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.
