To tell or not to tell!

[XNavyCorpsman]

I am orientating on an intermediate care unit and can't believe what I am seeing. I have seen blood transfusions started without gloves, meds being pulled and set on top of the cart and left unattended, computer screen left on with patient data clearly visible and left unattended, no gowns being used in patients rooms that are on contact precautions. I can go on and on. I am a strong patient advocate and feel the need to tell someone so that these things do NOT continue. What do I do?

[Nashvillejeanne]

Practice the art of nursing has you know it should be. Set an example for those around you. It is one way of "telling" without saying a word....

"Everything I have learned in life is from those with little life left"

Peace.

[klone, MSN, RN]

1. Do you have a lot of time on your hands to notice what OTHER nurses are doing?

2. You must be perfect & never mess up.

3. It sounds like you hate your job.

I think this is completely unfair. And I didn't think at all that it sounds like the OP hates his job, but rather is just concerned about some blatant safety and ID violations.

[OrganizedChaos, LVN]

I think this is completely unfair. And I didn't think at all that it sounds like the OP hates his job, but rather is just concerned about some blatant safety and ID violations.

I only said that because he would have a big target on his back & might lose his job. So unless he likes his job, he should go straight to the nurses committing the errors or not say anything. But if he doesn't like his job, then by all means...speak up to the NM!

[RNNPICU, BSN, RN]

To the OP:

I can understand your concern for your pts.

Most nurses try and adhere to practices, but call bells, emergencies, call to help a co-worker and your mindset immediately shifts to the new task at hand.

Before going to a manager you should ask yourself... "What have I done to immediately address the deficiency noted"

If you go with a list of complaints that go back a month, someone could ask YOU.. What did you do once you saw the deficiency. Since you did not appear to do anything, you are just as much a part of the issue. Staying silent perpetuates the problem.

If you want to be a good pt advocate, address the issue at the get-go, once you see a problem.

I once started going into a pt room, pt had been in the hospital for a while, on contact isolation. I knew this pt, had seen them before, knew he was on isolation. I had talked with another nurse, received a phone call, began thinking of the meeting I had in 30 minute. I then proceeded into the isolation room. Just before I went in, the nurse stopped me and said, "Wait... that pt is on isolation" I stopped and donned appropriate gown/gloves. It is so easy to forget, get distracted. All it took was a gentle reminder. That nurse was being an advocate for her pt and others.

You see, once you start getting into a routine, many things become second nature, something such as an interruption, can throw you off track,. Gentle reminders go a long way. "See something, say something" We are all accountable in the end

[bsyrn, ASN, RN]

Like I tell my students, keep your eyes open and mouth shut. These are all good learning experiences of what NOT to do.

[Momma1RN, MSN, RN, APRN]

Learn from their mistakes and don't make the same ones. If you see a computer with someones name on it, minimize or close out of the box. Speak with the infection control RN if you think that PPE isn't being utilized appropriately. Going to your NM and telling her all the things floor RNs do that aren't textbook isn't going to get you anything more than a side-eye.

[bluegeegoo2, LPN]

I only "tell" if there's a good possibility of direct patient harm after I have addressed the issue with the offender directly and they continue their poor practice. Otherwise, I let others be sloppy. It's their license, not mine.

[kidnurse07]

don't tell on anybody, YET... i need to learn these short cuts. LoL

[cardiacfreak, ADN]

OP, just a thought here, have you noticed anything YOU are doing wrong? I say that because if anyone finds out it was you who told, they will have a magnifying glass out looking to find what you are not doing right. Just my two cents.

[Angeljho, MSN, NP]

I guess I am a little taken back by these comments. I thought we, as nurses, are patient advocates and look out for what is in the best interest of our patients.

It's something called workplace culture. When the state comes around to do their survey, you'll be surprised by how things will turn around. However, it seems you work in a very laid-back environment and you won't be able to change it just because you tell. You'll only upset your colleagues for not being one of them. If you don't like where you work, leave. There are plenty of places out there that follow protocol to the T.

[aqua_clementine]

I would recommend keeping track of the occurrences and sending your Nurse Manager an email letting him/her know your concerns. A lot of times managers hire new nurses to get a fresh perspective on the unit--so, please tell, and please don't be afraid.

A similar thing happened when I started my current job--a million things shocked me. Some strategies that I took (and honestly, this happened over the span of 2+ years) were to outright ask the nurses what the policy was regarding infection control, or medications (although I already knew). I also would hand a nurse a pair of gloves, "Are you a small or medium?" or a gown. Or if I saw medications left out I'd say to the nurse "Pretty sure you didn't mean to leave these out--so I locked them up in the cabinet for you." Once I started talking about some of these things, I realized that there really was no accountability on the unit. (Tread lightly, and be friendly...it might get messy).

Sometimes if a nurse thinks that no one will confront her, she will continue doing what she knows is wrong despite knowing what is right. Do what is right. Be the nurse that wears gloves, that closes out a screen that is left open, and always wears proper PPE. Hopefully the environment will change.

Be attentive, be trustworthy, be professional. Be a good nurse & teach those behind you to be good nurses too.

[I love my cat!]

OP, I totally understand your frustrations. Nurses have always been taught to be patient advocates. In the real world of Nursing, it's not quite that simple.

I say, unless you think you will never be making any mistakes, as Elsa sings, let it go. Why? When your coworkers find out that the newbie has been reporting them (yes, they will find out!) EVERY move you make will be watched and scrutinized.

IMO, It's just not worth it being so new to a floor. You need as many coworkers on your side as you can possibly get.