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.

Just in time for the holidays...

Ah, it is always an interesting time reading the RehabLand Board of Nursing newsletter. So here's today's edition of what not to do as a nurse.

Don't say those licensing people forget the holidays...be careful out there!

Things not to do as a nurse: the holiday edition.

1. Don't sleep on the job. 
Yes, that nicely made bed looks comfy, but if you forget to wake up, you have a problem. NOTE: some facilities do let you take power naps, but remember, you are PAID to come to WORK (notice the items in caps).

There are some expectations that come with that.

2. Forget to pay your income taxes.
Here in RehabLand, the Department of Take it all Revenue can report you if you don't and you can lose your license. According to the numbers, almost 25% of nurses lost their license last year due to tax issues.

3. Don't force someone to do something they refuse to consent to do, like take a bath.
Do the words assault and battery mean anything to you? I knew they did.  Patient says no, you document to CYA.

4. Drive while intoxicated.
They shouldn't have to tell you "when to say when" if you are a health care provider. But if you tend to be indulgent, get someone else to drive.

5. Fail to monitor a patient and act accordingly.
The example used in RehabLand's newsletter was disgusting. An RN (old one at that--we can tell by their license numbers) flat out did NOTHING for a patient who became sick in the morning. Let him/her throw up, wait until nights when said patient drops the phone, while satting at 82%  (normally 100% person on room air) and passes out.

The night nurse had to call EMS to take this person to the ER.

And finally the topper of this edition:

6. Don't let residents who are supposed to be on the unit (per orders) out.
Another old RN decided to go on a smoke break and six (not one two or three...) residents who were confined indoors got out of the facility. One, Z., was gone for so long that he/she did not get scheduled insulin, had glucose issues, passed out and fell out of his/her wheelchair.

Old RN left Z on the ground, got the other 5 back into the building, hoisted Z back into a chair and told a CNA to take Z to his/her room. No assessment, no documentation, no nothing.

Z sustained a head injury, which was later diagnosed when Z started having other issues.

To all the ER nurses out there...

If you had a patient with a cardiac history who presented to your ER with nausea, vomiting and recent intractable pain, would you put a monitor on him/her?

Just wondering for a friend...we're having a discussion at work.