I just wanted to vent a little here. I was just assigned to a floor I don't usually work and I knew that I would be spending plenty of time locating the meds on the cart, reviewing the treatments so I could manage my time, blah, blah, blah. I ended up making about five different calls to the pharmacy to locate the medications that were not there. A couple of them were on their way, so I was reassured that they were being given. One, in particular, was a transcription error in the MAR, was not even the right medication that was written in the order in the chart. The pharmacy told me they hadn't filled the medication several WEEKS ago because the order was not the medication that they have faxed off the original DR order! The kicker is, nurses have been signing off as giving it and it has not been there! I placed the correction order with the pharmacy and changed it in the MAR so at least those nurses initialling the med can produce the med if anyone ever asked!
I'm a little neurotic, so a great deal of my nursing practice is run by, not only integrity in my own practice, but also a good dose of paranoia. What kind of response would I give a state auditor following me around for a med pass, not only unable to produce the medication, but also a confirmation from the pharmacy that it has never been sent with my initials all over the MAR?! Some of the treatments I was supposed to be giving were not available either, Triamcinolone, Lotrisome, etc.
A good friend and co-worker on my unit called me into a pt's room the other day to be witness to a pt actively dying, you could hear the fluid in the lungs from outside the door, non responsive, dropping BP. This was only two hours after shift report, in which the day shift nurse said, "so-and-so is fine" (her reports take about 10 seconds as she is walking out the door, by the way). The MAR had been initialled all day that this pt had been given meds. There is NO WAY this pt had been swallowing meds! All these situations are revolving around one particular nurse that I would not let take care of my sick tomato plant, let alone a family member. I no longer wonder why she looks rested and relaxed when I walk in, when the rest of us rarely get to sit down. It doesn't take long to sign the med book and call it a day ...
"it was her rectum!!!!! (no, it was her orifice - lamazeteacher) the previous nurse(who i wouldn't let take care of ,well anyone for that matter)had thought her rectum was a decub and had packed and covered the poor woman's rectum!!!!" quote from sheilagh's post # 3
i hope you wrote: "dressing removed from patient's orifice" (the rectum is above that). "no s/s of lack of intact skin/tissue. surrounding skin is pink and healthy".
there are some nurses on my floor who i dread following and as soon as i'm done with report go and look at all of them to make sure they're still breathing and not about to code on me.... and then i go and check the charts since they think if they hold on to the secretaries slips all day that they don't actually have to look to verify the doctors orders are correct.
i got a patient just this weekend who had her foley removed the night before and hadn't urinated allll day-so over 14 hours. her bladder looked like a little grapefruit and i think when i scanned her there was some odd 1960 ml's of urine that showed up. sad.
I believe the statement "look at me, I work so much harder than so-and-so" hits the nail squarely on the head. Is there a nurse out there who hasn't run into "Super Nurse" somewhere? You all know her. She's never late, never calls in, even when she's on her deathbed, volunteers for extra shifts, has enough time and energy to get all her work done, help the CNA's with their work, and apparently the left over work that "Nurse Lazy" didn't care enough to get done. She's a God-send to her patients, and the nemesis of the incompetant. She's just too good to be true, isn't she. That's because she isn't true. Super Nurse should have lunch with the Tooth Fairy and order a double helping of reality. I will even donate the tip.
WOW! Didn't know the nursing world could be so cruel. Doesn't change my mind about being a nurse but it just gives me a broader picture of what to expect.
Specializes in trauma, ortho, burns, plastic surgery.
Hey before to fulfill your statements with good or bad fellings... just think in a logical way, about situation...
1. Who is accountable for all of these?
2. Who make the admission?
3. Who verified meds?
4. Who send orders to pharmacy?
5. Who received orders from pharnacy?
6. When you receive orders from pharmacy you verify again, who did it?
7. Who did the treatments?
8. How many shifts passed until LAST tx was for REAL done?
9. A pneumonia is could be not developed in ONE SHIFT, lol
10. Neither a decub, neither many others...loooool... is team work or not work, for this reason philippino nurses are so good in LTC they know how to work in team.
11. To know how to work in team this is a big issue... not really what one or each other did...
LTCs use in a good way double and triple check startegy with good results...IF this startegy was worked in your facilities and all the team appllied the startegy , never was happend to miss somenthing, forget somenthing, or screw up somenthing....
LTCs need to be strictly logical controled, nurses are people, people are good and bad... so people need to be controled, is human, is not like punishment but is like a help..... is the only way by how a facility could survive in good conditions..for patients FIRST and to put on work my dear nurses, lol.
For a free life, with huge money and no reponsabilities and high social identity, looool.... well forget it...is not here... you could use your free time on the beach, mountain...dreaming, lol
Yes, there are nurses I hate to follow. Every nurse gets slammed once in a while and cannot get everything done. That's the nature of the work. But there are some who consistently leave a lot undone, forget to chart meds, don't call the doctor for critical lab values, etc. These are not always new nurses struggling with the demands of acute care floor nursing, but are often experienced nurses who are perfectly capable of keeping up with the pace but choose not to for reasons known only to themselves. I used to let it really bother me, but now I just do what I can and leave it all at the door when I go home. The only time I do anything is if it's something with potential to cause patient harm, then I write an incident report. Otherwise, I just clean up the mess and move on. If *I* find myself on the receiving end of an extremely busy shift, I always warn the next shift that I had a busy night, and apologize in advance if there is anything I missed. This way they at least have a heads up that there may be some things out of sort, so they're not surprised when those things pop up.
