octopus

I constantly see nurses carrying around sharps without a sharps container - just a syringe in their hand. Not handwashing properly. Not checking expiry dates on medications. Not checking patient ID bands before giving meds to them. Preparing medications for 3 or 4 patients at a time then giving them out - to the right patient of course!

If you've never worked as a nurse, then you have no idea. We do it, not because we think it's right or safe, but because we care about the patients and can't bring ourselves to say 'no' to caring for somebody if that means they may not receive the care they need. We know that we are placing ourselves at risk; we know that our decision to take 9 patients only perpetuates the problem; we know that it's false economy to think that if we take 9 patients it is better than taking 4 and doing a good job. But when we're faced with the reality of the ward situation, we still choose to look out for the patients as much as we can because someone's got to do it. Don't judge until you've been in the situation - you might be surprised by what you would do if faced with it yourself. One thing you're right about - we do need to stop doing this to ourselves. We need to join together and support each other to force change. Until we do we'll keep giving in when faced with the reality because we just can't help ourselves!

I'm 31 and about to study another course! Plus, in Australia, many of our nursing students are in their 40s and some are even in their 50s. I wouldn't worry about what other people say. If it's right for you right now - hold your head high and study hard!

Crazy how much we care what others think of us. Crazy what we consider to be a failure! Sounds like you aren't a failure, but you've been successful at identifying who you are, what you like and doing something about it! You go girl.

I work with graduate nurses, providing clinical support to them as part of a graduate nurse development program. A few issues here: 10 patients is way too many - but you can't control that! With your level of experience you are probably outside of your scope of practice (buzz word in Australia at present!) - if you continue to work in this situation, knowing that you our outside of your scope, and don't refuse to take this load you are putting yourself in a very risky situation. Not to mention the patients! Thankfully you have control on this one! You can choose not to continue to work under these circumstances. I recommend finding a hospital that offers a supported transitional program - the existence of a program suggests that they have a better learning culture and will give you the support they need.

I'm young (31 I believe still counts as young!) and I notice more differences with the Gen Y than the Baby Boomers. OK, so the Boomers are a bit stuck in the mud in the majority (at least here), but some of them are out there keeping up with new developments. But the Gen Y... their attitude is often not great, and I cannot understand why they always have their top button undone (Australia is different - we have uniforms buttoned down the front)... their cleavage is unmissable. OK, I'm ranting, but why would you want all those men looking down your shirt as you bend over to put their stockings on? Not to mention the rings, nailpolish, earrings - all rather unprofessional I think. I don't get it.

i provide clinical support to new graduates on three surgical wards. this fri we are meeting for formal reflection and discussion. i would like to structure the session around scope of practice - have the grads been asked to work outside of their scope of practice? have they caught themselves doing it without thinking? have they been in the middle of a task when they realised they didn't know what they were doing? how can they protect themselves from working outside of their scope of practice? do any of you have a story about a time when you were asked to do something that you didn't feel comfortable or confident doing (ie outside of your scope of practice)? how did it make you feel? what did you do about it? what advice do you have for avoiding these situations? by way of clarification, in the state i work we have a new 'decision making framework'. if we cannot answer yes to a series of questions in a flow chart (eg "is my education, experience and competence sufficient for me to undertake this activity safely?" or "am i permitted to undertake this activity under law and organisational policy?") then the activity is outside of our scope of practice and we must not undertake it. graduate rns are advised to make decisions about their work using this framework, and if they cannot answer yes to every question, they must tell somebody that they are unable to complete the task. that would mean a lot of things are outside of their scope of practice. in order to grow and learn, they must request supervision or further education before they complete the task. thanks in advance for your stories!