wouldn't a 6-2 nurse have to be experienced and know what the heck they're doing

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I work 2-10 in a nursing home. I come after a rn that is just as dumb as rocks. She has been a nurse for a while but at times I feel like I know more than her, and I've only been a nurse less than a year. I regularly have to explain how to do things to her. My question is wouldn't a 6-2 nurse have to be experienced and know what the heck they're doing since 6-2 is a fast shift where almost all the orders come in???This woman regularly leaves a bunch of her work undone like orders, labs not faxed, and its not a occasional thing either. I'm a team player and I don't mind coming in and helping when its been a hard day, but everyday I have to end up staying late because i'm finishing up my work plus stuff unfinished from the day shift. So i'm pretty much getting sick of it. I'm not lying but she asked me this once...lol..."When you fax a doctor and the fax u back with a new order...Do u have to write a telephone order for it?????" I was like wowwww......you're the rn im just the lowly lvn...I'm not implying I'm perfect in no way, or that I know everything, and I've made my share of mistakes, but I always try to pay attention and learn. I'm just afraid shes gonna mess up and order, or make a big error, and I'm going to get dragged up and it. What can I do??? I'm in no way insulting rns so please no one get offended.=)

Specializes in Case mgmt., rehab, (CRRN), LTC & psych.
yeah, she sounds exactly like a few of the nurses on the day shift at my place. kinda...........disorganized, get caught up in minor details and miss the big picture. but, they are there for a reason...................excel at "customer service" skills and other things i couldn't do as well. they are not bad either, just.........not especially productive.

i don't think that goes away with experience. its a personality thing, at least thats what i'm seeing.

i agree. there are type-a nurses and type-b nurses.

the type-a nurse is a master of time management, task orientation, nursing skills, judgment, and technical proficiency. these are the nurses who write everything down, operate off a "to do" list, and run circles around some of their coworkers with their efficient provision of care.

the type-b nurse is a master of diplomacy, customer service, building relationships, and connecting with people on deeper levels. ideally, we should display attributes of both types. however, some nurses are an extreme of one type.

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Specializes in Peds/outpatient FP,derm,allergy/private duty.

Yeah that fax question was naive, but since they go through a telephone line, and the paper is a facsimile, and nursing has quite a few redundancies in it's hard-wiring already, it isn't all that far out in left field. Or maybe I'm remembering all the dumb questions I've asked over the years.

There are actually still a significant number of people who believe you can fax a human being a la beam me up scotty. If she asked you when the doctor was going to pop out of the fax machine you'd really have a problem on your hands.

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Specializes in M/S, Travel Nursing, Pulmonary.
I agree. There are type-A nurses and type-B nurses.

The type-A nurse is a master of time management, task orientation, nursing skills, judgment, and technical proficiency. These are the nurses who write everything down, operate off a "to do" list, and run circles around some of their coworkers with their efficient provision of care.

The type-B nurse is a master of diplomacy, customer service, building relationships, and connecting with people on deeper levels. Ideally, we should display attributes of both types. However, some nurses are an extreme of one type.

Yes. This is what I was trying to get at. And the type B's are a good fit for daylight (in management's eyes). They are there when family is around, there to make the doc's happy, will go to pointless meetings and look oh so interested. Not at all like the Type A person.

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The facility may also have needed an RN body on staff for dayshift. When you get report from her, if you do, and all those tasks are left for you, ask her if she asked anyone for help. If she says she didn't, I would bring it up to the day supervisor and then go through the chain of command to remedy this situation before, as you said, she makes a huge mistake and it is life-threatening. You don't want to sacrifice your license because of mistakes she has made. Good luck....:smokin:

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Specializes in Med/Surg, LTAC, Critical Care.

In a perfect world, everybody would remember what they were taught in nursing school and do what they are supposed to do. Unfortunately, some idiots slip through.

I see you mentioned she is a former surgery nurse. From what I've seen most of them ain't to up to speed on "floor nursing" (they are pretty dang good at sterile skills though).

