Nurse Stupid works 7a-7p; I am pulled to fill in 7-11; I get there about 7:45pm to hear a taped report; I get out at 8:00pm and she's gone. The tape states Pt. B has a heparin drip at 1400 units/hr; PTT's are being done Q12 (6a and 6P),the 6P was >200; she called Dr. X's exchange and he never answered. I got out of report, found the heparin still running and stopped it (with Protonix piggy-backed into the line). I called Dr. X (Dr. Y was on call and didn't give a hoot, just said "Turn off the heparin and do a PTT in the AM"); of course, I had already turned off the heparin. In the meantime I am looking at the chart and there was an order signed off by Nurse Stupid at 11:30am to STOP THE HEPARIN. I called her at home, asking why didn't she turn the heparin off for a PTT of 200 ("I didn't have an order"), and she could not remember signing off the stop order at ll:30am--she was the RN team leader--I didn't have any communication with the LVN med-giver since the RN's usually handle the heparin drips. I fixed the problem, and made an incident report (I think they all go into File 13), but I don't think anything was learned from this experience by anyone. Incidentally, someone mentioned this to Nurse Stupid the next day and she cheerfully reported she had fixed the problem--a regular Florence Nightingale that one.
What Would You Do?
what would I do? fix it, chart it and do the incident/med error report. Just like you did. The reports will go to case management but you can't fix everyone you work with just cover yourself is all you can do.
Well, I would not be calling anyone stupid, thats for sure. Unless your perfect? Are you?
STUPID IS AS STUPID DOES
FOREST GUMP
FOREST GUMP
"Life is like a box of chocelets, you never know what you going to get".
Forest Gump
Forest Gump
Hey, the spell check didn't work, and I don't have a box of candy either. 
Like you've never had a bad day and then been told about it the next shift you worked?
Was it a major screw-up, of course. However, you did the right thing to fix and document it.
The system we're working in fosters these types of incidents by asking us to do way more than is safe.
Are some people more capable of handling it than others, sure. But no one is perfect. Don't go criticizing others unless your damn sure you don't have any skeletons in your own closet.
Andrew Lopez, RN
Nurses Views of The Nursing Profession.
http://www.nursefriendly.com/views
Was it a major screw-up, of course. However, you did the right thing to fix and document it.
The system we're working in fosters these types of incidents by asking us to do way more than is safe.
Are some people more capable of handling it than others, sure. But no one is perfect. Don't go criticizing others unless your damn sure you don't have any skeletons in your own closet.
Andrew Lopez, RN
Nurses Views of The Nursing Profession.
http://www.nursefriendly.com/views
1. Yes, I've had bad days.
2. Yes, I've made mistakes, but honestly, none as
totally s----d as this (if that word bothers you). To
be absolutely honest, I believe I have made stupid
errors, too, but I don't believe I ever compounded
such a dearth of common sense with a total disregard
for hospital policy (add to this no acknowledgement
that a mistake was made, and no interest in knowing
how to correct it or gain insight into how it happened).
I have always wanted to know what I did wrong, how to
correct it, and how to prevent it ever happening again.
3. In this case, the "system" had nothing to do with this
happening. I do, however, agree that more and more
mistakes are occurring due to lousy staffing,
exhausted nurses, etc.
4. Just exactly who was I criticizing? My message was
just a result of total frustration with seeing this
sort of thing happen again and again. I thought this
was a forum where nurses could spill their guts in an
atmosphere of tolerance--I never really expected
someone to take up for the "underdog."
2. Yes, I've made mistakes, but honestly, none as
totally s----d as this (if that word bothers you). To
be absolutely honest, I believe I have made stupid
errors, too, but I don't believe I ever compounded
such a dearth of common sense with a total disregard
for hospital policy (add to this no acknowledgement
that a mistake was made, and no interest in knowing
how to correct it or gain insight into how it happened).
I have always wanted to know what I did wrong, how to
correct it, and how to prevent it ever happening again.
3. In this case, the "system" had nothing to do with this
happening. I do, however, agree that more and more
mistakes are occurring due to lousy staffing,
exhausted nurses, etc.
