Policy and Procedures

Nurses General Nursing

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I recently left a job, for various reasons, but mainly because each preceptor I was with had a 'different way' of doing things, in all aspects. It was pretty confusing, and when I mentioned that I was having difficulty with policies and protocols, they said to just ask them.

They did have a Policy and Procedures manual but it was very brief. When I mentioned it to my preceptor she said she had never even seen it. To me this sounds sketchy and if anything were to go wrong, the nurses would be thrown under the bus.

I'm wondering how other people dealt with this or if it is common? It seems extreme to leave a job over this but I felt so uncomfortable following policies that were just by word of mouth.

Specializes in CVICU, MICU, Burn ICU.

Whatever any given institution has outlined in a written policy, they can be held legally liable for. This is one reason some policies might appear "vague". Tight policies can be restrictive, also, for situations that do not fit neatly in a box, and therefore can hinder the ability of staff (medical, nursing or otherwise) to provide the most appropriate patient-centered care and interventions. There is an art and science to good policy writing, and a continual need for policies to be reviewed and updated.

This is why, as a matter of habit, we should take our preceptors/coworkers/managements verbal recollection of any given policy with a grain of salt, and know where to access the up-to-date policies of our institution. It explains (aside from people just having different ways of doing things) why staff can have different ideas of a particular policy -- because maybe the last time they looked at the actual policy, it was as they are telling you it is now. And it may not be the case.

Some facilities are better at maintaining policies and procedures and making them as easily accessible to staff as possible than others.

OP, it can be a very frustrating, learning curve of a new job to learn which things are covered by a policy and which things are specific unit/facility practice.

I will never forget working in Home Care 20 years ago. We did a huge number of clean dressing changes in people's homes. The trouble started when every nurse had a different idea of what constitutes a clean dressing change. We had some nurses who had recently been employed in the acute setting, and thought they were better than everyone else.

Specifically how to pack wounds with strip gauze. Boil the scissors and tweezers, wipe them down with alcohol, or wash them in soap and hot water? A controversy erupted and people got fired for failure to boil. Some genius finally contacted the doctor's office, and wiping the implements down with alcohol was sufficient after all.

I had several jobs in direct patient care where I never read a procedure. I know it sounds bad, but when you are so busy there is no time. I just learned things on the job.

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