Slackers: The Ethical Divide of Nursing

The ethical divide between professional nurses with morals and accountability, and the others, becomes clear just as soon as a newly qualified student nurse becomes a professional. As in many occupations, nursing has its share of sour apples. And, as in many professions, some employees work to find a way around the system. Some nurses commit timekeeping violations. Others goof off and text on the job. Some chat too much with other workers, ignoring monitoring and auditing tasks. Slackers send a message that nursing is not serious business.
Sooner or later many nurses developed a career path. Many nurses begin with small slips, like writing inaccurate representations of events to favor their colleagues. And some others gang up on certain patients, to teach them a lesson. it’s human nature in some people to become predators against others and take advantage, but better nurses withstand the temptation to abuse those vulnerable and in their care.
Many times advisors and instructors will stress the importance of contacts within the industry and joining new network of friends. But this can backfire. Nurses cherish the bonds of friendship between each other, and sometimes too much. Would a friend ask you to risk your license putting false paperwork into a patient’s chart? Would you report a friend who removed records from the chart and shredded them? Would you realize if a future supervisor didn’t hire you because they remembered the deeds of a nurse clique or “posse’ you used to be with in the past? Being able to choose the company you keep may be the last true luxury nurses have. You may pay a price in the future for fun times today.
Nurses starting their first job take their license as proof they have studied hard, mastered all materials, and learned the necessary techniques and skills to provide positive and meaningful care to benefit all patients. Yet after a while, newly licensed nurses will start to notice something. Not all nurses share their same commitment. Some are lazy, some never finish the job right, and some just find ways to do things that are sloppy and incomplete. Every nurse must find the way they choose to deal with this.
Some nurses view a nursing job as a part time paycheck an avenue to another career. They want to be an actor, or an artists, or even have another job. Maybe they found their way to nursing through family connections and it didn’t seem all that hard to do. But they really don’t like the work, and they don’t mind if it shows. These nurses use their phone a lot when they are supposed to be working, and spend a lot of work time goofing around, looking at take-out menus or chatting with vendors and providers who come by to visit. But the medical world does not smile on this kind of slacking.
This kind of nonchalance leads to many nursing errors, such as too much or missing medication, skipped insulin doses, erratic chart-keeping, and missed shifts due to inability to copy the schedule. These type of employees perhaps showed more promise once upon a time. And many facilities can‘t afford to let such nurses go because a shortage of qualified and experienced nurses keeps them reliant on current staff. They arrive at work and hang out, looking for ways to skip the work and get coffee, hide in closets and rooms to talk to others, and just hang around.
Usually for nurses like these, the big attraction to coming to work is to socialize with the people working there. This can be a problem, because the bonds between nursing co-workers should not be more important than the professional commitment as a provider. Often, many nurses can prey upon the weaknesses of others. They can use peer pressure to cause one nurse to treat a certain patient or even a co-worker nurse badly or with disrespect. This is slacker peer pressure.
Yet so many nurses convince themselves that coming to work late doesn’t matter, that calling in sick for entertainment and social reasons doesn’t help co-workers, and that unclocked breaks just don’t really count as infringements. These types of nurses can contribute to an entire downturn in morale, because nurses working hard observe their peers slipping by with doing much less. Why should work hard, a nurse might say to themselves, when if ‘so and so” was here, they would just watch the clock until the small hand clicked at the top?
Sadly, many types of people use nursing to abuse the system. The steal medications, overcharge insurance companies, send false bills, and sign invoices for amounts of supplies much larger than what was actually used. Nurses may not realize that when they are asked to sign a bunch of audits, or when other staff convince them to sign many orders the did not witness or to even file papers in the chart that are not legitimate, they are risking their license. And showing new nurses whom to trust on the job is not something you can teach in a textbook.
Insurance fraud usually starts in small to medium sized businesses where slacking off and discovery of errors puts some people at a disadvantage. A nurse who has noticed a serious error made by one of their co-workers can choose to report it, or instead leverage this information for better shifts, a raise, or even a promotion. Nurses should be vigilant to review their state nursing board website and keep updated on the regulations governing their license. Maybe some employees notice that an employee takes off work an hour early every day their manager is not in the office. A new nurse trainee observes that not every staff member has t clock in and out per timekeeping regulations. Maybe they notice that the physical therapy staff bill for more sessions with their patient clients that actually occurred. Any omission of reporting such things can build a situation where nobody has ethics and finally some incident brings the whole situation to light. And at that point, nobody is a winner.
Many slacker nurses or people who are just too burned out to care adopt a philosophy of “say nothing, do nothing” at work. They think this keeps them free from blame when situations arise on the job for nurses to commit dishonest acts or abuse patients. When the nursing employees have this many compromising issues on the job, the patient care comes second. Soon, going to work in really a tripwire into unethical behavior that could lose them their job, let alone their license. And many nurses later confess to horrible infringements of patient rights simply because they got strong-armed on the job from the director of nursing or the administrator.
It is so much easier, in nursing, just to keep a clean slate and make sure that the nurses you choose to associate with are the one most admired and emulated by all. The nurses with authority are the ones who should provide a leadership example for everyone. As a new nurse, any nurse who questions why a felow employee is performing a certain action or declaring certain statements or giving orders, should be vocal to their superiors about just what is going on. Just the knowledge that one person had noticed this might be enough to form a correction plan and sever “bad apples” from a healthy tree.

