Unsafe future nurse! What do you think??

[NICU_Nurse, BSN, RN]

I am a nursing student four months away from graduating, and I've run into a "situation" of sorts with another student in my class; it is causing great concern to me, and I was wondering what all of you experienced, professional nurses would think about this. A friend of mine, 'Melissa', is in my class; we've been attending nursing school together since the start of Basics. There are a number of things that lead me to believe that she will be an unsafe nurse, including the fact that she frequently sleeps throughout class, refuses to study because her 'television was calling to her', and spends many a lecture hour playing on her Palm Pilot rather than taking notes or paying attention. I know for a fact that she has completely FABRICATED various items of information while charting during clinical hours, including vital signs and patient status, because she is simply not paying attention or spending time properly assessing her patients. This list could go on FOREVER. She has said that 'everyone' guesstimates vital signs, etc. and uses that as her excuse, or says that 'he looked just fine and I didn't have access to the bp machine' or similar such nonsense. Somehow, she has managed to pass three semesters of a two-year program, albeit by the skin of her teeth, and I have no doubt that she will somehow manage to eek by on the NCLEX, becoming an actual nurse responsible for patient care. Now, recently, things have been occuring that have me very worried, and I don't know if there is anything I can really do about this, but I needed some professional opinions to ease my conscience. This reqires a bit of foreshadowing, so bear with me. ;>) She has been working as a nurse tech in a local ER. Though she has been doing satisfactory work (I'm assuming; she has yet to be fired or reprimanded...) the only thing she seems to spend her time doing is trying to hit on the med students and interns and paramedics (this is a large teaching hospital). We have not yet learned how to start IV's; this is out of our legal ability as a nurse tech, and we have yet to cover it in school (that is what we'll be learning in this last semester). However, the nurses in this ER are frequently busy and overwhelmed, and often ask her if she can start an IV and they will sign off for it. Because she is anxious to 'be a real nurse', she often does not correct medical staff and patients or their families when they address her as 'nurse'. Naturally, she is performing duties out of her scope of practice; it was only inevitable that she would begin to start IV's without properly learning how to do it. She took it upon herself to take a vial of Lidocaine, a TB syringe, and an IV catheter/kit home with her from the hospital. RED FLAG NO. 1: She is stealing supplies (including anesthetic!!!) from work. She convinced her ex-husband that she knew what she was doing and only needed extra practice (he was wary, naturally, but trusted that she was being honest), and sat him down to start her first IV HepLock. She withdrew 0.2 cc of Lidocaine (WITHOUT CONSULTING A DRUG BOOK; SHE ADMITTED THAT SHE *GUESSED* THE AMOUNT NEEDED!!) into the TB syringe, found a vein in the antecubital area, and injected the needle ON TOP OF the vein, rather than to either side. Her husband yelped loudly when she did it, and she withdrew the needle, afraid that she'd gotten it into the vein. She had already begun to press they syringe, so no doubt if she HAD accidentally stuck it into his vein, some Lidocaine was now flowing through his vascular system. (I also have a strong instinct that she DID puncture the vein; don't ask me why- it was just the first thing I thought when she told me this.) She then took the syringe WHICH HAS ALREADY BEEN STUCK INTO HIS ARM AND WITHDRAWN, EXPOSING THE NEEDLE TO AIR and injected half of the remaining Lidocaine on either side of the vein into the tissue. RED FLAG NO. 2: She inserted a CONTAMINATED (contaminated by the air and by the bacteria/germs on his arm) needle BACK INTO his arm to finish the injection. After his arm became numb, she then took the IV catheter, started the IV, got a flash, then pulled it out and put a bandaid on his arm. Okay, anyone seeing yet why I am worried here?????? She called me, excited, and told me EVERYTHING and acted like nothing was wrong, even though I was terribly shocked at her bad judgement, to say the LEAST. It gets worse. I asked her about taking the Lidocaine from work, and she said that THAT WAS NOTHING, that she had access to a number of drugs/antibiotics on the cart at work, including (I can't remember exactly) Stadol or Haldol or something of that nature. She said she'd been tempted to take some home just to try it out. OH. MY. GOD. Okay, so then she continues to talk, telling me that Ancef is also on the cart, and now that SHE KNOWS ABOUT IV'S, she is planning to take some home with some IV supplies just in case she gets sick, so she can begin her own IV and self-medicate when she has the flu/cold/etc. She said that the doctors at work do it all of the time, in the ER, so why can't she do it at home? OH. MY. GOD. RED FLAGS! RED FLAGS!! I am so shocked at hearing all of this, that I don't even know what to THINK!!! What do YOU think? Before you respond, understand this: She is not joking. She is totally serious. I am not overreacting. I know her very well, and this is all true (in fact, I don't doubt that it's worse, but she just didn't tell me ALL of it). These are but the most recent examples. I fear for her patients. She is irresponsible and dangerous, in my opinion. I had to get this off of my chest, and I appreciate anyone who reads this responding with their opinions. Thank you.

