To tell or not to tell!

BrandonLPN, LPN · Mar 23, 2015

Telling on nurses for the bad practices you noted will not effect any change. There are other ways to go about these things. Tactfully address the issue with the staff in question. Try to set an example. If, for example, poor compliance with isolation precautions is an issue on your unit, you can bring that to your supervisor's attention in a general way without singling out any particular person.

Telling your supervisor that Suzy RN left a cup of pills on the med cart yesterday will only end badly for you. It will not bring about any positive change and will be an exercise in pointlessness.

laKrugRN · Mar 23, 2015

Welcome to nursing! There will always be nurses who break the rules, cut corners, etc. Just do it the RIGHT way yourself and pick your battles. If these nurses are as bad as you say, they are digging themselves a hole and will soon cave in.

Anna Flaxis, BSN, RN · Mar 23, 2015

How does not wearing gloves when starting a blood transfusion adversely affect the patient? Just curious....

Fiona59 · Mar 23, 2015

Whenever a coworker forgets to log off a programme, I just hit the log off button.

heron, ASN, RN · Mar 23, 2015

OP - the tone of your post comes across as exceedingly self-righteous. Was that your intent?

With no context for your observations, it's hard to judge just how egregious those offenses were. I have to echo other posters' advice to see to your own practice, at least until you have a real handle on the culture of the unit and the problems (such as understaffing, for instance) the staff are facing.

Advocate does not necessarily equal adversary. Increased tension among the staff won't tend to improve the quality of care, either.

BuckyBadgerRN, ASN, RN · Mar 23, 2015

And not wearing a gown? The nurses are putting themselves at risk---the patient is already down with whatever has them on precautions in the first place!

How does not wearing gloves when starting a blood transfusion adversely affect the patient? Just curious....

QuarterLife88, MSN, RN, NP · Mar 23, 2015

Unless one of your co-workers is blatantly bringing harm to a patient, mind your own business. When people do wrong it usually catches up with them eventually, your intervention not required. You're a new nurse (or at least new to this unit). Focus on learning the job not trying to be Captain Save a Patient. And you might re-think that martyr, "I'm willing to sacrifice my job" attitude when you can't pay your bills or fill your belly.

BrandonLPN, LPN · Mar 23, 2015

And not wearing a gown? The nurses are putting themselves at risk---the patient is already down with whatever has them on precautions in the first place!

One could make the argument that the un-gowned nurse is increasing the risk of spreading the ickiness to his other patients in other rooms.

canigraduate · Mar 23, 2015

You are coming across as nitpicky and petty, and overly defensive.

It is OK to be upset at these things, because you were taught differently. It is NOT OK to run tattling about every little thing you come across.

What I would suggest is that you talk to the actual people who are doing these things and find out what's going on with them. You may be surprised at some of the things you hear.

Here are my thoughts:

1) Blood transfusion started without gloves - this is a risk to the nurse, not the patient. It is better to follow standard precautions and hospital policy and wear gloves, but it is not a patient safety issue. Speak with the nurse directly and remind them gloves are for their own safety.

2) Meds pulled and set on the cart and left - well, this is bad practice, but it happens, especially on a busy floor such as Med-Surg. Tactfully approach the nurse and say you noticed they were left out, or secure them for the nurse and let her know. I have worked on many units that didn't have a way to temporarily secure the meds and had to make a detour for a higher priority task. Putting meds back in a Pyxis or Omnicell is incredibly time consuming. I don't carry meds in my pockets, so I leave them (labeled and usually hidden under paperwork) on top of my mobile workstation if it doesn't have a drawer.

3) Computer screen with info left up - if it's at the nurse's desk, no biggie, there shouldn't be anyone who isn't allowed to see that info back there. If it's at a mobile workstation or one out in the hall, then log the user out. If it happens more than once, approach the nurse responsible.

4) No gowns on in precaution rooms - are you sure? Some of the units I have worked have a safe zone inside the door. If they are going in to do patient care without a gown, that's a different story and should be addressed. Again, approach the responsible nurse. If it is a widespread problem, and it doesn't fix itself after your tactful discussions, approach the unit manager with specifics.

If you go in to the NM with a litany of complaints like a child and haven't attempted to address any of them yourself, you are going to find yourself being observed very carefully, written up for everything, and dismissed very quickly. No one wants someone who doesn't fit in with the team.

And relax. Jeez. No one is perfect. Nurses are going to make mistakes. You are going to make mistakes and you don't want someone jumping down your throat for it.

Frankly, from the tone of your posts, I don't want to work with you, because I am not perfect and never will be.

jschut, BSN, RN · Mar 23, 2015

What I would do in your situation is YOU do what's right and keep your mouth shut. With any luck, your co workers will see your correct ways and follow suit. CYA... take care of yourself and as long as no harm is coming to the patient, all is well.

jj224 · Mar 23, 2015

*orienting.. Not orientating

Anna Flaxis, BSN, RN · Mar 23, 2015

*orienting.. Not orientating

Sadly, "orientate" is a word. I wish it weren't true, but it is. ~Sigh~

Orientate - Grammarist