I once worked with a nurse who kinda fit this description (not a surgery nurse though), all of day-shift HATED to get report from her. She was nice as can be, but... and I can't say this in a nice way so here goes...she was dumber than something I shouldn't mention... She graduated the same LVN program I did (the class ahead of me actually), and we worked on a telemetry floor together. She had a patient that was displaying CLASSIC DVT signs. I asked if she checked Homan's sign.... she had no idea what that was:eek: Couldn't even tell me what anti-coagulants here patient was on!

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Specializes in adult ICU.

I'm gonna go out on a limb here and probably get flamed, but here goes.

It's been my experience that LTC RNs are not the cream of the crop. LTC for most RNs is not a desirable practice area. (There is a very non-scientific poll on here in the polls section; if you took it, I think LTCs were chosen as least desirable as well.) Many that cannot get a hospital job, cannot hack a hospital job, get fired from a hospital job, etc. end up in LTCs. They also don't get to learn how to be an RN in their fullest capacity if they start out there -- their patients may be medically complex (multiple comorbidities), but they are not clinically complex (multiple, high acuity therapies/treatments.) The ones that stay there ... well, they just don't know very much.

I have also come across many RNs that work LTC that are power-hungry egomaniacs. It is relatively easy to climb the managerial ladder in LTCs with just an ADN as most off the staff that you supervise are LPNs and CNAs; and ADN can easily be the highest educated nurse on a floor in LTC. Most RNs know this, and the ones that want to be bosses straight out of school flock to LTCs.

I am not knocking all LTC RNs. I am sure there some very good ones out there that chose to work where they work. From what I've seen, however, with quite a few of them, that is not the case.

As far as your coworker, OR nursing is a very narrow specialty area. They don't spend much time doing nursing care of sick patients, but they can probably run down all the instruments XYZ surgeon wants in OR 2 for his lap appy. Your coworker probably hadn't honed her basic nursing skills much if OR is the only practice area she has ever worked in (don't know if that is the case.) As far as going from the OR to LTC, that is a weird jump...probably took a pay cut, probably is going to work much harder in LTC, probably is going to have to work weekends in LTC, etc. Why did she do this? My guess -- let go from the OR for some reason. I'd keep my eye on the situation and see what you think.

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Specializes in Peds/outpatient FP,derm,allergy/private duty.

Private Duty tends to have that reputation, too. But I've noticed that over time, what someone is looking for in a job changes. When I was younger I craved the faster paced, higher acuity jobs. Now, as a fairly new empty nester I feel I'm learning quite a bit by having a job that is slower paced, but gives me a real window into the day to day experiences of a person who is severely disabled and have more time to listen to an elderly person talk about their experiences in life. It's like a "Tuesday Afternoons with Morrie" experience. I wouldn't have chosen this route, but that's where I found myself and it's been a blessing in disguise. :)

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Specializes in Med-Surg, Tele, DOU.

Yes, I think I agree with Grandmawrinkle on this one to some extent. It just seems that this is one of those people you need to watch and document. He/she should certainly know what to do with a fax order etc. And also should be interested very interested in those details of the paperwork considering this is how facilities are being reimbursed etc.

I'm not saying your colleague is as dumb as a rock, because they may be very good at customer service etc. However there are too many things to think about for me. :twocents:

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Specializes in M/S, ICU, ICP.
and oh yea when i come in she'll ask me to go assess a patient for her because she's not sure if somethings wrong with them.:eek::uhoh3:

you mentioned earlier that this person had worked or and or nurses do not usually assess their patients. the pre-op nurses in holding do that more than the or nurses, even pacu nurses do more actual assessments after a patient has had surgery. or care is also highly specialized at what they do, but lack tremendously in basic med/surg type skills which is more like ltc.

realizing the the patient in or usually has several nurses to the one patient, and there is only one real doctor in the room to bark orders, ltc is a big change. suddenly this rn is out where there are multiple orders and patients and skill sets they have not had to use. actually i am glad the rn knows enough and cares about the patient enough to swallow her pride and ask someone else to assess the patient.

ltc reminds me the most of med/surg and the work is simular. 6 months really is not that long when you realize that the rn has not been in school for a long time and her skill set is unused. i had a great l & d nurse one time move and go into home care and she was a disaster at ng tubes, supra-pubic cath changes, colostomys. she was a great nurse but it was an extremely different skill set. it took her about year of working to get a handle on an entirely different type of nursing.

nursing has become so specialized that nurses are no longer like lightbulbs where we can be pulled from one place to another and still appear very bright. lol.

