Please stop! Little things that are just bad practice.

[JBudd]

Little things that are just bad practice.

Like looping IV tubing back into itself (against our policy, and they went to great lengths to hand out caps to carry in pockets). And not even cleaning off the port you looped it into!

Disconnecting a running IV to take a pt to the bathroom.. and just leaving the bare end hanging from the pole. Don't interrupt IVFs ! Take the blinking pump with you!

What are yours?

[sistrmoon, BSN, RN]

At my facility intermittent tubing is changed every 4 days along with continuous tubing, this was recently changed from daily. Nothing in our policy states anything about the amount of times you connect/disconnect the tubing from the patient. Unfortunately not all of our pumps are attached to rolling polls, some are attached to the beds so in order for our patient to be able to ambulate anywhere they have to be disconnected.

We've had a couple different policies on this. When I first started, all tubing was changed every 4 days. Then for awhile if they patient had a central line(and we're an Onc floor, so it's a good percentage), you had to use new IV tubing with *every* intermittent infusion(so, if a person was on antibiotics every 6 hours and it wasn't connected to continuous fluids, they were getting 4 tubing changes in a 24 hour period. Ridiculous.) I guess that didn't show any CLABI prevention(and was probably quite costly) so now we do the continuous every 4 days and intermittent every 24 hours. And if the tubing is disconnected for any reason, it's considered intermittent. But people still don't seem to have a real understanding of it and I'm always changing tubing, either because it isn't labeled or isn't being changed the way it should be.

[sistrmoon, BSN, RN]

Invariably, someone else fixed the beep, just adds more volume, and you're stuck without a bag anyway. At the beginning of my shift I bring enough fluid into my rooms to last my shift and one bag spare for the next shift. Then I'm never stuck without one and whoever answers the beep when there's 25 ml's left can just spike and go. The tubing won't run dry if you spike a 1L bag and program the pump for 1050 ml. It will just beep til someone adds volume.

We got admonished for this from management. We are not to hang extra IV bags in the room(not sure why) and are not to have them out and ready and labeled(or even still in the plastic bag) on the counters. I think it's probably some lame JCHAO thing about leaving "medicine" laying around. I know that's why we aren't supposed to put saline flushes in our pockets either. Eyeroll.

[blondy2061h, MSN, RN]

We got admonished for this from management. We are not to hang extra IV bags in the room(not sure why) and are not to have them out and ready and labeled(or even still in the plastic bag) on the counters. I think it's probably some lame JCHAO thing about leaving "medicine" laying around. I know that's why we aren't supposed to put saline flushes in our pockets either. Eyeroll.

Yeah, our manager makes us hide them on JCAHO day but otherwise condones the practice.

[sistrmoon, BSN, RN]

Another bad practice is hanging used isolation gowns and masks up on a hook. These are single use items.

Chemo gowns too!

[sistrmoon, BSN, RN]

Now I'm one of those dinosaur nurses who practiced when isolation gowns were yellow FABRIC and we were actually taught in school how to remove a gown for reuse (in the days before disposables!). I'm sure some of the other old-timers remember it.

Ours are still yellow fabric. Is that weird?

[sistrmoon, BSN, RN]

Report! Get to it. I float, so every four hours I'm going to another unit. I find the night shift staff coming in at 7p to be worst about this. I recognize that they are just starting their shift and they want to chat and maybe don't care if report takes an hour because they have the next 12 hours to pull it together. I, on the other hand, need to give report so I can get to the next unit where I'll be starting late no matter how fast I can give report so please don't make me 45 minutes to an hour late to start my next 4-hour assignment. It's hard enough to pull it all together in 4 hours without starting any later than necessary.

And please try to find me. I work in a huge hospital and I don't know everyone's name on every floor so it's hard for me to find all the people I need to give report to, particularly when they're wandering around the nursing station chatting.

I find day shift to be the worst about this at my place:) But depends on the nurse. I'm the type that looks at my assignment and is ready for report. I don't spend ages looking up stuff I can look up later(hopefully.) As an aside, changing assignments/floors every 4 hours sounds like a nightmare. You don't ever get an 8 hour run?

[jubu97rn]

Repeatedly giving Tylenol of ibuprofen (or any OTC) without an order. I've had people ask me for Tylenol or some such and when I tell them I need to get an order, they tell me all the other nurses have been giving it to them. Then I look like the bad guy because I don't want to risk my license or their safety. Get an order!

[joanna73, BSN, RN]

I work LTC and we don't have time for long winded reports. Please get to the point with 40 people. I don't really need to hear a whole list of everyone that's stable:

"Smith is fine. Nothing with Jones. Brown is fine, etc....." for 10 minutes. Great.

I need to know the pertinent details for the residents who are not fine, the ones who require monitoring, not a long list of everyone that's stable.

[scaredsilly, BSN, RN]

The nurse who volunteers to work an extra shift because we are short, then spends the entire 12 hours complaining about all the family functions she is missing and how tired she is blah blah blah.

[tumbleweedlvn]

I work in long term care, and we still use paper charting. I absolutely despise it when the previous nurse doesn't leave enough room for the next person to chart and doesn't start a new NN, or uses the last of something (a form, supplies, etc.) and doesn't replace it. I was taught in nursing school to help each other out and respect your fellow nurses, not cause each other more work and stress. How hard is it to be courteous to your co-workers? I mean if we don't help each other out and help watch each other's back, who will?

[SpaceCadet77]

Since nobody else is saying this, I will. Much of the criticism here is quite disrespectful to our nursing peers. I sat for the same boards you did. I'm quite finished being judged and having my skills reviewed. I don't open my mouth when other nurses take hours passing meds, doing assessments and treatments. I don't express my annoyance when nurses babble irrelevent information at me in report (I don't care about problems that arose that you SOLVED!!!) . Every nurse is right in their work during their shift. How do I know? A pretty piece of paper from the state tells me so!

If more nurses took this to heart instead of overstepping their bounds, we would all be better off and happier on the job.

[No Stars In My Eyes]

Since nobody else is saying this, I will. Much of the criticism here is quite disrespectful to our nursing peers. I sat for the same boards you did. I'm quite finished being judged and having my skills reviewed. I don't open my mouth when other nurses take hours passing meds, doing assessments and treatments. I don't express my annoyance when nurses babble irrelevent information at me in report (I don't care about problems that arose that you SOLVED!!!) . Every nurse is right in their work during their shift. How do I know? A pretty piece of paper from the state tells me so!

If more nurses took this to heart instead of overstepping their bounds, we would all be better off and happier on the job.

AMEN!