Things not to do as a nurse, part LVIII

Here's another installment of the popular section on what not to do as a nurse. Listen up, new grads. This is NOT the way to get your 15 minutes of fame.

If you think it is, just remember, NCLEX is getting harder. Here in RehabLand, the pass rate went down, but luckily, the licensing folks are thrilled we are still above the national average pass rate.

Here are a few things that got nurses in RehabLand in trouble lately. Just remember, don't try these at home (or work, either) if you plan on keeping that bright, shiny license.

1. If you're supposed to monitor someone in the ICU, monitor them.

Don't paint your nails, don't go on Facebook, don't blow off the newer nurse you're working with who points out the fact that your patient now has a heart rate of 160 and maybe you should call the doc for orders. Also, when said heart rate goes to 200, don't tell everyone that "I had no idea."

Doesn't work. End of story.

2. If you plead guilty to felony theft, you may lose your license.

Another pretty simple example.

3. Falling in love with a felon could get you in trouble.

No, it's not related to #2, but it could be. Jailhouse Nurse falls for an inmate she's caring for. She goes out and gets him a handcuff key and a gun.  To add to the fun, she smokes some marijuana (a friend brought it in from a legal state) and gets caught doing that while with said inmate/felon. Boundary violations are not a good thing.

4. Oxygen saturation is important for everything.

Remember your ABCs: Airway Breathing Circulation. Yes, those are important. Failing to notice low oxygen sats and to do something about it, can get you into licensure trouble.

5. When you are a private duty nurse, you have to be there (both physically and mentally).

Two examples: one nurse decided to run "personal errands" for almost two hours while caring for her private duty patient, who had hourly vital signs. She also "forgot" to chart that "errand."

Another private duty nurse decided to huff some Dust-Off while her patient's mother fell asleep. The mom found the nurse passed out in the living room on the couch, and when aroused he/she was in no state to work.

6. Why you don't want to become Walgreens/CVS/insert favorite drug store here.

This was pretty interesting. Two nurses were  cited related to "collecting medications to give to poor/uninsured patients" Surprisingly, my license does not say MD or registered pharmacist, either.
Some medications just should not be shared (one RN took unused vials to reuse).

7. Don't bring medical records home.

Ever. No matter how behind you are at work. Can you say HIPAA? This RN took home records that affected a patient's care. Very ugly.

And finally...

8. Don't spank your patients.

Even if they are kids who wriggle around and smack you on the nose while doing their dressing.

That is all. Stay tuned for more in our next installment.

Hot Friday

The unit (and some of our patients) was steaming...literally and figuratively.

As usual, in our neck of the woods, it was hot today. No one told this to the HVAC people, who last year, were lucky enough to have the heat on in mid-May when we had a cold spell. Oh, the joy of rooms that are so hot, patients sticking around in them get sick and vomit. This happened to one of our characters today...just as I was finishing my lunch.

His nurse of course, was nowhere to be found when he first started retching. I got the lucky job of elevating his head, turning it and getting him a bucket. By that time, it was too late. He was a mess. His nurse did show up and I did stick around to help her clean him up and get the doc to look at him, since he's a nice guy and he just doesn't normally do that. He had some other complaints that seemed a bit strange, so we gave him the full treatment...EKG and all. No surprise that after we got his IV access started he tells everyone, "I sure feel better now that I threw up!"

I had the same two patients and Mr. Colo. (They're still working on a colostomy for him...he needs it). I was working with some new nurses, too, so that made things interesting. Trying to demonstrate new stuff and have patients cooperate can be a challenge. Fridays are busy days and one of my normally reasonable characters got crabby fast. He wanted to be "waited on first". Thankfully, the charge nurse helped me out, but I was guilty only of not being able to be in two places at once.

This character is an anxious respiratory mess and you know that ABC stuff (airway, breathing, circulation)...well, he knows the routine and he just hams it up. Just for grins, I put him on an O2 sat monitor, as I start his trach trial (he needs to be plugged for several hours for his trip home). What do you know, he sats in the 90s all the time. All his entreaties for suction, etc., were driving me nuts. I just made him cough up the little bit of sputum he has (always white), because he needs to know how to do it. I still had to suction him twice this afternoon and he made a big mess going back to bed. Happily, I had a helper, so we got done reasonably quickly, but it was still a mess.

My other patients were reasonably less demanding, even the more demanding one. We kept his water cup filled and he was happy. It didn't hurt that I found an ice cream for him at lunch, either!

Needless to say, this wet and tired nurse was so happy to get out of Dodge and get a shower at home. The temperature at home was a delight. The night is young and so is the weekend, which I'll enjoy two days in a row off.

It doesn't get any better! More to come...