Nursing and critical thinking

[LouisVRN, RN]

I am almost at my boiling point with a particular nurse I work opposite from. On a daily basis that I get report from her, I feel like she has not turned her brain on once during the day. I barely listen in report as I have learned the majority of what she tells me is what I told her the night before whether it is still applicable or not and the rest I can gather from looking at the patient. There have been MULTIPLE medication errors with this particular nurse, and it is well known when you get report from her you run and review your chart before doing anything with the patient.

During report yesterday, having taken care of the patient the day before I enquired about where her medications were as they were not on the MAR. Now it wasn't a protonix and colace that were missing, but medications that this patient needs to take as ordered by her specialist to not have her health suffer severely/die. I was told that the attending discontinued all the other medications and wrote new orders (He also discontinued her antibiotics which were also written by a specialist). I inquired as to whether or not she had asked the doctor about discontinuing these medications to which I was met with a totally blank look. Now this is not someone that is new to nursing, she has many years of experience, but I am at my wit's end. I no longer feel that it is safe to get or give report to her. I feel like I'm jeopardizing my license by turning my patients over to a nurse who I KNOW in my heart is unfit to care for them. I have begged and pleaded with the charge nurses not to give my critically ill patients to her because I am genuinely concerned for their safety.

I do report all medication errors per policy (which are frequent, usually monthly if not more often) but what else do I need to do. I am not the only one with these concerns.

[Scrubby]

It really sucks when you have to do the work of two nurses because the other nurse doesn't have a clue.

If things are as bad as you say and this nurse is making medication errors all the time then I would take my concerns to management. As an RN you have to act on this one before this nurse seriously harms or even kills a patient. Take all the evidence that this nurse is making errors continuously and express to management that you are concerned about the quality of patient care, and that this nurse needs education.

[subee, MSN, CRNA]

There's always the possibility of a chemical dependency or psychological issues which are making her IMCOMPETENT - temporarily or permanently.

[iluvivt, BSN, RN]

You HAVE TO write every up...every single incident.....eventually all those mistakes will end up with the manager and they have to address them. In my experience it takes a lot....you have to establish a pattern of incompetency. Do not tell this nurse you are going to do it...just do it. Next when you resume care of the patient or patients....take the best care of them that you can...put out any fires she started. You can not be responsible for anyone's license or nursing care but your own BUT what you can do is be a patient advocate and follow the polices and procedures that are already in place to identify problems and problem employees . A lot of times in larger organization unless something is really blatant it does take time...so get that paper trail going on her

[tewdles, RN]

yup...you must complete the necessary paper trail which will result in her either being nurtured and grown into a safe nurse or her separation from your employer...I know...she screws up and you get to do paperwork.

But, you must advocate for your patients and the best way to do that in this environment is to make sure that there is an undeniable stream of evidence highlighting her "difficulties".

[mfifiRN]

as a conscientious caring nurse, you must protect yourself, your licence & your patients. Pulling this nurse aside in a non confrontational way To ask her about er well being may be helpful. Also, gather your data and show this to the supervisor who will be able to remedy the situation.