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.

What not to do as a nurse, version 100

We have new staff members at the Hotel, so I'll be sure to bring along the latest installment from the RehabLand State Board of Nursing newsletter.

This issue was more sad than silly, unfortunately. When they say you are a "licensed professional nurse" they really are stressing all three of those things. Licensed (you have one) professional (you are one at all times) and nurse (the occupation, not just the job).

Here are the top 10 items: (I wish there weren't this many, but...)

1. Yes, you really can get a ding on your license if you decide to take some controlled substances you got in 2010, and for which you no longer have a prescription.

The little problem happens when your employer makes you pee in a cup.

Can you say "just dispose of this properly and get a script if you need one."? I knew you could.

2. Don't just screw up one thing, screw up many.

A nurse had a really, really bad day and just kind of forgot to follow a bunch of orders on an acutely ill patient (meds, isolation, etc.)

3.Sleep on duty.

Just say no. Sleep on your own time and no one ever reads about it in a newsletter or on the news. End of story.

4. More on not following orders: disobey transfer orders on a patient, then remove a surgically implanted port, then attempt to reinsert it yourself.

O.M.G. After reading this, I would have had a hard time not thoroughly throttling this nurse.

5. Just forget to renew your license for a year.

Whoops! No license, no job. Sorry!

6. You work in an office and you just don't call the patient back when they ask to reschedule. If that's not enough, you just forget other things, too.

My question: How did you pass your boards? Certainly you had to remember SOMETHING?

7. Do drugs (at work, at home, at some place you can't remember).
Yes, all of those came up this issue (cocaine, meth and alcohol). The scariest one: the pregnant nurse doing meth. And yes, the kid tested positive.

Hello, another state agency, Children and Family Services.

8. Fake your license renewal.
Because, really, who wants to pay the State of RehabLand money to work when you can do it for free?

9. Get drunk, go driving, and wave a gun around in the air.
You will win the following: an unlawful use of a firearm, peace disturbance, and driving while intoxicated charges.

10. And finally, the worst one this issue: steal a dead patient's identity to get a cell phone in his/her name.

Despicable... be warned, professionals!

Bully pulpit

I have a friend (no April Fool-- call him/her M) who is having this problem, and because he/she felt threatened while we completed our studies, he/she kept quiet until his/her internship was over. He/she suffered.

ANA discusses bullying in their Healthy Nurse section on Bullying and Workplace Violence:

Lateral violence refers to acts between colleagues and bullying is often described as acts perpetrated by one in a higher level of authority. This behavior may involve covert or overt acts of verbal and non-verbal aggression. These types of behavior have been reported to result in enough psychological distress to nurses to cause them to leave the profession (Dellasega, 2009). 

The person perpetrating this bullying is in a higher level of authority. Ever heard of C-suite? Well, he/she is up there. It's hard to believe that your former preceptor would, out of the blue, accuse you of theft of intellectual property and assault your character in company e-mail of a prominent hospital system, but the former preceptor did.

All the while, my friend was just happy to receive a national award recently. When he/she came home the other day, there was a family crisis. Off to the hospital, but not for work. One of the family had become ill and required emergent surgery.

After I calmed him/her down, we discussed what happened since school. Everything is documented. Since the degree is done, I suggested he/she contact an attorney. Life's too short to live in fear of this crazy person.

As the saying goes, tough times never last, but tough people do.

More to come...

It's back again since it's Sunday

This one is various questions from today's version here:

What would you choose to be famous for? 
I would like to be a famous philanthropist. Since my chances right now are slim to none, I'll take the Nurse of the Year in the HotelRehab group.

If you have a webcam, are you ever paranoid people can see you? 
I turn mine off and block the view. That's all I'm saying. I'm very opinionated about this. Don't get me started!

Do you find it difficult to sleep at night? Any reason(s) why? 
Yes, my husband often steals my covers.

If you had to go on a game show, which would you choose? 
Jeopardy.

What about if you had to go on a reality show? 
I would not do a reality show. Just don't like them.

Which would you choose then? 
See above.

Tell me about your favorite TV show: 
I love the news...always different.

Why were you last irritated? 
Driving gets me going some days. I'm glad I had a good day, today.

What time did you get up this morning? 
0545. My body clock says that's sleeping in on weekends.

Do you like the countryside? 
Yes, in winter.

Do you think you’d make a good model? 
Depends on what you want me to model. I'd make a dandy scrubs model.

Would you ever want to be one? 
Not really,

How often do you change your hairstyle? 
I mix it up every so often. No idea how often. Sometimes it's the cut, other times, color.

Do you have a favorite day of the week? Which is it? 
Sunday. Of course!

Really spring?

Yes, we're having a snowstorm in RehabLand. Who could think of a better way for us to appreciate spring when it gets here? (Those crazy meteorologists.) Anywho...here are a few goodies I ran into once I got off the slick roads and out of the grocery store today. (I had to get my triple coupons!)

Since the groundhog predictions of an early spring are off, some litigious folks in Ohio want to get Phil. Thank you BBC for being on the mark for this important story.

Grumpy has a weekend rerun ALL nurses will enjoy. Thanks for thinking of us Grumpy. I'd stash you a Diet Coke, anytime!

Yet another problem: how to tell if the new iPad you just bought is really in the box. Hard to believe this could have happened at a major retailer, but if it's worth something, people will try to steal it.