[PhantomRN]

when I read your post my first response was that this is a big joke. I cannot believe that this behavior would be tolerated at a decent nursing school. Why havent the instructors read her the riot act? Does she have an inside track or what? This makes no sense.

And if it is true People like her will be found out. It is amazing that no one has caught on to her antics yet. Obviously she is good at lifting items from the ER. Having said that I doubt there is a nurse out there who hasnt accidently walked out of the the hospital with something that belonged to them, my things are pens and tubexs. I always bring them back though.

Just curious did you ever ask her what type of nursing she wants to do when she gets out? And are you asking if you should turn her in? I would as I would be concerned for later patients safety and also with someone trying to associate her with me. I hope you are standing clear of her.

:confused:

[mustangsheba]

If this person didn't have poor judgement, she wouldn't have any judgement at all! Danger! I agree with Phantom - don't be associated with her. When she gets caught, you might suffer in the fall out, or even worse, be blamed for something she does. In this instance, I think I would have to ask a trusted instructor to keep a close watch on her and tell her some of your concerns. This is a difficult situation, but this person is not ethical to say the very least. Good luck.

[NICU_Nurse, BSN, RN]

First of all, I think the reason she has gotten away with this so far is because no one has reported her. I don't work with her, but I do know a number of people who do. I have been in clinicals with her, however, and much of this information comes much later, much too late to really do anything about. She naturally doesn't run up to people and say, "I just made up all of the assessment data for all of my patients!" I hear about these things in the matter of conversation, sometimes it's been months since she actually did it, and she obviously doesn't give me patient names or exact dates. I have no solid proof, only her word, which honestly, though I have NO DOUBTS WHATSOEVER is true, I don't think it's enough to hang her on. You see what I'm saying? She is foolish, dangerous, and irresponsible, but how do you really PROVE that? As far as the going home with supplies, well, I'm not saying that she accidentally ended up with Lidocaine and syringes and whatnot- I myself have come home to find my pockets full of alchohol pads, gauze, tape, etc. that I didn't use that day. She PURPOSELY took those items home with her to perform the procedure on her husband, and she is making plans to PURPOSELY take other items home as she sees fit. She's already told me that she's taken entire bottles of aspirin/Advil/whatever home with her because it costs so much at the drugstore. I don't know why I posted this, exactly...I suppose that every fiber of my moral being was screaming silently when I heard her latest stories. I am far from a nursing expert; I have learned much in nursing school, but I know that there are years of knowledge and experience ahead of me. However, I don't believe that you have to be an EXPERT to notice that nagging feeling in the pit of your stomach, which is exactly what I feel when I talk to her about nursing-related topics. As far as standing clear of her, yes, as much as possible. She is more of an acquaintance than a friend. We inevitably end up in clinicals together (the school is rather small) and lecture is ALWAYS together in the same class. I talk to her on the telephone and in class, but that's about it. I try to dissociate myself from her as much as possible, to be honest, but I suppose in a way I've been keeping tabs on her behavior as soon as I realized what she was doing way back in our first class a year and a half ago. I have simply been at a loss as to what, if anything at all, could possibly be done about this. I suppose another part of me assumed that as school progressed, she would learn more and more and become a better nurse/student. I was wrong. As her responsibilities increase, it just seems as if she is becoming more and more reckless. I know there is a chance that she won't pass the NCLEX. I know there is a chance that this will all catch up with her. I just can't help feeling a horrible, sinking feeling that is akin to fear and sympathy for her patients. I take nursing very seriously, and admit that I have much to learn. I know that while nurses in some cases, experience-wise, may actually know more than the med students/etc., there IS a huge difference in formal education that generally leaves THEM at the advantage, not us. I do not ever assume that I know everything, which she seems to be doing. She is not only not paying attention in class or learning what she needs to be learning, but by working in this ER, she has begun to watch what the older nurses and all the doctors are doing and think that SHE can do that too, without figuring in that these other people have LIGHT YEARS of experience and knowledge on her. With the IV situation, she didn't even bother to LOOK UP LIDOCAINE before she injected it into her ex-husband, much less would she have been able to explain her rationale for choosing that particular vein, etc. She went against BASIC ASEPTIC/INFECTION CONTROL procedures, putting her husband at risk (For infection, first of all, and secondly, what exactly does happen when Lidocaine is injected into the bloodstream? She surely has NO idea.). Do you see what I'm saying?

[PhantomRN]

The last question first. You will learn about lidocaine in ACLS. We can go IV with that med. In that instance it is used to stop arrhythmias.

My concern with your fellow student is she is not ethical. She steals, lies and fabricates stories to suit herself. She could give a flying kisssy about the patient or her own husband for that matter. She is one of those students who if she did not know the answer to a problem(didnt look up the lido) she would guess rather than asking. She is very dangerous!!!!