Oh, man, want a list? My favorite is one who, I swear, has probably NEVER given blood. The minute you see her name, you know that there's not going to be the first corpuscle passed. She told me in report one time that "the lab's having trouble getting the blood, the pt has a very rare blood type, weird blood factors" for a stat 2 PRBC/1FFP order on someone with a HGB of 6.9 and platelets in the toilet -- and idiot me believed her because she was so detailed about why the blood wasn't ready. I tell the US to call me the second the lab says the blood's ready, go get the tubing ready to go, assess the site to make sure it's in date and the vein's a big pipe, etc. Assess all my pts, give 2100 meds, keep checking with the desk every time I go by -- any word from the lab yet? Zip.
Finally at 2230, I call the lab to see what's up, and the lab says they called and said the blood was ready -- at 1400. There was nothing special about the woman's blood type or factors, they just had to do leukocyte reduced because she got a lot of transfusions, but that's nothing special. And they called and told the nurse who said they couldn't find the blood and TOLD her it was ready. She just couldn't be queen of the nurse's station and actually work, so she just skated the blood on someone dying from leukemia.
Very class act....and I've told my family that if something ever happened to me, she is absolutely NOT to come into my room as my nurse.
Specializes in CCU, SICU, CVSICU, Precepting & Teaching.
"it was her rectum!!!!! (no, it was her orifice - lamazeteacher) the previous nurse(who i wouldn't let take care of ,well anyone for that matter)had thought her rectum was a decub and had packed and covered the poor woman's rectum!!!!" quote from sheilagh's post # 3
i hope you wrote: "dressing removed from patient's orifice" (the rectum is above that). "no s/s of lack of intact skin/tissue. surrounding skin is pink and healthy".
i rather suspect this was meant to be a vent thread, fun and fun-ny. i also suspect you lack a sense of humor, because you sure do step on vent threads a lot with your "advice."
Some of these stories are really sad! Love the one about the rectum being as stage IV! Hope that nurse has learned some anatomy since then! The one about the meds being initialed...can totally see that happening, too, in LTC. I can remember DRIVING to the drug store to PICK UP meds that the drug store just didn't want to be bothered with delivering. Of course, management needs to KNOW the drug is out of stock in order to get it. I have been left with unreported transfusion reactions, which really burns me:angryfire because it's company policy to stop the transfusion and call blood bank IMMEDIATELY and then the doctor. Yes, I think we have all followed some winners in our careers. It still sucks, though, because WE are the ones who get to spend half our shifts cleaning up their messes. I have seen pts given coumadin the night before a heart cath because....it was ordered. Needless to say, a full day spent giving vitamin K and drawing follow-up INR's just to have the cath delayed till the next day. I think I dropped to my knees and said a prayer of thanks that I looked at the MAR from the day before after seeing it on the home med list. That situation could have resulted in a death. I am not Supernurse by any stretch of the imagination, but I do try to give the best care I can give with the time and resources I have been allotted. Unfortuantely, some nurses just don't seem to care anymore. At least they are in the minority. Most nurses I know really do care. Of course, we all make mistakes. If we ever run across someone who hasn't made a mistake, he or she has probably not been working.
Looks like I sparked a lot of other horror stories with the OP. I've had fun reading them. Keep 'em comin. My little annoyances don't seem too horrible compared to some of these ...
Yeah, we have a couple of those at my facility too. It's not always as easy as I think it should be to catch them in an error (although a co-worker caught and wrote up a serious med error on one of these lazy nurses today). It's frustrating, and I'd recommend letting management know about all these things ASAP. I also like to call these nurses on their crap...
Do you know where the (fill in the blank) Cream is for Resident A? I had to call pharmacy on it, so there is a new one now, but gosh, I'll feel dumb if it was in the cart all along and I couldn't find it. Pharmacy can easily fill you in on the last time it was filled.
One I had this weekend: Pt. was out of eye drops, Cosopt, and I called pharmacy and re-ordered. The nurse the day before had initialled it as given (which it could have been), but the PM nurse did too...and then the nurse who followed me signed it out, and the next day nurse. The next time I worked that wing, the new, still sealed bottle was in the cart...
You bet I discussed it with management. Will anything be done? Probably not...
I have been left with unreported transfusion reactions, which really burns me:angryfire because it's company policy to stop the transfusion and call blood bank IMMEDIATELY and then the doctor. Yes, I think we have all followed some winners in our careers. It still sucks, though, because WE are the ones who get to spend half our shifts cleaning up their messes. I have seen pts given coumadin 
the night before a heart cath because....it was ordered. Needless to say, a full day spent giving vitamin K and drawing follow-up INR's just to have the cath delayed till the next day. I think I dropped to my knees and said a prayer of thanks that I looked at the MAR from the day before after seeing it on the home med list. That situation could have resulted in a death. I am not Supernurse by any stretch of the imagination, but I do try to give the best care I can give with the time and resources I have been allotted. Unfortuantely, some nurses just don't seem to care anymore. At least they are in the minority. Most nurses I know really do care. Of course, we all make mistakes. If we ever run across someone who hasn't made a mistake, he or she has probably not been working. 
lamazeteacher
2,170 Posts
"it was her rectum!!!!! (no, it was her orifice - lamazeteacher) the previous nurse(who i wouldn't let take care of ,well anyone for that matter)had thought her rectum was a decub and had packed and covered the poor woman's rectum!!!!" quote from sheilagh's post # 3
i hope you wrote: "dressing removed from patient's orifice" (the rectum is above that). "no s/s of lack of intact skin/tissue. surrounding skin is pink and healthy".