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.
How do you know he "tests really well"? Did you ask him something like that? Do you have evidence of that? When you say he has "common sense" what do you mean? You are basically saying he is intelligent and common sense would imply if he does not understand something he would ask for assistance. The entire post is a contradiction.
I'm not going to flat out call him stupid. Outside of nursing and all sciences, he has some wit. He's just not a good nurse. Like I said, if I explain things to him, he'll get it. The problem is that he doesn't always know he's doing something wrong because he doesn't know it's wrong (you don't know what you don't know).
We've discussed our education so I know he's failed A/P and nursing courses several times. It took him >8 years to obtain his BSN. Unfortunately not all universities are "competitive" as long as you can dish out the $$$. As for testing well, that's something he told me.
I'm not going to flat out call him stupid. Outside of nursing and all sciences, he has some wit. He's just not a good nurse. Like I said, if I explain things to him, he'll get it. The problem is that he doesn't always know he's doing something wrong because he doesn't know it's wrong (you don't know what you don't know).
We've discussed our education so I know he's failed A/P and nursing courses several times. It took him >8 years to obtain his BSN. Unfortunately not all universities are "competitive" as long as you can dish out the $$$. As for testing well, that's something he told me.
I imagine if he did take 8 years with multiple fail-outs, he doesn't test that well after all.
I would be remiss if I didn't admit how these clueless nurses got me through my darkest hours of nursing school. Just when I would be doubting myself and wondering if I could see the torture that is nursing school through to the end, I would see a clueless nurse at work do something (or not do something) that would make me think, "if they can do it, I can do it."
Sometimes this works the other way too though! I start doing practice problems from my review books and can only make 40-50% on some of the sections, and then I just feel all the stupider thinking of all the incompetent people I've worked with who made it through this .
Someone asked me just a few days ago if D5W has sugar in it.
I had a nurse call me (I am rapid response and get all kinds of questions) and ask me if the D50 I gave with the insulin IVP would affect the pt blood sugar. I was thinking really? You should know if D50 affects the blood sugar. You aren't a new grad anymore.
I haven't witnessed anything quite that egregious, but I have met nurses whose apparent intelligence levels led me to question how the hell they ever passed nursing school.
I've been known to think or mutter under my breath, "That person outranks me?!" I swear half the reason I'm in school is to remedy that situation.
These are the nurses who can quote theory, evidence based practice but don't know a foley from a french fry,
Some people are so book smart, they have no common sense.
Angeljho, MSN, NP
392 Posts
I'm not going to flat out call him stupid. Outside of nursing and all sciences, he has some wit. He's just not a good nurse. Like I said, if I explain things to him, he'll get it. The problem is that he doesn't always know he's doing something wrong because he doesn't know it's wrong (you don't know what you don't know).
We've discussed our education so I know he's failed A/P and nursing courses several times. It took him >8 years to obtain his BSN. Unfortunately not all universities are "competitive" as long as you can dish out the $$$. As for testing well, that's something he told me.