What not to do as a nurse: Fall edition 2015

Yes, the quarterly Board of Nursing newsletter just showed up in my mailbox, and as usual, it contains some pretty interesting stuff.

For all you newbies (or even not so newbies), make sure you don't do any of these at work.

1. Practice without a license. 

I was quite surprised at the number of folks listed in this section this time. Remember: you have to pay up at whatever interval your state requires to be legal.

2. Create documentation discrepancies

Time and time again, there were multiple examples in this issue. My personal favorite was the nurse who charted a skin assessment (multiple times) even when she didn't work.

In particular, if you are in home health, and this happens, they may call into question that you ever visited your client. In fact, if they pay you and you lied about your charting, they may ask for the money back (this happened.)

Moral of the story: as the old nursing saying goes: If it wasn't charted, it wasn't done, really does apply. Other folks really do read your notes: risk managers, quality managers, and even some patients.

3. Inappropriately use your medical record access

No, it didn't involve any celebrities, but please follow your organization's policy on medical record access. This nurse, who had been counseled before re: this issue, decided to look up about 20+ other folks just for the heck of it, and got dinged.

Rule of thumb: if you're not taking care of this person (or you are not evaluating them for a program, etc., as part of your job), do not read their medical record.

4. Forget to be careful in the OR

This was one I haven't seen in a long time, but if you are sending patients to the OR, make sure you send the right patient to the right OR suite. Screwing that up can cause lots of time to be wasted and trouble (in the form of lapsed safety). Identifying your patients really is a big deal.

Also, if your job includes sending specimens to pathology, please do it.

5. Forget to double check those safety devices

One nurse was dinged because he/she did not verify that a fall risk patient really had his bed alarm turned on. Said patient then escaped to the floor.

Yes, some people may fall no matter what you do, but you, as a professional, need to document and be responsible for these folks.

6. Take off without giving report

The stories I could tell about the Slug and this issue...said nurse did not inform appropriate staff that he/she was leaving for the day after lunch, and consequently, left  people in a lurch. Thankfully, no one was hurt.

And finally...

7. Don't self-medicate and go to work impaired

Unfortunately, there were several incidents of this in this newsletter. One person actually used his/her own prescribed medication inappropriately and was sent home due to impairment.

Also, treating yourself with propofol for pain relief is also contraindicated. If you are in a lot of pain, it may be time to see a pain specialist.

Stay tuned for our next edition.

Forever grateful

I am happy to be off work today, especially since I thought I was going to be wearing a cast on my dominant arm. Let's just say walking up hills and wearing certain footwear is hazardous. (I wasn't going far, so I thought I was immune). Nevertheless, after a quick trip for an x-ray and eval, I found out, I was scraped, sore and suffering from a really bad bone bruise between the bones of my arm.

I raise my glass today in honor of those who have come before us, who died and were disabled on the job to give honor to a hard day's work.

The honorable today includes all of you: nurses in the EDs, in the ORs, in the rehab units, in the clinics, in the every inpatient, outpatient, consultant and administrative role.

Your work is honorable and I salute you! Happy Labor Day wherever you are.

Happy 4th of July

This nation will remain the land of the free only so long as it is the home of the brave.  ~Elmer Davis

Thank you all who fight for liberty and justice for all every day, especially on the floors, on the wards, in the waiting, operating and triage rooms.

I raise my glass to you, wherever you are. If nurses aren't brave every day, no one benefits.