skeptical of another nurse

[The Bell Jar]

I don't even know what to do, if anything at all.

The on coming nurse -a nurse whom I've never met comes into the patients room, and announces to the family and myself that she is from XYZ agency and that she works 24 hour shifts. The family is shocked are like "how is that even legal?" And she didn't say anything and I said " Um maybe she means 12 hr shifts (the scheduled shift)" She was like "oh I guess that's what I meant."

This nurse was supposed to replace me for one on one nursing. Things got weirder when she expressed that she didn't know what the pulse oximeter was. I showed it to her. This agency says they require 6 months experience.I'm seriously asking...do some schools not have these in clinicals?

Then I was trying to give report at the bedside on this patient (family had left the room). This had been a 13 hr shift for me at this point.I was giving it succinctly and SHE INTERUPPTED ME and said that she was going to put her stuff in the break room.....downstairs....across the building.AND that she needed to introduce herself to all staff on duty.

I was just shocked! She wandered off... and the family wanted my attention and I had other things to chart.

When she came back she began doing a full set of vitals and I thought okay,maybe things will be OK......then she yelled "I need someone to write these vitals down STAT!!!" On a peacefully sleeping elderly patient. Um remember them or write them down on a scrap piece of paper like everyone else?

Then she wanted to write her notes in military time, and asked me how to do it. I explained to her how to do it, but she still struggled with the 'math' of it.

Next she began asking me what descriptive words to use in an assessment. I'm not joking it was like she had never done even a basic assessment.She kept asking me what would I write.....we're talking LTC not an ICU.

There is more but I'll leave it here. Am I getting old and crochety or is this cause for concern. There was something 'off' about this person. I really want to say something to the agency but WHAT? I know how small nursing circles are and I don't want this to come back and bite me in the you know what.I just feel that the agency needs to know the situation, because like I said, there is more.

On the other hand, these types usually disappear or get fired quickly, should I say nothing and let things take their course?Mind my own business?

[caliotter3]

I am sorry, normally I would say to mind your own business, but in this case you need to alert SOMEBODY! Write up a statement, keep a copy, and give it to your supervisor and ask your supervisor if you should send it to the agency or if s/he will handle it. That "nurse" sounds like a whack job and dangerous.

[Gooselady, BSN, RN]

Cripes! You're right that people this out of it tend to disappear, but in the meantime?

All you can do is write down the factual specifics of her behavior and send the email to your manager, who ought to know who to take the information to. I mean factual and objective, like 'asked me what pulse oximeter was' and 'abruptly stopped report saying ______ (whatever she said), saying in a loud voice 'someone needs to record these vitals stat!' . Hell, that ought to be plenty. You must have wondered if you accidentally woke up in Wonderland, or there have been some recent escapes . . . hopefully she had a legit looking name badge. Sorry you had to hand off to such an oddity. Sending an email regardless of whether it will 'do' something or not is just the decent thing to do, and it's likely she struck many others as equally strange, so your email would be part of a paper trail. Wow.

[Libby1987]

I never mind my own business when it comes to patient care. Does your mgmt respect and trust you?

[AJJKRN]

I personally just don't want to believe you're serious even though I really think you are

[amoLucia]

OP - you commented that the agency nurse spoke of working 24 shift. I've known some agency nurses to do some crazy hours. Could it be that she really was doing 24 hours like with 2 different agencies)? Maybe you saw one very, verrrry sleep-deprived nurse?

Severe sleep deprivation can cause such crazy confused behavior. Like other PPs comment, you need to bring this situation up with your administration. They need to check it out with the agency to see if I'm right.

Sometimes one agency doesn't know about the other agency so they may need to know. That nurse may not even perceive herself as being so affected if she's that tired. Kinda like an intoxicated person doesn't see himself as 'drunk'.

[blondy2061h, MSN, RN]

This seems only slightly below par for what I've experienced with agency nurses at my facility (not a dig at agency nurses- we only tried it once and ended up with a crazy). But yeah, I'd be calling supervisor star. I'd be concerned with being liable if I left a patient with a nurse I knew was incompetent.

[IVRUS, BSN, RN]

Perhaps she wasn't a nurse at all, but was impersonating one! Did the "agency" fully vet her? There have been cases of indiviuals who steal someones nursing license number and make fake ID's to obtain gainful employment. This person either had some serious deficits, or wasn't a nurse at all. IMO

[brillohead, ADN, RN]

I work private duty, and I've been amazed at the incompetence of some of the "experienced" nurses who have been sent to orient on one of my cases.

I actually had to argue with one recently about giving report -- that before she left in the mornings, she needed to say a few sentences to the oncoming nurse about what had/hadn't been done yet for the patient's morning routine, etc. Yes, she *argued* with me that she didn't need to say anything because, "It's all in my documentation." (Mind you, she signed off on things in the MAR that she never did.... but it's all in her documentation!)

I actually looked up her name in my state's licensing database to make sure she was a nurse -- how on earth do you get through nursing school without understanding the concept of giving report / handing off responsibility to a patient???

[caroladybelle, BSN, RN]

On the topic of sleep deprived, I almost wonder more if she had taken a stimulant or something, because the behavior is more hyper or a bit manic, than sleepy. Either way, it is not an appropriate situation.

The other thought is that she is working under another's credentials.

[caroladybelle, BSN, RN]

As far as agency being problematic, much depends on the agency. When I worked agency, mine probably screened stricter than many the facilities that I worked at.

Interesting, when one travel group that I worked for, began alcohol screening, we lost several travelers. What is scary, is that you knew well in advance when the drug test with alcohol screen was. Yet I knew several nurses bounced on that screen, that I would not suspect as having that issue.

[The Bell Jar]

That's what I was wondering if somehow this person was sleep deprived. But still not a good situation. Actually every other nurse from this agency has been really wonderful,maybe thats why I'm so shocked.

Also,this person did not seem to grasp what PRN meant and I had to explain it.

No I don't really have a 'strong' relationship with management, because I'm new. BUT I've been a nurse for several years.