Congratulations graduates! You worked hard and now you're prepping for that NCLEX. Some people say it's the hardest exam they've ever taken. You may get nauseated (I did) before it's done.
Please, grads, don't find your way into your state's Board of Nursing (BON) newsletter for getting a ding or losing your license. Trust me, keep it clean and shiny. You are worth it!
Here are some of the things I noticed in this edition:
1. Use respectful language.
Yes, believe it or not, one RN was censured due to this little problem. They just keep piling on the issues, too, as they did for this nurse, if you're really a pain (unauthorized record access, changing orders, etc.)
Just say no.
2. For all of you nursing instructors out there, don't dope slap your nursing students.
One RN did and she was written up in this BON newsletter. One word: priceless. I think some of my nursing instructors may have thought it, but no one ever did it.
3. Don't steal a resident's purse, then get something from the med room and shoot up.
This nurse did. She obviously forgot the video cameras reported her every move.
4. Don't ask nursing students to do the wrong thing.
Telling your student to give a patient normal saline instead of Dilaudid is a perfect example. Someone will notice. The patient did and reported the nurse.
5. If you forget a specimen, get it to the lab. Do not take it home.
Yes, someone actually took a specimen from a procedure home, since the nurse forgot to send it along. A technician found it when cleaning the room. Admit your mistakes, but get it to the lab!
6. Drug testing is not optional.
Just remember: your facility policy is not optional. Compliant is a lot different than "slightly compliant".
7. Do not forget to document drug wastes.
Always, always, always waste drugs per your facility policy (we have special containers for various classes of drugs) and make sure you document appropriately. Your license really does depend on it.
Many happy returns and best wishes for a long nursing career!
Showing posts with label what not to do. Show all posts
Showing posts with label what not to do. Show all posts
Saturday, May 21, 2016
Wednesday, February 10, 2016
What not to do: February edition
Yes, the mail came...and the stories abound in RehabLand's Board of Nursing newsletter. Students, take note. These things noted below can cause you to lose your license.
1. Make up stuff
Making up visits, vital signs, or even, whether a dialysis machine works is not good. Can you say "fraud"? Fraud means fabricating the truth, whether it's in documentation or conversation.. The truth really is a good thing, and should be obvious in your work, so don't bother making up a bunch of tales that you have to remember.
2. Commit another felony
Yes, it is hard to get and keep a nursing job if you're convicted of a felony. This edition has some new ones: video voyeurism, tampering, and deviant sexual assault. Friends, do your self a favor: forget about felonies.
3. Forgetting to call
If you do have a drug problem, and you're required to call in, call. Don't forget 79 times. Call.
4. Appearance is everything
If your eyes are glassy and red, if you smell like you've been drinking, you may lose you license.
Stay tuned for our next edition. Never a dull moment!
1. Make up stuff
Making up visits, vital signs, or even, whether a dialysis machine works is not good. Can you say "fraud"? Fraud means fabricating the truth, whether it's in documentation or conversation.. The truth really is a good thing, and should be obvious in your work, so don't bother making up a bunch of tales that you have to remember.
2. Commit another felony
Yes, it is hard to get and keep a nursing job if you're convicted of a felony. This edition has some new ones: video voyeurism, tampering, and deviant sexual assault. Friends, do your self a favor: forget about felonies.
3. Forgetting to call
If you do have a drug problem, and you're required to call in, call. Don't forget 79 times. Call.
4. Appearance is everything
If your eyes are glassy and red, if you smell like you've been drinking, you may lose you license.
Stay tuned for our next edition. Never a dull moment!
Tuesday, November 10, 2015
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.
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.
Saturday, February 14, 2015
Things not to do as a nurse, February edition
Yes, the fun never stops in RehabLand. Days ago, the State Board sends out renewal notices and today, they send out their regular newsletter.
Guess it's a reminder to answer those questions correctly.
We have plenty of our regulars: lapsed licenses and drug testing abuses. Here's the ones from this edition that you really need to put on your "DO NOT" list, students (and any other RNs for that matter...).
1. Do not attempt to substitute blue mouthwash.
Yes, we all know that certain forms of morphine smell just like some of the mouthwashes on the market, but stealing pain meds from terminally ill patients, is, was, and ever shall be unforgivable.
It will also cost you your license (there were actually two mouthwash switchers in this edition from RehabLand State Board of Nursing).
2. Don't go to a party, get wasted, then trespass.
This is also a problem, especially when you are convicted.
3. Do not share your Pyxis/Omnicell/drug dispenser password.
One person lost his/her license for this (and diverting narcs), but my question is, what happened to the idiot who shared the password?
Here at the Hotel, you would be fired for violating the information security policy.
Speaking of policies...follow them.
4. Don't assess the patient after a violent incident involving security.
This nurse was reprimanded for leaving that lil' old task to someone else. If your facility states you will assess following any altercations you must.
Besides, it's a lawsuit waiting to happen. Remember: you're considered in a position of power.
5. Don't just "borrow" a retiring physician's prescription pad.
When you are from a little town, people talk. And those pharmacists are smart. Hence the reason why they didn't fill any of your prescriptions.
And finally, my personal favorite:
6. Don't go offroading in the company car.
This applies to anyone really, not just nurses, unless of course your company car is an off-road vehicle and/or your job demands it.
Home health RN was out on his/her regular route seeing patients when he/she ran off road and damaged the axel of the car, requiring towing. Luckily, no one was hurt, but since this is a recordable incident while on duty, HHRN was required to submit to a drug screen.
