I am relatively new to this forum, and I came specifically to ask a few questions. I have read these posts and I have a lot of respect for the responses I have seen here. I work in a relatively small community hospital ICU, and we are having a problem with some incompetent nurses. Management has been very reluctant to deal with the problems and we have been left in a difficult position on more than one occassion. We have recently started a supposed "self-govering" body for our unit and we are looking for advice on how to address this issue. We have had to rearrange assignments and schedules related to incompetent nurses, and I truly mean incompetent, not new nurses or inexperienced ICU nurses.
So, my questions are...
(1) Does anyone have any advice as to a different way for us to address this. NUMEROUS incident reports have not been effective. I am talking issues like inability to read the cardiac monitor, an unawareness that albumin is a blood product, an inability to turn on a portable oxygen tank. I hate to sound so mean, but it is really hard.
(2) If you are in this position, how do you handle complaints from other nurses who have to take sometimes unfair assignments to keep the patients safe from the incompent nurses?
(3) We are looking for some sort of written "standard" we can create that everyone must meet to work in our unit. (We really have nothing that is required to deem you "competent" to be an ICU nurse.) Any suggestions?
We are a relatively small hospital, with no pharmacist or supervisor at night, so we are really dependent upon each other to help out at night. The weakness of some of our staff, nurses who have worked here for years, is really hurting us. Help us, please!
Thanks in advance for any help.:thankya: :thankya:
I am relatively new to this forum, and I came specifically to ask a few questions. I have read these posts and I have a lot of respect for the responses I have seen here. I work in a relatively small community hospital ICU, and we are having a problem with some incompetent nurses. Management has been very reluctant to deal with the problems and we have been left in a difficult position on more than one occassion. We have recently started a supposed "self-govering" body for our unit and we are looking for advice on how to address this issue. We have had to rearrange assignments and schedules related to incompetent nurses, and I truly mean incompetent, not new nurses or inexperienced ICU nurses.
So, my questions are...
(1) Does anyone have any advice as to a different way for us to address this. NUMEROUS incident reports have not been effective. I am talking issues like inability to read the cardiac monitor, an unawareness that albumin is a blood product, an inability to turn on a portable oxygen tank. I hate to sound so mean, but it is really hard.
(2) If you are in this position, how do you handle complaints from other nurses who have to take sometimes unfair assignments to keep the patients safe from the incompent nurses?
(3) We are looking for some sort of written "standard" we can create that everyone must meet to work in our unit. (We really have nothing that is required to deem you "competent" to be an ICU nurse.) Any suggestions?
We are a relatively small hospital, with no pharmacist or supervisor at night, so we are really dependent upon each other to help out at night. The weakness of some of our staff, nurses who have worked here for years, is really hurting us. Help us, please!
Thanks in advance for any help.:thankya: :thankya:
First, I don't consider Albumin a blood product. It's a colloid like PRBC's, platelets, and FFP, but as far as I know not administered the same.
To answer your question, I would try advocating for some education programs for these struggling individuals. Perhaps a post-graduate ICU course which includes dysrhythmia instruction.
Do you have an education department in you hospital? What kinds of classes are provided for continuing ed?
I definately don't think these nurses should be written off as incompetent if they are actually TRYING to do their jobs. Maybe they just need a bit more instruction and mentoring from senior staff.
Most places have an annual "Skills Fair". Everyone has to attend and get checked off on stuff like turning on an O2 tank; maybe take an medication quiz, a "strip" reading clinic, etc., depending on the needs observed by leadership as needing to be addressed.
Also JACHO stuff can be placed online (intranet) to be completed.
Skills checklists--if you are not doing them, that would help.
i would suggest calling your licensing body to find out what can/should be done.
reporting incompetence and unsafe practices of other nurses is part of your legal responsibility. most often, this is done through managers, but if your manager isn't responding - either go up the management chain (which could get you burned) or go directly to the licensing body. let them do the investigating. that's their job.
wow, just because nurses are laking nursing skills they deserve to be reported to bon and lose their license? if nurses are reported due to lack of knowledge then there wont be any nurses left. for your information pebbles, nurses are reported to bon if they do something that's out of their scope of practice or if nurses are suspected of being impaired or stealing narcotics.
Specializes in Trauma acute surgery, surgical ICU, PACU.
wow, just because nurses are laking nursing skills they deserve to be reported to bon and lose their license? if nurses are reported due to lack of knowledge then there wont be any nurses left. for your information pebbles, nurses are reported to bon if they do something that's out of their scope of practice or if nurses are suspected of being impaired or stealing narcotics.
that's something that may be different in different locations. my board of nursing would deal with issues such as these. i was making a suggestion on a possible course of action to the op. you could have disagreed without the "telling me off" tone. thanks.
If a pt dies as a direct result of this lack of knowledge, it's definitely reportable. If the nurses are trying but aren't getting any help, they the methods need to change. If every chance has been given and these nurses still aren't getting it, then they need to leave the ICU. If these nurses truly don't believe they're doing anything wrong, then they need to leave and be reported because they are beyond unsafe.
How about required CCRN certification within one year? Allow no "grandfathering" in. No CCRN certification in one year, then the nurse can not work ICU.
for your information pebbles, nurses are reported to bon if they do something that's out of their scope of practice or if nurses are suspected of being impaired or stealing narcotics. 
emmycRN
191 Posts
First, I don't consider Albumin a blood product. It's a colloid like PRBC's, platelets, and FFP, but as far as I know not administered the same.
To answer your question, I would try advocating for some education programs for these struggling individuals. Perhaps a post-graduate ICU course which includes dysrhythmia instruction.
Do you have an education department in you hospital? What kinds of classes are provided for continuing ed?
I definately don't think these nurses should be written off as incompetent if they are actually TRYING to do their jobs. Maybe they just need a bit more instruction and mentoring from senior staff.