4. Just exactly who was I criticizing? My message was
just a result of total frustration with seeing this
sort of thing happen again and again. I thought this
was a forum where nurses could spill their guts in an
atmosphere of tolerance--I never really expected
someone to take up for the "underdog."
What this nurse did was stupid. See my reply to NursingHumor.
Voice your opinions by all means, but be prepared to stand by them. I found your post to be highly critical and demeaning to the nurse who made the errors, and nurses in general because it reflects on all of us. It did offend me.
Assuming you've been in nursing for a while, I'd think you were used to this type of thing happening. I'm not condoning it or the nurse who made the errors, I am saying that it happens.
And we don't know what else was going on at that time system-wise, do we? How do you know it had nothing to do with it?
Don't compare yourself to others unless you've been in exactly the same situation yourself, with the same level of experience and confidence as that nurse and handled it. If it was brought before the state board of nursing, that is how a nurse is judged.
Somehow I doubt that is the case since we don't know about about the nurse in question.
And what pray tell is wrong for taking the side of the underdog? If it were you being criticized, would you prefer to be left high and dry? Maybe that type of behavior is commonplace where you work, I don't know.
I think we can agree, you're entitled to your opinion and so am I.
I'd hope that we can both voice them freely here.
Andrew Lopez, RN
http://www.4nursing.com
Assuming you've been in nursing for a while, I'd think you were used to this type of thing happening. I'm not condoning it or the nurse who made the errors, I am saying that it happens.
And we don't know what else was going on at that time system-wise, do we? How do you know it had nothing to do with it?
Don't compare yourself to others unless you've been in exactly the same situation yourself, with the same level of experience and confidence as that nurse and handled it. If it was brought before the state board of nursing, that is how a nurse is judged.
Somehow I doubt that is the case since we don't know about about the nurse in question.
And what pray tell is wrong for taking the side of the underdog? If it were you being criticized, would you prefer to be left high and dry? Maybe that type of behavior is commonplace where you work, I don't know.
I think we can agree, you're entitled to your opinion and so am I.
I'd hope that we can both voice them freely here.
Andrew Lopez, RN
http://www.4nursing.com
That nurse was incorrect in their actions. BUT:
NEVER call a person stupid. If there is a problem, the person needs to be talked to. That is a very powerful word to call a person.
NEVER call some one at home to ask why they did not do something, when you know it was not done. If there is a problem fix it and drive on. Most nurses I know that do that are very power oriented.
Last - You ranted a problem without a viable solution to the problem. I think we have all encountered a problem like this and it is how we handle it that makes us good co-workers.
I do not think people are for the underdog, I think they were against your anger in the post and the way you articulated the problem. This place is to spill you guts but it is a place to get constructive criticism.
NEVER call a person stupid. If there is a problem, the person needs to be talked to. That is a very powerful word to call a person.
NEVER call some one at home to ask why they did not do something, when you know it was not done. If there is a problem fix it and drive on. Most nurses I know that do that are very power oriented.
Last - You ranted a problem without a viable solution to the problem. I think we have all encountered a problem like this and it is how we handle it that makes us good co-workers.
I do not think people are for the underdog, I think they were against your anger in the post and the way you articulated the problem. This place is to spill you guts but it is a place to get constructive criticism.
hi all i'm a nurse from the uk , i just wanna add a comment to this, yes ok she made a mistake, we can all do that if not given enough info but what really gets to me is that no matter where in the world nurses are y are we so bad at supporting each other, i ask y?, the damn job is hard enough as it is, so plz all b patient to each other as well as the patients, nurses are human too, ps lol i'm gonna b taking the nclex soon i am a qualfied rn in the uk but gonna b moving to the usa, if anybody wants to chat contact me on my yahoo messenger the name is: wolf_funk have a good day all
hey, we all need to vent sometimes!
Maybe stupid was a bad choice of words. I dont know that I wouldn't have used it myself though. You come home, you've had a bad day, you're fired up because the nurse before you not only created the problem, but really showed no concern for future precautions...I'd probably say the same thing...