As you may have guessed, he/she flunked (positive for marijuana). Remember kids, buzzed driving, driving while high (or getting high during working hours) is really NOT a good thing.
Guess it's a reminder to answer those questions correctly.
We have plenty of our regulars: lapsed licenses and drug testing abuses. Here's the ones from this edition that you really need to put on your "DO NOT" list, students (and any other RNs for that matter...).
1. Do not attempt to substitute blue mouthwash.
Yes, we all know that certain forms of morphine smell just like some of the mouthwashes on the market, but stealing pain meds from terminally ill patients, is, was, and ever shall be unforgivable.
It will also cost you your license (there were actually two mouthwash switchers in this edition from RehabLand State Board of Nursing).
2. Don't go to a party, get wasted, then trespass.
This is also a problem, especially when you are convicted.
3. Do not share your Pyxis/Omnicell/drug dispenser password.
One person lost his/her license for this (and diverting narcs), but my question is, what happened to the idiot who shared the password?
Here at the Hotel, you would be fired for violating the information security policy.
Speaking of policies...follow them.
4. Don't assess the patient after a violent incident involving security.
This nurse was reprimanded for leaving that lil' old task to someone else. If your facility states you will assess following any altercations you must.
Besides, it's a lawsuit waiting to happen. Remember: you're considered in a position of power.
5. Don't just "borrow" a retiring physician's prescription pad.
When you are from a little town, people talk. And those pharmacists are smart. Hence the reason why they didn't fill any of your prescriptions.
And finally, my personal favorite:
6. Don't go offroading in the company car.
This applies to anyone really, not just nurses, unless of course your company car is an off-road vehicle and/or your job demands it.
Home health RN was out on his/her regular route seeing patients when he/she ran off road and damaged the axel of the car, requiring towing. Luckily, no one was hurt, but since this is a recordable incident while on duty, HHRN was required to submit to a drug screen.
As you may have guessed, he/she flunked (positive for marijuana). Remember kids, buzzed driving, driving while high (or getting high during working hours) is really NOT a good thing.
Monday, February 9, 2015
More on interviewing
Yes, I know I talked about this last year, but since I'm now on my 10th interview panel (I did a bunch last year), I've found a few more things to add:
Things that may cause us not to hire you:
1. If you are a travel nurse and tell me you just want this job until a gig comes up in Florida, you may not get hired.
Yes, spring will be in RehabLand soon. Why should we bother our HR folks to do a whole bunch of work if you won't stay anyway?
2. If you have issues, we may not hire you. As part of a credentialing process, we have to do a background check.
The state of RehabLand will not renew your RN license if you have tax issues.
3. If you may be part of an investigation due to criminal wrongdoing and/or a sentinel event, thanks for letting us know, but we may not select you for hire.
Things that may cause us not to hire you:
1. If you are a travel nurse and tell me you just want this job until a gig comes up in Florida, you may not get hired.
Yes, spring will be in RehabLand soon. Why should we bother our HR folks to do a whole bunch of work if you won't stay anyway?
2. If you have issues, we may not hire you. As part of a credentialing process, we have to do a background check.
The state of RehabLand will not renew your RN license if you have tax issues.
3. If you may be part of an investigation due to criminal wrongdoing and/or a sentinel event, thanks for letting us know, but we may not select you for hire.
Saturday, December 20, 2014
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 ofTake 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.
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
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.
Saturday, July 5, 2014
In the news
Since I'm taking a break, I thought I'd have a look at the latest health news.
Here are a few that caught my eye. Hope you enjoy.
What not to say (from www.cnn.com)
Um, yes, some things really ARE important enough to not be busy for, Mr. Professional Basketball Player. Cancer doesn't give a rat's (fill in your favorite anatomical part) who you are.
A hypoglycemia dilemma (from www.nytimes.com)
This interested me, because I often feel hypoglycemic. Think you can figure out this dilemma? Check it out.
A different type of dilemma if you have back pain (from webmd.com)
Steroid injections may help some folks with back pain...or not. Read more here to learn more about a recent study.
Just another reason (also webmd.com)
Please be careful with supplements! Bee pollen for weight loss could cause other potentially life-threatening conditions, even if it sounds like a good solution for you.
If it sounds too good to be true, it probably is.
Happy weekend all!
Here are a few that caught my eye. Hope you enjoy.
What not to say (from www.cnn.com)
Um, yes, some things really ARE important enough to not be busy for, Mr. Professional Basketball Player. Cancer doesn't give a rat's (fill in your favorite anatomical part) who you are.
A hypoglycemia dilemma (from www.nytimes.com)
This interested me, because I often feel hypoglycemic. Think you can figure out this dilemma? Check it out.
A different type of dilemma if you have back pain (from webmd.com)
Steroid injections may help some folks with back pain...or not. Read more here to learn more about a recent study.
Just another reason (also webmd.com)
Please be careful with supplements! Bee pollen for weight loss could cause other potentially life-threatening conditions, even if it sounds like a good solution for you.
If it sounds too good to be true, it probably is.
Happy weekend all!
Wednesday, November 20, 2013
What not to do as a nurse postscript
Normal nurse: you obey the law, because your state can (and will) revoke your license if you don't.
Our nurse: was dodgy and always on his/her cell phone. Now we know why. Must have been to the lawyer or the bail bondsman or someone else.
Security came recently and escorted him/her off the premises.
Never a dull moment at the Hotel.
Our nurse: was dodgy and always on his/her cell phone. Now we know why. Must have been to the lawyer or the bail bondsman or someone else.
Security came recently and escorted him/her off the premises.
Never a dull moment at the Hotel.
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