What is your biggest nursing pet peeve?

RN1982 · Apr 24, 2009

Nurses that are late! OOH....can't stand it, not even 5 minutes. So rude and thoughtless, don't they know we want out of there! duhhhh, please be on time, please

I agree. Or the nurses who take their sweet ol' time getting report. They come in, chit chat, get their coffee. Then they say they are running late so they want a rushed report. Irritates the hell out of me.

expltcrn · May 13, 2009

Listening to nurses who call the doctor without using SBAR or a similar presentation format:

i.e "Doctor I am calling because the patient has a fever" - that's it, period - no history, other vitals, assessment findings, etc.

I heavily teach, preach and practice the SBAR to improve patient safety patient outcomes.

elthia · May 13, 2009

Nurse's and HUC's that disregard orders instead of getting clarification. Last night I had a postop pt that should have had a PCA started, however because the order was written for PACU not the floor,and the primary team wrote a different set of orders, no one clarified the PCA orders and the pt had vicoden and morphine 1 mg IV q 4 hours prn for an ortho procedure. :eek:

When I reviewed the chart I found out the ortho team wanted a morphine PCA, toradol, vicodin, a prn sleeper, and 2 doses of postop abx. So I had to get telephone orders for that because someone wrote DISREGARD ORDERS over that order sheet. sigh...

talaxandra · May 15, 2009

Listening to nurses who call the doctor without using SBAR or a similar presentation format:
i.e "Doctor I am calling because the patient has a fever" - that's it, period - no history, other vitals, assessment findings, etc.
I heavily teach, preach and practice the SBAR to improve patient safety patient outcomes.

ihave no idea what SBAR is but I agree with the rest of it - I feel like wrenching the phone from their grasp and apologising on behalf of nurses who have a clue. Ditto ringing for a Warfarin order without knowing the INR or even why the patient is prescribed it, ringing for fluid orders without knowing the patient's history, reason for hydration and latest blood work...

amiro31 · May 17, 2009

5 different family members calling at different times to ask how patient X is doing...and wonder why you're ****** that you have to repeat yourself 5 times, instead of them just designating one person to gather information and disperse it to the rest of the family.

meluhn · May 17, 2009

I hate that we get docked for a lunch we never get. I hate giving tons and tons of stupid, pointless meds. I hate cnas that think we don't do enough because we delegate to them stuff they dont like to do. I hate that I never get out on time because of all the charting I have to do. I hate that I (nurses) have to work insanely harder than any other member of the healthcare team would even dream of working. I hate that no task is too meanial for management to make it a nurses job. I guess I am a little burnt out.

sicushells, RN · May 17, 2009

1. When I'm in report and get interrupted by the Dr. alllll that info you just asked me is written down, on my sheet, that you're holding. in. your. hand.

2. When new(er) coworkers ask me questions and then tell me I'm wrong. If you aren't going to believe me, stop asking. If you know the answer and want verification say, "can you verify this with me?" grr...

3. The "old school" nurses that don't know or care about current evidence-based practice, can't be bothered to learn about anything new, tell you all about how you aren't as good a nurse as they are, and leave your patient in poopy sheets in the chair for 4 hours when you follow them.

4. Nurses that ask for you help and then won't even cover for you to eat.

5. When nurses are obviously swamped and drowning and can't accept help from anyone else, cuz they're "super-nurse".

6. CTA's that spend more time on the phone during their shift than you do all week, but are 'so swamped' 'running ragged' and can't help you turn/bathe/ambulate/do oral care/get a glass of water. (i'm really not talking about the people that are doing baths, getting stuff done. But if you have time to be sitting and laughing on the phone, you certainly have time to do your job).

7. Know-it-all families, actually families in general. (There are the rare exceptions).

8. Patients we torture and force to stay alive for weeks after their spirit is broken because family or the surgeon has a guilt complex.

9. Drug addicts/ETOH-ers/smokers who pray to God in a holier-than-thou mindset while demeaning you and blaming you for their illness.

10. People who come in for elective surgery and then blame you and their surgeon for the post-op pain.

11. The fact that our housekeeper spends most the day in the break room and it still is dirty and smells rank. what the heck?

12. Patients who refuse to be active in their own health care and then won't even ALLOW you to help them.

13. Abdominal post-op patients who want to eat and drink and call you the evil nurse when you won't let them. And 'threaten' to go AMA (pleaseeee as if that upsets me. Go home, drink gallons of water. Good luck getting the hospital in time when your anastomsis ruptures and you bleed to death in your kitchen. Then again, someone would probably find you in the "nick of time" [read: 3mins 59secs after you stop breathing] so you'd be brain damaged, trached peged, etc.)

13 seems like a good number to stop at.

And I should say sometimes I feel glad to be a nurse. I told my patient tonight that I felt blessed to be part of her healing process, she's kind of a miracle.

RN1982 · May 17, 2009

Sorry but this is going into all caps....

PLEASE STOP CALLING FROM YOUR PATIENT'S ROOM TO HAVE THE OTHER RNS OR NAs GET YOU THINGS SUCH AS ROUTINE MEDS OR BLANKETS BECAUSE YOU ARE TOO LAZY TO TAKE OFF THE ISOLATION GOWN AND GET IT YOURSELF. WE HAVE PATIENTS TOO, NOT JUST YOU.