Maybe stupid was a bad choice of words. I dont know that I wouldn't have used it myself though. You come home, you've had a bad day, you're fired up because the nurse before you not only created the problem, but really showed no concern for future precautions...I'd probably say the same thing...
I know you all have missed me...my computer is acting silly so I'm on my husbands. I didn't have nurse stupid last night I'd say more like lazy fits the bill. It's time to get off we're crazy (labor & delivery) with several delivered at the same time and others in the wings. Everyone coming on comesto the rooms where we are and asks whats going on and what needs done but there's one that goes and sits at the nurses station not going to work until she gets report ...at the station. I'm sorry but when I'm helping a doc in a delivery (as is everyone else) it's time to get up and find out what needs done. I would think you can see nobody is coming to give you report come get it. It's not like it's the first time. I did give her a telling off last night. I'll tell her sorry this morning for my way of saying it but still tell her if you see it's busy get up and do something. Not like it's the first time. We're good at doing c-sections right at 6:55 pm and there are a few that don't come into the OR and get report they wait for us to get into recovery to take over where as if they'd come into the OR they could get the lowdown and take over as soon as the final count is over as we all like to go home on time. I knew you'd be glad I'm back to hear me bitch.
I agree with the original writer. What that nurse did was not only stupid it goes to the question of basic competency. Did she not know the PTT was 200? Did she even know enough to check the PTT? Does she not read orders she signs off? Does she not know that Protonix is not compatible with Heparin? The whole thing is mind boggling; one error compounding another. Don't tell me this is another one of those wimpy web sites where people are not allowed to say what they think so long as they do not use profanity. There is nothing wrong with strong opinions or words for that matter. Try reading some commentary magazines and see what kind of strong language you will find! No one ever died from words but patients can die due to negligence or incompetence.
What nurse stupiid did was not stupid; it was dangerous. If the patient had died she could have been prosecuted criminally as well as civilly. Practise principals - NOT PERSONALITIES.
This was re: Cassioo's post...Wow, this same thing happens in my L&D unit and it is so frustrating. I work l&D and Newborn nursery. It is so frustrating when you are back in the OR or in a delivery and no one will come relieve you. The same ones that won't relieve you are also the same ones coming to give you report before you even put your purse down or clock in. I come in at 6:30 so I don't have to rush and you are right after 12 hours we all want to go home !!!
[ QUOTE ]
smbrn said:
Don't tell me this is another one of those wimpy web sites where people are not allowed to say what they think so long as they do not use profanity. There is nothing wrong with strong opinions or words for that matter. Try reading some commentary magazines and see what kind of strong language you will find! No one ever died from words but patients can die due to negligence or incompetence.
[/ QUOTE ]
We are quite liberal in what is allowed on the forums, long as it is not blatant spamming, attacks or profanity, you'll find we let people voice their opinions, beliefs, with little or no censorship.
However, the use of profanity in a public forum is a striking sign of ignorance. It will not be tolerated regardless of the context.
That aside, your views are welcome.
Andrew Lopez, RN
(Network site owner)
http://www.nursinghumor.com
smbrn said:
Don't tell me this is another one of those wimpy web sites where people are not allowed to say what they think so long as they do not use profanity. There is nothing wrong with strong opinions or words for that matter. Try reading some commentary magazines and see what kind of strong language you will find! No one ever died from words but patients can die due to negligence or incompetence.
[/ QUOTE ]
We are quite liberal in what is allowed on the forums, long as it is not blatant spamming, attacks or profanity, you'll find we let people voice their opinions, beliefs, with little or no censorship.
However, the use of profanity in a public forum is a striking sign of ignorance. It will not be tolerated regardless of the context.
That aside, your views are welcome.
Andrew Lopez, RN
(Network site owner)
http://www.nursinghumor.com
OK, OK, the person was stupid!!!!!
I try to talk to the person, if there is no positive response I use the peir eval and written counseling. If that does not work I write a letter with documentation to my director. I have had a person removed from CVICU.
I try to talk to the person, if there is no positive response I use the peir eval and written counseling. If that does not work I write a letter with documentation to my director. I have had a person removed from CVICU.
I agree with you. Not only was your "nurse stupid" STUPID, she was NEGLIGENT. Yes, nurses are human and we all make mistakes. God knows I've made some of my own. But repeat offenders of things like this deserve the title. I run into this type of problem sometimes myself. I call the mistake to the nurses attention and help to fix the problem. I know that we all want to go home asap at the end of the day, but it is very important to stop, look behind you, and make sure that your 
is covered before you walk out the door. We can never be too careful in our profession. 
is covered before you walk out the door. We can never be too careful in our profession. I thought grade school was where you learned not to call names. I have done some stupid things and I have also found some stupid things that never got to the person that did them just because. The only time I would call a nurse at home would be to ask her if she gave something that was unclear per paper work. I would quietly tell her about her goof and unless it was something that was going on all the time I would try not to be part of the problem. I have worked with many nurses that were "perfect"
Document, document, document. I am not sure what the protocol is for reporting a RN to the nursing boards for gross misconduct however, this might be well worth your while to look into.
****o,
This is my first post here, so hi all. About the nurse and the Heparin mistake
unfortunalty I have run into these kind of things often and often from the same nurses. As far as what I would do, the same thing. Inform her of the mistake, and an incident report, and hope the nurse learned from this.
By the way this looks like a great site and I'm sure I will find more interesting posts to reply to.
This is my first post here, so hi all. About the nurse and the Heparin mistake
unfortunalty I have run into these kind of things often and often from the same nurses. As far as what I would do, the same thing. Inform her of the mistake, and an incident report, and hope the nurse learned from this.
By the way this looks like a great site and I'm sure I will find more interesting posts to reply to.
Have you noticed that medical error is being brought to the forefront as a huge issue needing to be studied and addressed? What ever has been done in the past obviously has not worked. Of course attacking one another has not proven effective but what the effective approach is will hopefully be unturned in the near future. The profession is stressful in many ways, and witnessing error as well as our own errors is extremely stressful. All I can say is that it is about time that it is given some seriously organized attention. Individual error can be caused by system error, so in my thoughts we all need to work willingly together to study the system to find ways to improve it so we all have a safer place to work. A great way to start is to individually look at the systems we personally work in, and to suggest improvements as we notice them and to develop a sense of awareness. At this point if we don't, we are all responsible for individual errors. Just my thought. Vicki
Dixiecup wrote:Well, I would not be calling anyone stupid, thats for sure. Unless your perfect? Are you?Dixiecup - It looks like to me RNsince83 was put in a very frustrating sitiuation... that involved patient safety. So, if she is venting with us, which is precisely the purpose of this Nursing Forum, I don't see anything wrong with her calling this inept nurse the nickname of Stupid. Actually, I thought it was kind of funny. In otherwords, this was her way of bringing levity to the situation. ;)
nursinghumor wrote:Sir, you being the site owner I will post gingerly here. I've become very active on this site as of late, and honored Aaron [shortbus] has given me moderator privy. However, I don't see of the options to moderate at my disposal. I'm a moderator on a car forum website and pretty much know what to look for regards to being able to delete, edit, move, etc. members post. [Off topic, sorry about that].smbrn said:
Don't tell me this is another one of those wimpy web sites where people are not allowed to say what they think so long as they do not use profanity. There is nothing wrong with strong opinions or words for that matter. Try reading some commentary magazines and see what kind of strong language you will find! No one ever died from words but patients can die due to negligence or incompetence.
We are quite liberal in what is allowed on the forums, long as it is not blatant spamming, attacks or profanity, you'll find we let people voice their opinions, beliefs, with little or no censorship.
However, the use of profanity in a public forum is a striking sign of ignorance. It will not be tolerated regardless of the context.
That aside, your views are welcome.
