What are the huge "DO NOT EVER DO" things that new nurses need to know about? calling

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I am graduating in a few days, and off to be a new registered nurse. I would love to hear from experienced nurses about the "BIG" things that they need to remember or the things they try to avoid. Medication tips, or how to deal with patients...anything would be helpful, and thank you !!

Specializes in Trauma ICU, MICU/SICU.
:trout: :nono: Lending a helping hand when another nurse's patient has just made a disastrous code brown mess will win their respect and they will be willing to help when it's you staring at a big mess wondering where to start. Same with CNAs. Cleaning up patients isn't just a CNA's job. ;)

I believe Greenhorn made that statement in jest. I sure got a chuckle out of it. I was once called into a room (purely 'cause they just had to see my reaction) to see a pt. with a big ole' loada code brown in his hand. There were already about 4 ppl in there (in addition to the very nakad as a jaybird brown pt. in question) and I walked right back out. We all got a good laugh out of that one. Of course, I'm quick to help with brown codes, etc.

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Specializes in Trauma ICU, MICU/SICU.

Always tell your patients what meds you're giving. Most pts. that are on chronic meds, know their meds very well. They will usually question new/different meds.

Also when you get to the colace/senokot, it will remind you to ask about bm's. Before I got in the habit of asking about bm's before giving colace, the pt. would always volunteer if they had diarrhea before taking that one.

Pts. appreciate this and have told me so.

Never assume that a drug addict doesn't need pain meds or is drug seeking. A drug addict needs MORE pain meds to alleviate his/her pain.

Never, NEVER stick your face close to an agitated pt. It will get hit.

NEVER roll your eyes when leaving a pt's bedside. Their family will be right their when you least expect them and you will get caught. :uhoh21:

If you aren't good at a skill and need another nurse to try for you (i.e. attempted and failed at IV or Foley insertion). Ask helper nurse if you can watch. You will learn a lot this way.

If you have 2 pt's tanking simultaneously and another needs pain meds, you need to ask for help and give specific instructions of what you need help with. Don't try to do all that at once. NOT good for your patients or you.

Don't be afraid to stand up to residents or even go over their heads if you don't agree with their assessment or plan. I've had to fight for CT's to rule out PE's on many occasions with pt's that had PE's or fat emboli.

If a doc yells at you in front of a pt. Be professional. Finish what needs to be done for the pt. When you are done. Speak to that doc (away from the pt.) and explain that it will not be tolerated and that it jeopardizes your credibility to your pt. This can be esp. fun when said doc is an arrogant visiting resident from a hospital named after a genious and said doc is dead WRONG about said pt. (not that this happened to me or anything). ;) Even more fun is calling said doc back in 10 minutes with critical ABG results confirming that the pulse ox was not broken as genious hospital resident had exclaimed earlier at bedside.

Treat your techs and other UAP's with respect and help them out when you can. They will really WORK for you if you do this. If you're a lazy nurse who sits on her hiney hines all night and orders said techs around, the techs will blacklist you so to speak.

I'm sure their's more, but I just took benadryl for a rash and I'm getting very sleeeeeepppppyyyyy.... Z Z Zz zzzzzzz

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Sounds to me like you really got some excellent advice from the ones who are out there.

It was real interesting to read these thoughts, for I had forgotten how all the questions came to mind when we first started.

You are a smart person to ask this question. I think you'll do just fine with a mind set such as yours.

macspuds

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Specializes in ortho/neuro/general surgery.

Don't assume that just because a pt is sleeping, that they're not having pain

-learning a lot from this thread!

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Don't wear you stethescope around your neck near an agitated patient or you might get choked with it.

Never mix Lantus insulin with other insulins or give it IV. It will crystalize.

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Specializes in Float.
Never mix Lantus insulin with other insulins or give it IV. It will crystalize.

Just to clarify - we don't give any insulin IV except Regular? correct?

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Specializes in Med Surg/Tele/ER.
IVP Potassium will stop the heart instantly. It is what they give for the death penality lethal injection.

Just wanted to add....if you ever have to mix your own fluids, say adding K+ make sure you shake the daylights out of the bag!!!! and NEVER set the bottle of K+ down....could be confused for sterile water or lido

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Specializes in ER, ICU, Infusion, peds, informatics.
just to clarify - we don't give any insulin iv except regular? correct?

the ultra-short acting insulins (humalog) can be given iv, as well.

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Congratulations Cal, :welcome:

Always double check handwritten medication orders, adjusted doses, and dosing schedules. If it you have an odd feeling about it; go into procedural pause; then double check it!

I am a new one month nurse in a psychiatric facility. Best of Luck to you in your new career!

Nurse Smiley

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Specializes in L & D.

Always check your IV lines to be sure they are connected to the patient, especially if there are several lines running. Just had the embarrassing experience of administering IV Pitocin to the floor under my patient's bed for a couple of hours. No wonder she didn't develop the expected adequate labor pattern. In this case, no harm done...but no less a mistake. Nursing 101 is easy to forget when you're in a hurry.

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Specializes in ortho/neuro/general surgery.

Never give hydroxyzine (Vistaril) IV.

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Specializes in Neuro ICU, Neuro/Trauma stepdown.

speaking of...never trust the pharmacy (someone other than yourself basically) to always send the right meds or put the right meds on the mar. i've had med errors before for giving what was on the mar, it was there and I had the meds, so i gave them.

Ever notice how much hydroxyzine and hydralazine look alike? two completely different meds, but that's what i got last week. luckily i noticed right away, that would have been the last thing that patient needed.

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