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you mentioned earlier that this person had worked or and or nurses do not usually assess their patients. the pre-op nurses in holding do that more than the or nurses, even pacu nurses do more actual assessments after a patient has had surgery. or care is also highly specialized at what they do, but lack tremendously in basic med/surg type skills which is more like ltc.

realizing the the patient in or usually has several nurses to the one patient, and there is only one real doctor in the room to bark orders, ltc is a big change. suddenly this rn is out where there are multiple orders and patients and skill sets they have not had to use. actually i am glad the rn knows enough and cares about the patient enough to swallow her pride and ask someone else to assess the patient.

ltc reminds me the most of med/surg and the work is simular. 6 months really is not that long when you realize that the rn has not been in school for a long time and her skill set is unused. i had a great l & d nurse one time move and go into home care and she was a disaster at ng tubes, supra-pubic cath changes, colostomys. she was a great nurse but it was an extremely different skill set. it took her about year of working to get a handle on an entirely different type of nursing.

nursing has become so specialized that nurses are no longer like lightbulbs where we can be pulled from one place to another and still appear very bright. lol.

i don't know just working after this woman makes me nervous.

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Specializes in Case mgmt., rehab, (CRRN), LTC & psych.
And oh yea when I come in she'll ask me to go assess a patient for her because she's not sure if somethings wrong with them.:eek::uhoh3:
I don't see anything particularly wrong if this nurse asks for a second opinion. If she's not sure that something's wrong, she's taking prudent action by asking a competent coworker to assess the patient.

She is probably cognizant that her assessment and clinical skills are weak, so she's being safe by asking for your opinion. This is a whole lot better than the nurse who does not realize or care that he/she is dangerous.

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Specializes in Psych, LTC, Acute Care.
I'm gonna go out on a limb here and probably get flamed, but here goes.

It's been my experience that LTC RNs are not the cream of the crop. LTC for most RNs is not a desirable practice area. (There is a very non-scientific poll on here in the polls section; if you took it, I think LTCs were chosen as least desirable as well.) Many that cannot get a hospital job, cannot hack a hospital job, get fired from a hospital job, etc. end up in LTCs. They also don't get to learn how to be an RN in their fullest capacity if they start out there -- their patients may be medically complex (multiple comorbidities), but they are not clinically complex (multiple, high acuity therapies/treatments.) The ones that stay there ... well, they just don't know very much.

I have also come across many RNs that work LTC that are power-hungry egomaniacs. It is relatively easy to climb the managerial ladder in LTCs with just an ADN as most off the staff that you supervise are LPNs and CNAs; and ADN can easily be the highest educated nurse on a floor in LTC. Most RNs know this, and the ones that want to be bosses straight out of school flock to LTCs.

I am not knocking all LTC RNs. I am sure there some very good ones out there that chose to work where they work. From what I've seen, however, with quite a few of them, that is not the case.

As far as your coworker, OR nursing is a very narrow specialty area. They don't spend much time doing nursing care of sick patients, but they can probably run down all the instruments XYZ surgeon wants in OR 2 for his lap appy. Your coworker probably hadn't honed her basic nursing skills much if OR is the only practice area she has ever worked in (don't know if that is the case.) As far as going from the OR to LTC, that is a weird jump...probably took a pay cut, probably is going to work much harder in LTC, probably is going to have to work weekends in LTC, etc. Why did she do this? My guess -- let go from the OR for some reason. I'd keep my eye on the situation and see what you think.

In a way I see your point. I started out in LTC as a LPN and got my RN and went to the hospital. The hospital is okay but the politics SUCK! I know eventually maybe 5-10 yrs from now I will go back to the nursing home and work in a management position. The pace is different and its not very intense. Working in the hospital and 12 hr shifts is hard on the body. I am ready for a 8-4pm shift or 9-5pm.

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