Nurses that just "pass the buck".

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Specializes in LTC, Hospice, Case Management.

Extremely frustrated today and just need to vent.

We have several nurses (probably at least 50%) that just pass the buck and I just don't get it. Example.. I was doing a 5 day MDS today, my first real detailed look thru a new resident chart. One of the MANY things that were wrong was an order for Zinc Oxide 220mg po BID. (Hmmmm! Me thinks that butt paste would taste pretty yucky and be damn difficult to swallow!) So I go look at the med sheet which also states Zinc Oxide. I then ask the nurse who had this resident to help me look in the med cart and see exactly what pharmacy sent. Hmmm, the med cart has got Zinc Sulfate - which makes lots more sense. This medication (the zinc oxide) has been signed for 16 different shifts! NO ONE QUESTIONED WHY THE MED SHEET AND ACTUAL DRUG didn't match. Come one, isn't this pharmacy 101?

Now on top of all of this, one of our state survey tags was on medication error rates. We have done numerous group and 1:1 inservices on proper medication administration and error prevention. This particular day shift nurse is just back from a one day suspension for medication errors. We are expecting our resurvey any day and this is just one of many, many, many examples of how so many of our nurses just won't "buy in" that we are obligated to get it right. I see no chance in hell of our passing resurvey.

So.. how do ya all get your nurses to take accountability? We are inservicing, 1:1 direct audit and education, suspension as a last ditch effort.. but still doesn't seem to help. So frustrating

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Specializes in Med-Surg/Peds/O.R./Legal/cardiology.

You may have to go with the one week suspension and then termination for next offense. Let the staff know that this is the next course of action. Sounds like the nurses have gotten quite lax. and you'll have to jerk a knot in their tails to turn it around. Good Luck, Nascar!

ebear

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How about nurses who give patients pain creme for their shoulder or aspirin for their headache and the next day when they are off and the relief nurse is on and I as a CNA not viewing the MAR on a daily basis is assuming this resident has some kind of doctor signed order for this creme or whatever and comes up to the nurse and tells her the resident is requesting it and finding out that there is no order and the patient has been getting this medication for months!!!! Or how about signing for a medication that isnt in the cart!!!

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Extremely frustrated today and just need to vent.

We have several nurses (probably at least 50%) that just pass the buck and I just don't get it. Example.. I was doing a 5 day MDS today, my first real detailed look thru a new resident chart. One of the MANY things that were wrong was an order for Zinc Oxide 220mg po BID. (Hmmmm! Me thinks that butt paste would taste pretty yucky and be damn difficult to swallow!) So I go look at the med sheet which also states Zinc Oxide. I then ask the nurse who had this resident to help me look in the med cart and see exactly what pharmacy sent. Hmmm, the med cart has got Zinc Sulfate - which makes lots more sense. This medication (the zinc oxide) has been signed for 16 different shifts! NO ONE QUESTIONED WHY THE MED SHEET AND ACTUAL DRUG didn't match. Come one, isn't this pharmacy 101?

Now on top of all of this, one of our state survey tags was on medication error rates. We have done numerous group and 1:1 inservices on proper medication administration and error prevention. This particular day shift nurse is just back from a one day suspension for medication errors. We are expecting our resurvey any day and this is just one of many, many, many examples of how so many of our nurses just won't "buy in" that we are obligated to get it right. I see no chance in hell of our passing resurvey.

So.. how do ya all get your nurses to take accountability? We are inservicing, 1:1 direct audit and education, suspension as a last ditch effort.. but still doesn't seem to help. So frustrating

It sounds like they got bogged down in the drudgery and just swiped that order over the scanner and sacked it up without even looking at it. I understand how that can happen, even if it doesn't make it right.

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How about nurses who give patients pain creme for their shoulder or aspirin for their headache and the next day when they are off and the relief nurse is on and I as a CNA not viewing the MAR on a daily basis is assuming this resident has some kind of doctor signed order for this creme or whatever and comes up to the nurse and tells her the resident is requesting it and finding out that there is no order and the patient has been getting this medication for months!!!! Or how about signing for a medication that isnt in the cart!!!

I was looking through turn and reposition sheet and noticed that Ms. so and so had been turned and respositioned religiously for two weeks in a row after she died.

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Specializes in LTC, Hospice, Case Management.
It sounds like they got bogged down in the drudgery and just swiped that order over the scanner and sacked it up without even looking at it. I understand how that can happen, even if it doesn't make it right.

Ok once...maybe even twice... BUT 16 TIMES! Come on, that is bull hockey! And remember this is only one example.:trout:

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Are you really surprised? Nothing some nurses do surprises me anymore. I have worked with nurses who will d'c 02 sat checks on pts, and move tx to the next shift so that they won't have to do them or just flat out not do tx. Have seen tb test that are supposed to be given on admit not given; so when I come in on my weekend shift I will give the test and indicate it on the TAR . When I come back the next weekend they haven't been read. It can make you crazy. I left week days to work weekends to go back to school, but after a month I came in and worked a couple of prn shifts on my old hall, I was changing out a q week nitro patch. The one I took off had my initials on it . No other patch in sight . Sorry sorry nurses.

:uhoh3::o

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Specializes in subacute/ltc.

aahhhh my favorite for last week AHR of 47 with irregular rhythm, hold med, go to call Doc, take MARS with me, pull chart....notice everyone for five days has been holding dig and b/p meds, no charting on this...not on report....not given in report and no one on any shift has notified the doctor..I only worked weekends, have since left this facility..just the tip of the iceberg...

Take Care

Tres

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OMG!!!!!.... All of the above examples are just ridiculous! I agree with one of the other posters, set up a system:

1st offense: 1 on 1 inservice

2nd offense: one day suspension

3rd offense: one week suspension

4th offense: term no discussion

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Specializes in LTC.

How about the nurse that gives a narcotic that has been discontinued (our DON is the only one who can remove narcs that are d/c'd) is marked as discontinued on the MAR and on the narc sign out sheet? I mean why have a MAR if no one is going to LOOK at it? Geez..........

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Specializes in ER.

(Hmmmm! Me thinks that butt paste would taste pretty yucky and be damn difficult to swallow!)

ROFLMAO :rotfl:

that said: I am truly sorry that these things are an issue

Good Luck in trying to remedy the situation

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Specializes in med/surg, telemetry, IV therapy, mgmt.

Went through this all the time. Correct the error and write up the nurses who (1) originally transcribed the order and didn't follow up and clarify it since that is a med error, and (2) everyone else who followed up and signed off for the incorrect med as it was written in on the MAR since that is also a med error. It puts the responsibility back on the people who made the mistake in the first place.

Of course, if your DON isn't going to back this up and discipline these nurses that are doing this, then a big part of the problem lies there.

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