Started a new job, and wondering if these are signs of bad things to come

[2010NewRN]

I started a new job about 2 weeks ago at a residential program for the mentally ill. The place has two units. One for long term mentally ill patients, and a unit for those in transition from an inpatient hospital stay back to the community.

So far, orientation has been . . . . interesting.

There's been a couple things that are happening, and I'm just so unsure if I should bail because these are signs of things to come or voice my concerns to the DON and possibly be known as, "that nurse."

1) I haven't seen a single nurse do blood sugar checks and insulin injections the same way. In fact, on several occasions I have witnessed nurses giving insulin without ever wiping the vial with an alcohol pad nor the injection site. I asked if there was a protocol for doing insulin administration, and was just told, "Everyone does it different."

I was taught to always use alcohol to wipe the vial and the injection site. Is there something I don't know?

2) I've witnessed OMT's and nurses dropping resident's medications on the floor, and still giving that medication to the patient to take. This totally grosses me out, and is against everything I've learned in school. What gives?

There have been other issues, more personal in nature, such as established nurses bad mouthing me to the DON when I've done nothing wrong. In fact, I was called into the DON's office last week to discuss these non issues. It was embarrassing and upsetting.

So nurses with more experience than I, what's your take on this??

Kind Regards,

NewNurse

[RNJill]

I just have to preface this response by saying that I'm also a new grad, so I can't give you an "expert" take. However, from everything I've been taught with regard to issue 1, it's standard practice/the sanitary thing to do to to use an ETOH swab on the site before you use it. Issue 2 definitely would be a problem-NOT giving a medication that was dropped on the floor just seems like a no-brainer.

About going to the DON, I feel like only you can make that call. In a perfect world, we would all go to management types with our concerns and have them dealt with fairly and constructively, but that doesn't always happen and in the mean time, most people really need their jobs! As you are the one working in this environment, you are the only one who can truly say WHAT is happening, the level of disregard for safe practice, and whether you could deal with working there under sub-optimal conditions. Conversely, you have to ask yourself what the worst case scenario would be if you spoke up and if you could deal with that. In the mean time, whatever you decide, your best bet is probably just to practice as well and safely as YOU can and do your very best to give them no grounds for complaints about you.

Good luck and hang in there! Hope you get some responses from veteran nurses :-)

[Zookeeper3]

One thing you can control is YOU and your practice. You can say "here is some alcohol to wipe that"... you can suggest it... but if you do it right that is what matters. You know the practice of others is wrong, but you don't go to the DON... you address it with your peers. That shows poor communication skills. If it bothered you... what did YOU do about it.

You'll learn that there are great, good and so-so nurses out there. We fix that with peer pressure. When something is dangerous we stop it from happening. So mind yourself and learn... and help remind peers. Many a time a new nurse hands me an alcohol pad and reminds me... but this isn't a big issue as I see it. You're going to be very shocked in the next 6 months if you're already reporting others to the DON.... Just pointing out culture and how things are done.... we try to encourage better nursing first with each other... and Yes... you are "that nurse" and I am not surprised that they are retaliating... you've set the stage for it.

[morte, LPN, LVN]

One thing you can control is YOU and your practice. You can say "here is some alcohol to wipe that"... you can suggest it... but if you do it right that is what matters. You know the practice of others is wrong, but you don't go to the DON... you address it with your peers. That shows poor communication skills. If it bothered you... what did YOU do about it.

You'll learn that there are great, good and so-so nurses out there. We fix that with peer pressure. When something is dangerous we stop it from happening. So mind yourself and learn... and help remind peers. Many a time a new nurse hands me an alcohol pad and reminds me... but this isn't a big issue as I see it. You're going to be very shocked in the next 6 months if you're already reporting others to the DON.... Just pointing out culture and how things are done.... we try to encourage better nursing first with each other... and Yes... you are "that nurse" and I am not surprised that they are retaliating... you've set the stage for it.

Zoo...I don't see were in the OP the OP states that he/she has gone to the DON...only that he/she has been called into the DON's office.....

[KeechieSan]

Just practice nursing the way you want to practice it and you'll be fine. Don't harp on what others do wrong, it is a waste of time.

[Davey Do]

2010NewRN:

Your concerns are valid. It is a good thing that you are questioning situations and doing some data-gathering in order to chart a course. The final decision is yours. You're the one who has to sleep with yourself. Your own opinion of what kind of nurse you are is the most important.

Zookeeper gave some good advice- show them the right way without pointing fingers.

Bottomline: I can only control the quality of nursing practise when I'm on duty. I'd drive myself crazy, and it would be a short trip, if I had to remedy my peers' practises. Do what you feel you need to do, and then let it go and be the best nurse you can be.

Keep on questioning.

Dave

P.S. Everybody has to eat a little dirt before they die.

[Flying ICU RN]

Lead by example, do you own thing, and don't criticize.

Speak up only if witnessing something illegal, or truly dangerous (both instances are very rare).

If you become a Pariah, you will be set up for failure by your peers.

[jjensen]

You will find that there is school book nursing and 'real world' nursing... You have witnessed the real part...

It is up to you on how you decide to practice; Good luck...

[Blackcat99]

My advice is that you keep your mouth shut. Don't worry about what this person is doing or not doing. Don't criticize or complain about others. At my last nursing job, hardly anyone used alcohol wipes.

[malem]

I am a nursing student but I am a tech /PCA in a hospital. The other posters are correct about " real world" nursing.

I kept trying to do things the way I was taught in the tech program in school. It made my co workers so angry when I kept my alzheimers patients covered while I bathed them. They stripped people down and poured water over them like a cow at a county fair, because it was faster and the patient could not complain.

I just kept doing what I believed in and kept my mouth shut. I was really, really helpful to them and eventually it worked out. They went from being hateful to just teasing me all the time. It is VERY difficult to be the new one on the floor and to want to do things the way you were taught. I would just keep doing it but not point out to others where they are wrong. If they bug you about it just say that you are more comfortable doing it your way.

[Dersam2]

She didn't say she was going to the DON, she said the others were going to the DON bad mouthing her.

[AndyLyn]

My advice?

1. Continue to practice what is best for your patients.

2. Play nice.

3. Look for another job on the sly.

It sounds like the environment at your present work place is full of lazy, cliche-y nurses who do the opposite of the above. Unless you feel like your staying put can significantly change their work ethic, it may be more pleasant to you to hone your skills someplace else.