Chewie_123 · May 17, 2009

Ex-ICU nurse who is now the manager of a med/surg floor. Has that unfortunate "everyone-but-ICU-nurses-are-idiots" attitude, has never worked a med/surg floor outside of clinicals, and has no idea what a shift on an understaffed med/surg floor can be like.

Fun!

Older nurses who automatically assume I have no work ethic because I'm half their age and have never had to do a hard day's work my entire life.

Being treated badly for being a new grad. If I ask you a question/for help, its not because I'm trying to annoy you. I honestly need the help, and am asking out of respect for your experience and gained knowledge.

expltcrn · May 19, 2009

ihave no idea what sbar is but i agree with the rest of it - i feel like wrenching the phone from their grasp and apologising on behalf of nurses who have a clue. ditto ringing for a warfarin order without knowing the inr or even why the patient is prescribed it, ringing for fluid orders without knowing the patient's history, reason for hydration and latest blood work...

here is the sbar synopsis.

sbar was developed by kaiser permanente of colorado, and has been increasingly adopted by hospitals through the united states. sbar is used to report to a healthcare provider a situation that requires immediate action, to define the elements of a hand off of a patient from one caregiver to another, such as during transfers from one unit to another or during shift report, and in quality improvement reports. liability issues may surround the communication that occurred in any clinical situation, but particularly when unexpected changes in a patient’s condition occur. it is often difficult to determine what the healthcare prescriber (physician, physician assistant, nurse practitioner) was told. an inexperienced or fatigued nurse may omit specific important information. one of the goals of sbar is to provide a structure for such communication. the elements of sbar are explained below and applied to contacting a prescriber.

situation: when calling a healthcare provider to report a change in the patient’s condition, the nurse identifies his or her name and unit, the name and room number of the patient, and the problem. the nurse describes what is happening at the present time that has warranted the sbar communication.

situation: “dr. little, this is maria sanchez of 3 north. i am calling you to notify you that your patient, liam kelly, in room 319-2, fell on the floor today while being transferred out of bed.”

background: the nurse includes relevant background information specific to the situation. for example, this could include the patient’s diagnosis, his mental status, current vital signs, complaints, pain level, and physical assessment findings.

background: “as you know, mr. kelly had a discectomy and bone fusion on january 17. his legs have been weak since surgery. he fell when our aide was helping him get up with a walker. his current vital signs are 145/90, pulse of 88 and respirations of 20. he is able to move all of his extremities, although he is complaining of pain in his incisional site of 7 on a scale from 1-10.”

assessment: this step of the communication provides the nurse with the opportunity to offer an analysis of the problem. if the situation is unclear, the nurse tries to isolate the problem to the body system that might be involved and describes the seriousness of the problem. this may be challenging for some nurses because many have been conditioned to hold back the results of their critical thinking skills. some facilities use the assessment step to convey more extensive data about the patient, such as changes from prior assessments.

assessment: “i see no changes in his neurological status since he fell; neither of his legs is shortened and externally rotated. he is quite anxious now and also worried something his neck has been injured.”

recommendation: the nurse states what he or she thinks would help resolve the situation or what is the desired response. this might be phrased in the form of a question: “do you think we should give him a medication, perform lab work, do an xray, perform cardiac monitoring, or transfer to another unit? will you come to evaluate him?”

recommendation: “i believe it would reassure mr. kelly if you would examine him. when can we expect you to come?”

tips for attorneys

1. note any mention of sbar communication in the medical record.

2. in a nursing or medical negligence claim, inquire if the facility has adopted the use of sbar. if so, ask to see the materials used to educate the staff, and for any policies or procedures that may exist relating to sbar communication.

3. for more information, see www.ihi.org, and search for “sbar”.

hope that helps:)

chicookie, BSN, RN · May 19, 2009

my biggest pet peeve has nothing to with actual nursing.

Its that stupid fake self scheduling. I put on the calender M/W/F, then all of a sudden the week before it says M/T/Sat. What kind of self scheduling is that!?! I asked the other days off for a reason PLUS it isn't my weekend to work. GRRR.

It also ****** me off that the patient is fine, has no complaints, sweet as they can be, then the family comes and all of a sudden the patient has three thousands complaints.

or the patient that has PD but came in with peritonitis, and when I do their pd it has to be perfectly perfect. Obviously they weren't doing it perfectly perfect so don't get on to me that I hung the bag first before I attached the tubing. :icon_roll

meluhn · May 19, 2009

my biggest pet peeve has nothing to with actual nursing.
Its that stupid fake self scheduling. I put on the calender M/W/F, then all of a sudden the week before it says M/T/Sat. What kind of self scheduling is that!?! I asked the other days off for a reason PLUS it isn't my weekend to work. GRRR.
It also ****** me off that the patient is fine, has no complaints, sweet as they can be, then the family comes and all of a sudden the patient has three thousands complaints.
or the patient that has PD but came in with peritonitis, and when I do their pd it has to be perfectly perfect. Obviously they weren't doing it perfectly perfect so don't get on to me that I hung the bag first before I attached the tubing. :icon_roll

They weren't doing it perfectly perfect and that is why they have peritonitis. Assuming PD means peritoneal dialysis, in which case it does have to be perfectly perfect. :coollook: