his word's it's "day shifts problem".

This morning he told me in report that his patient had no output from the NG tube overnight, which was placed for gastric decompression to treat a small bowel obstruction. Okay he told the provider (good) and a routine CXR was ordered on day shift to determine proper placement of the tube. At bedside shift report I found that the suction was at the wrong setting (at 20 mmHg instead of 75mmHg) and the NG tube was clamped. He never unclamped it when the pt arrived on the floor from the ED 8 hours ago! Once the settings were adjusted correctly be me there was output. I told the nurse outside the room that he did not have it set up correctly, and he just shrugged and walked away. I told management and filed an incident report. The poor patient was having intense abdominal pain all night, which the patient felt relief once the NG tube was draining.

Management told me that he was a new nurse and this was a learning experience because he never had taken care of a pt with an NG tube before. Why didn't he ask another nurse to look at the setup if he was unsure? I know it's Nurse's Week and I'm trying to not be salty over this. Our unit empowers nurses, which I believe in as well. But the nurse holds no accountability for himself whatsoever and me and my colleagues are tired of his frequent mistakes and management defending him. When he doesn't seem to care at all. Management can't find anyone else dumb enough to be willing to care for 8 pts on nights, which is why I think he is still employed. Sorry I just had to vent. Happy Nurse's Week y'all!

Feel free to vent, anytime. That is why we are here!

I think the poster who responded immediately after your original post offered great advice.

Although, with eight patients, doing bedside report in this manner will take forever.

But in the long run, it may benefit you, and the new nurse.