Andrew Lopez, RN
(Network site owner)
http://www.nursinghumor.com
IMHO, RNsince83 was just doing some venting. I never read anywhere in her post that she used profanity? All I read was she referred to the negligent nurse as stupid, but did not use any profanity, i.e. damn. ;) It looked like to me she gave this nurse the nickname of Nurse Stupid has a way to bring levity to the situation. Maybe I have a very dry sense of humor.
Looks like to me RNsince83 took all the appropriate measures to amend the situation. BTW, I saw nothing wrong with calling the nurse, either. I've been an RN over 8 years & never worked where report was given via tape recorded message. My wife has been an RN over 13 yrs and her present job involves tape recorded reports. A lot of the confusion could have been prevented if the off going nurse had given a face-to-face verbal report, IMHO.
:)
1mg.epi wrote:That nurse was incorrect in their actions. BUT:IMHO, the only underdog here was the patient. Plus, I think some of the members [self included] interpreted RNsince83's use of the nickname Nurse Stupid differently than others here. Again, I saw it as her way of bringing levity to a very serious situation.
NEVER call a person stupid. If there is a problem, the person needs to be talked to. That is a very powerful word to call a person.
NEVER call some one at home to ask why they did not do something, when you know it was not done. If there is a problem fix it and drive on. Most nurses I know that do that are very power oriented.
Last - You ranted a problem without a viable solution to the problem. I think we have all encountered a problem like this and it is how we handle it that makes us good co-workers.
I do not think people are for the underdog, I think they were against your anger in the post and the way you articulated the problem. This place is to spill you guts but it is a place to get constructive criticism.
I'm certainly not going to start a debate here with you, although I do have a difference of opinion on some of your viewpoints. BTW, I thought Shortbus's previous reply said it best.
maybe instead of being a med surg nurse she should be like a school nurse or something that doesn't require taking care of people in a critical condition.
hsieh wrote:maybe instead of being a med surg nurse she should be like a school nurse or something that doesn't require taking care of people in a critical condition.
School nurses can have kids that are in critical condition and can have meds that have the ability to cause problems. Everyone needs to be careful all the time because it is easy to get into a rut or routine and then some monkey wrench gets tossed into the mix.
Maybe nurse stupid is just lacking in some skills, ALL of us have a weak area.Maybe she is afraid to ask for help in understanding this skill.Why not offer to learn TOGETHER instead.Maybe deep down there is a great nurse, give her a chance.Mistakes are usually the best educators.:)
Wow. I'm not a nurse yet. In fact I don't even START nursing school for another 3 weeks but I read every single response to this thread.
First off after asking what alot of the terms and acronyms meant and reviewing the situation with a nurse I know I have to agree that what "Nurse Stupid" did was not really stupid at all but perhaps negligent and dare I say it?- inept. IMO those words are more fitting.
I also noticed that some folks really jumped on rnsince83 for using the word "stupid". Maybe not the BEST word to use (see my words above) but I think the focus on that one word and how it was used took away from the situation a bit and drew the attention toward rnsince83 instead of the situation she was upset about. I didn't like that.
We all have our opinions and we all have a right to vent. I think this forum is the PERFECT place to do that. Who else can nurses vent to except other nurses? Who else would understand?
I hope that in a few months when I come in here and have to spout off about something in school that is bothering me, I am supported instead of patronized.
As you can see I am opinionated as well and I really hope I don't get any responses asking where I come off since I'm not even a nursing student yet.
Anyone who is a nurse will have a valued opinion in my book but the opinions have to stay constructive. Am I right?
First off after asking what alot of the terms and acronyms meant and reviewing the situation with a nurse I know I have to agree that what "Nurse Stupid" did was not really stupid at all but perhaps negligent and dare I say it?- inept. IMO those words are more fitting.
I also noticed that some folks really jumped on rnsince83 for using the word "stupid". Maybe not the BEST word to use (see my words above) but I think the focus on that one word and how it was used took away from the situation a bit and drew the attention toward rnsince83 instead of the situation she was upset about. I didn't like that.
We all have our opinions and we all have a right to vent. I think this forum is the PERFECT place to do that. Who else can nurses vent to except other nurses? Who else would understand?
