New Grad- What did I just get myself into?

[newRNnc]

Just started at a SNF and today we got to shadow another nurse for about an hour. In that hour, I saw the nurse draw blood without gloves, give 3 injections without gloves, administer a higher dose of one of those injections than was ordered because "she felt like the patient needed it", check blood sugars without gloves, and not once wash/sanitize her hands in between patients. I am a brand new RN and want to learn as much as I can, but the safe and correct way! Can I please have your opinions on what to do with what I witnessed today and moving forward!? What I saw today really scares me!

[RainRN1, ASN, RN]

That's not appropriate and an med error needs to be completed along with md and family notification!!!!! Complete crap. I have worked in ltc/snf'S for 18 years you wear gloves and you administer the correct dose of medication. That is resident abuse especially if it was a psychotropic medication that's a chemical restraint at the very least. If she did that in front of u imagine what she does on her own. Please if you don't report her, stop her the next time you see it. Your just as guilty if you don't report. Sorry but it's nurses like her who make those facilities scary and we r definitely not all like that. Nurses are responsible for lives not machines no matter what field we r in.

[IceDancer]

You just witnessed bad practice, in multiple obvious ways. As an orientee you need to discuss this with whomever is managing your orientation, it is perfectly acceptable to say in private, " I was orienting with so and so and noticed blah blah blah, that seems contrary to facility policy, can you clarify?". If I actually worked there in a regular capacity (off orientation) and witnessed it, I would write up an incident report as well as have a discussion with my supervisor about it.

[purplegal]

You should have a discussion with your supervisor about it. While bad practice, I'm not sure how they would address not wearing gloves. However, changing the dose of an injection is a serious med error and for sure requires corrective action.

I would also ask to shadow a different nurse. Everyone has to find a way to manage their time, but some shortcuts are not forgivable. Also, no nurse has the authority to change a dose on their own because of his or her own judgment. If that nurse truly felt like the patient needed a different dose, she should have contacted the doctor, given her reasons, and taken an order before doing anything like that.

[strawberryluv, BSN, RN]

That is not right. I am a charge nurse in a LTC floor and I do it right. Injections with gloves. Hand sanitizer in between giving meds from a medicine cup. Blood sugar checks with hand sanitizer pumps in between patients. I think I would definitely report everything to your supervisor because she is promoting infections and harm to patients by her poor use of judgment and infection control practices.