Has anyone ever worked with a nurse who seemed as if they never went to nursing school? There's this nurse whose abilities I always question (and he's been working at this LTC facility for a little more than 3 years now). He has common sense and tests really well, but severely lacks basic clinical knowledge. This year alone:
1) He was pre-filling regular insulin and administering it regardless of the FS reading (Ex: giving 4 units to a patient who really needed "2" or "8"). I explained to him how insulin works and why his practice was dangerous and he DID change it. However, he was really, really surprised that the difference between "2" and "8" units could be dangerous because they were "small increments".
2) He needed my assistance with a clinical problem. He asked if orthostatic hypotension - yes, HYPOtension - was a rise or drop in B/P.
3) He was giving IM vaccinations (hep A/B) using insulin syringes. He knew his landmark sites for IM and SQ, but didn't understand that the length of the hypodermic needle mattered.
When I was an aide in the hospital, I worked once with an a RN who obtained a sample for a fecal occult blood test (the kind where you wipe the stool on the boxes inside of the card... see pic), and she wiped the stool on the front of the sample card and put it in the bag like that to be sent to lab.
Hand to God, she never even opened the card, just smeared a glob of poop on the front of it, labeled the bag and handed the bag to me to deliver it to the lab. Of course, the inside of the bag became all smeared, too. I politely explained to her that the lab techs would murder me if I brought this to them.
Working in LTC with a nurse who was an IEN (internationally educated nurse). She was an ICU nurse. I had to explain to her why we need to assess dressings at least every 3 days.
"But the dressing is intact," She says.
Yes, but have you seen the skin underneath that dressing lately? No. It's now been 5 days. We need to assess, I said.
She continued to argue that it wasn't necessary, that dressings can stay in place if they are intact. One example of many that baffled us. Using white out on the MAR was another.
Not sure how her patients fared in the ICU given her nursing skills. Scary.
I once had a nurse come up to me to ask a question about a surgical procedure (Cysto) with a B & O suppository in a little souffle cup in her hand. I asked her if she was going to use a glove. "No, (eye roll) I'm going to hand him this cup" I never asked if she planned to let him give the suppository to himself or have him take it with a sip of water.
Has anyone ever worked with a nurse who seemed as if they never went to nursing school? There's this nurse whose abilities I always question (and he's been working at this LTC facility for a little more than 3 years now). He has common sense and tests really well, but severely lacks basic clinical knowledge. This year alone:
1) He was pre-filling regular insulin and administering it regardless of the FS reading (Ex: giving 4 units to a patient who really needed "2" or "8"). I explained to him how insulin works and why his practice was dangerous and he DID change it. However, he was really, really surprised that the difference between "2" and "8" units could be dangerous because they were "small increments".
2) He needed my assistance with a clinical problem. He asked if orthostatic hypotension - yes, HYPOtension - was a rise or drop in B/P.
3) He was giving IM vaccinations (hep A/B) using insulin syringes. He knew his landmark sites for IM and SQ, but didn't understand that the length of the hypodermic needle mattered.
Has anyone ever worked with similar nurses?
I don't think that qualifies him having common sense or sense at all really... Seems pretty darn dangerous to be working with human lives if you ask me.
On a lighter note, I saw on one of our nursing handoff sheets tonight that he nurse wrote in the diagnoses space "end STEMI" get it? "N" STEMI? I chuckled a little bit.
Some of it may just be the person finding the right nitch. I started my career at a smallish community hospital.
I had done most of my clinicals at a large teaching hospital. I was an absolute BOOB the 3 mos I worked out in the sticks. I trained in a primary care program- I was working in a team approach. No residents, few specialists- just one FP PCP after another with absolutely no standard protocals. It's amazing how the drugs, protocals, equipment change in just 30 miles- you would think I moved to a new country. The more I got lost in the stuff I didn't understand, the more the stuff I did know fled from my mind. I swear there were times I could barely find my way home after an 8hr shift. I went back to the hospital where I did my clinical training, and it was like I really knew what I was doing. I can imagine they are still talking about me at that community hospital- that was 30 years ago..
O yes, I think we all have come across those individuals we had a "o my" moment to. In any field we have those more competent than others in their field. Physicians, judges, lawyers, teachers etc. The problem of being incompetent when you work in the medical field, however,is patient safety that could cost patients their lives obviously. One thing is helping out a fellow nurse learn something minor, and another is to continue to stand by and watch a serious medication error almost occur had you not been there. Our profession needs to change "the blame game" mentality, so that nurses like the one you work with feels he can ask for more training if he needs it from a supvsr, to enable him to become a better nurse. IF he wont? and you do not report the incompetence you have witnessed, you will be just as guilty of possibly causing a patient serious harm and or death. My advice is to help him out and let someone in charge know whats going on. Even if he doesnt think so, that is the best way to help him AND the patient.
newboy, I'm going to go in a different direction with this: are you certain this person is REALLY a licensed nurse? I'm asking because it's not unheard-of for someone to obtain a nursing job, do some serious damage, and then be discovered as a fraud later.
Someone posted here only a few months' back about an agency nurse who just could not have been a nurse (stories not unlike what's posted here). The agency wasn't known to be terribly detailed in its vetting/hiring practices, so......an imposter with a good tongue game can (and did, and does) get past agency administration.
Look up this person's license online, verify that they HAVE one. Not kidding.
I once had a nurse come up to me to ask a question about a surgical procedure (Cysto) with a B & O suppository in a little souffle cup in her hand. I asked her if she was going to use a glove. "No, (eye roll) I'm going to hand him this cup" I never asked if she planned to let him give the suppository to himself or have him take it with a sip of water.
Well those slippery bullets do slide down easily enough with a sip......
I did once when working with a male RN BSN up north who didn't understand things I knew when I was a CNA. It got so bad that I went to the DON and she blew me off. He quit shortly thereafter and went to work at another hospital. It came out later that next year that he was not a nurse and had stolen someones credentials. When the real nurse went to file his taxes they came back from the IRS with a statement about 85k in undeclared income. Thats how they caught the faker. I said in my head more than once that this guy was not a nurse but thought I was just being paranoid. You gotta have a lotta nerve to pull a stunt like that.
Ha we had a code. Man aspirated and stopped breathing but was paced. Pregnant (fairly young) ICU nurse shows up and elbows her way to the bedside where she promptly states "So what are we letting the pregnant lady do chest compressions or what?". If I wasn't in the room I wouldn't have believed the story. He was hooked up to the monitor already and the hospitalist was like "um. We aren't doing compressions. He has a pulse". *facepalm*
I did once when working with a male RN BSN up north who didn't understand things I knew when I was a CNA. It got so bad that I went to the DON and she blew me off. He quit shortly thereafter and went to work at another hospital. It came out later that next year that he was not a nurse and had stolen someones credentials. When the real nurse went to file his taxes they came back from the IRS with a statement about 85k in undeclared income. Thats how they caught the faker. I said in my head more than once that this guy was not a nurse but thought I was just being paranoid. You gotta have a lotta nerve to pull a stunt like that.
RubicsCube
37 Posts
No wonder so many people die from medication errors each year.