I have less of a problem with her injecting the lido in the wrong place. Even if someone knew where to inject the drug they could still miss. And then the part where took it out and reinserted incorrect yes, but those Things are part of the learning curve.

Never fear if she is able to pass her boards the girls on the floor where she will go to work will eat her alive for acting like that.

[MollyJ]

Well, I will confess that during my last quarter, I did take home a sterile intra-cath and do veni-puncture on myself and I doubt I was the only one, but I used great technique. (This was when HIV still meant a place where bees lived.) And I would never have stuck another human without appropriate supervision.

BUT....this girl needs a wake up call. Pick an instructor you trust and tell her all you know. And I want you to know that what you know is hearsay. She may be lying. Sounds like lying might be her forte one way or the other. Anyhow, your instructor will realize that she is hearing some very concerning hearsay and will let your colleagues clinical instructor know your concerns and they will watch her like a hawk.

I believe sincerely and with all my heart that the role of a good school of nursing is to weed out the lazy, the incompetent and the marginal.

I think this girl lies. In the ED's I've worked in, I've seen RN's take a chance with new grads (a their boards were back in the long ago when we could still do things like that) and let them start IV's supervised (and even that was long ago and not recent), but I would NEVER say to a student nurse/na, here start and line for me and chart it. Use my name. This girl's attitude toward drugs is way too cavalier for me. BTW, we do inject lidocaine for arrythmias and I doubt she gave a bad dose, but your whole point is, if you don't know, don't do.

Let your favorite instructor know and then let the system do its' work.

She sounds dangerous and troubled.

[JennieBSN]

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[realnursealso/LPN, LPN]

The first thing to take into consideration is that she broke the law. Stealing syringes and iv kits is a very bad offense. Second of all if you have knowledge of this and someone dies, you could be in trouble with the law also if anyone ever found out you knew. Please run, don't walk to your instructor the very next day of school and spill it all. We don't need people like this in our profession. You will feel so much better if you tell someone. Also tip a trusted person off in the er, and tell them to watch her closely. This is dangerous to anyone who comes in contact with her...faked vitals are not good either. Usually nurses who do this are eventually found out, but only after a patient suffers. Let us know what you decide, but please for your sanity and the safety of all those patients, and her family members, tell someone. Take care:) and God bless;)

[CarolineRn]

Kristi, Please take the advice of Molly, RealNurse and Kday! I am just starting nusing school, so I'm not speaking from a professional perspective, but from the potential patient's prospective. Report this woman, before she does real damage.

[RNforLongTime]

Kristi,

I agree with the other posters and say that you should report this person to your instructor or the Direcor of the Nusring dept at your school if the instructor doesn't believe you. People like this give nurses a bad name in the public and we need ALL the good nurses we can get in the face of the nursing shortage!

I have found that people who skate by in nursing school usually do NOT pass their boards. I hope that you "wake up" your instructors to the dangerous practicies of your fellow student. Nurses who don't give a crap do not belong in the profession.

Good Luck!

Kelly

P.S.--KDay--OMG--is that nurse still working at your facility!!! I hope not! It sounds like she should've been reported the the State Board of Nursing in your state!

[NicuGal, MSN, RN]

You have to turn this girl in before she does something reallllly bad! I agree, you need to go to an instructor or the dean of your school. Or, is there a nurse or two that have befriended you that you can turn to...sometimes in your last year you do find a few that you know you can go to for help on the floors. At our hospital, if someone is suspicious for stealing, we can call security and they will be waiting for them to leave the floor and they have the right to look in our bags. It has happened and people have been fired. That is another option you have....go to security and talk to them about the stealing.

I had to turn in someone for stealing meds...I saw her do it and it was the hardest thing I ever had to do. but it needed to be done.

[debbyed]

Kristy,

You have found yourself in a very difficult situation, even for a seasoned nurse. Yes, her practices are unsafe and will lead to disaster, either hers or a patients. However, you must be careful about what you say to whom. If you have no documented proof of what you say and you "turn her in" you could be leaving yourself open to a law suit and your "friend" sounds like just the person who would sue.

I would suggest that :

1. You distance yourself from this person. If you are assigned together ask to be re-assigned due to personal reasons.

2. Stay away from her outside of school because one day she will be caught with drugs she has stolen and you also could be blamed if you are there.

3. Ask to speak privately to an instructor you trust. Tell her that you need her advice on what to do in a hypotheical situation. At this point do not name names. Listen carefully to her responses that decide your next course of action.

If you do these 3 things they will raise red flags with your instructor(s) even though you have not aquised anyone of any thing. They will see who you are staying away from and who you don't want to work with and hopefully will be alert for the things you have talked about.

If somehow this person graduates and passes boards, be assured that she will be found out quickly when in the "real world" but hopefully your instructor(s) will begin to observe what you have observed.

Best of luck to you, I think you will make a fine nurse.

P.S. sorry about the spelling, I just worked a 12 hour shift last night and am pretty tired. Feel free to E-mail me anytime.