I hope that in a few months when I come in here and have to spout off about something in school that is bothering me, I am supported instead of patronized.
As you can see I am opinionated as well and I really hope I don't get any responses asking where I come off since I'm not even a nursing student yet.
Anyone who is a nurse will have a valued opinion in my book but the opinions have to stay constructive. Am I right?
Wait, I would ALSO like to say that alot of the responses were very supportive and informative. I acknowledge that a lot if not most of you showed rnsince83 alot of support.
Thanks, didn't want it to sound like I was condemning everyone.:o
Thanks, didn't want it to sound like I was condemning everyone.:o
Joshua wrote:Wow. I'm not a nurse yet. In fact I don't even START nursing school for another 3 weeks but I read every single response to this thread.Yes, sounds right to me [my opinion & not representative of this site's opinion as a whole ;)].
First off after asking what alot of the terms and acronyms meant and reviewing the situation with a nurse I know I have to agree that what "Nurse Stupid" did was not really stupid at all but perhaps negligent and dare I say it?- inept. IMO those words are more fitting.
I also noticed that some folks really jumped on rnsince83 for using the word "stupid". Maybe not the BEST word to use (see my words above) but I think the focus on that one word and how it was used took away from the situation a bit and drew the attention toward rnsince83 instead of the situation she was upset about. I didn't like that.
We all have our opinions and we all have a right to vent. I think this forum is the PERFECT place to do that. Who else can nurses vent to except other nurses? Who else would understand?
I hope that in a few months when I come in here and have to spout off about something in school that is bothering me, I am supported instead of patronized.
As you can see I am opinionated as well and I really hope I don't get any responses asking where I come off since I'm not even a nursing student yet.
Anyone who is a nurse will have a valued opinion in my book but the opinions have to stay constructive. Am I right?
I see nothing wrong with venting in a constructive & productive manner that is not directly offensive to one individual.
MagRed -- you're such a polititian! But that's what makes you a good moderator, so don't take offense at the term!
Joshua did to the right thing, but is still left feeling oppressed by a system that lets such carelessness continue. Sure, it's a system defect but it's the "Human Factor" that confounds the problem.
Joshua -- here's something you can do as follow-up. Find out where your incident report really goes (hopefully, in this day and age, it's not file 13). Learn who reads these reports and what will be done with them.
In our system, the report is called a Patient Safety Tool and reflects the committment we have to the National Patient Safety Goals. I can name you the people in our Quality Improvement Department who read our reports. I can have conversation with them and ask for data that allow me to see what our trends are, especially around medication administration.
Your workplace has a system (whether it is fully functional or not, I can not say) so find out what it is. Channel your energy into quality improvement. Learn how to look for a root-cause for what happened and help build a strategy so that it is unlikely that it will happen again.
You're on the right track, and it's totally understandable that you would be frustrated. But until you do more than voice your frustration, you'll fall prey to the habit of pointing fingers rather than changing the future!
It's empowering to be part of the solution, not just a reminder of the problem!Good luck with that.
--p
Joshua did to the right thing, but is still left feeling oppressed by a system that lets such carelessness continue. Sure, it's a system defect but it's the "Human Factor" that confounds the problem.
Joshua -- here's something you can do as follow-up. Find out where your incident report really goes (hopefully, in this day and age, it's not file 13). Learn who reads these reports and what will be done with them.
In our system, the report is called a Patient Safety Tool and reflects the committment we have to the National Patient Safety Goals. I can name you the people in our Quality Improvement Department who read our reports. I can have conversation with them and ask for data that allow me to see what our trends are, especially around medication administration.
Your workplace has a system (whether it is fully functional or not, I can not say) so find out what it is. Channel your energy into quality improvement. Learn how to look for a root-cause for what happened and help build a strategy so that it is unlikely that it will happen again.
You're on the right track, and it's totally understandable that you would be frustrated. But until you do more than voice your frustration, you'll fall prey to the habit of pointing fingers rather than changing the future!
It's empowering to be part of the solution, not just a reminder of the problem!Good luck with that.
--p