A Day in the Life of a Professional Nurse

The pace of a day in the nursing profession can be hard to get used to. Thinking about nursing skills and remembering important information isn’t enough. Nurses need to update their knowledge of each patient’s chart, comprehend endorsements from the earlier shift, hand off important duties to qualified staff such as supervisors, certified nursing assistants and licensed vocational nurses. Case management responsibilities may fall to a desk nurse, but the medication nurse must serve as a conduit of patient wishes and advocates for patient care.
The pace of the shift takes its cue from the total number of patients the nurse is responsible for, and the frequency of calls to the bedside from each patient. If the patient needs accelerate and the number of calls spike, it is appropriate to notify the nursing supervisor or the Director of Nurses to staff accordingly. Specific chores such as giving IV medications, assessing new intake admission patients, recording vitals for special needs patients, and delivering special treatments such as dialysis and/or oxygen administration can fill a shift before you know it. (And then there is still the charting to do).
As in every job, timing in and out is important to maintain the integrity of the facility’s nursing acuity. Oversight agencies evaluate the timekeeping rolls to derive the accurate account of the nurses assigned at any one time. A nurse who regularly arrives late or misses an entire day of work creates a practical problem that may take hours to solve. In the case that no other staff are available, other nursing staff may have to increase their workload and absorb that nurse’s patient assignments and duties. This can have a negative effect on patient care and reduce the allotted time each nurse can regularly spend with their patients. Patients will notice and feel passed over or that their case has been “rushed”.
Timekeeping is an essential but irksome chore for every professional nurse. Arriving to work on a timely basis and staying after when needed are invaluable qualities in a career nurse. Flexibility in scheduling makes any nurse a prize who is very attractive in a competitive hiring market. Nurses who arrive constantly on time will be given priority and also will get preferred responses to requested time off. Nurse who regularly call in sick or miss work, for any reason, will find themselves short hours or written off the schedule altogether.
Nursing is not always just about medication or vital statistics. The term “bedside manner” is a joke in some circles, but a very real and desired trait in professional nurses. Each patient needs to feel as if their needs are being met. Positive statements, cheerful questions, and small jokes can brighten up a patient’s day. Nurses can easily underestimate how the smallest word or gesture can seemed magnified to a patient with little outside or family contact. This directly affects the quality of care offered by the hospital or facility. During surveys and in feedback sessions, patients often remark on these issues. Positive feedback, online or via word of mouth, is crucial to any organization today.
Patients prefer to rely on key staff and feel better when the routine of their day is supported. The welfare of the patients is the priority of the nursing supervisor. New staff should maintain the behavior and tone of the other nurses. Otherwise, patients can feel estranged. A proper evaluation of the nursing staff should be their flexibility to medicate and treat each patient in the facility, not just the “chosen few”. (And charting must be consistent as well). Puzzling out idiosyncrasies is not a skill every nursing manager has. An hiring institution bringing new nurses on board expects a concordance to facility norms. To do this cheerfully and in a consistent manner is what every nursing home, private patient, or hospital wants.
Encouragement of activities and interventions according to the care plans in the patient’s charts will help the patient feel supported and well cared for. This kind of goal can help patients handle pain, lessen anxiety, and improve their ability to communicate ills and problems some patients might otherwise feel embarrassed or discouraged from sharing. The duty of care falls to the institution and its staff to observe the entire range of symptoms and conditions noted for that patient, as well as known contraindications and/or medical risks.
If a clinical condition becomes exacerbated, the nurse must be able to note increases in pain, swelling, blood pressure, blood sugar, nervousness sleeplessness, and general well-being, all from exchanging a few words with the patient a few times a day. The investment of a few jokes or special inquiries about personal interest or hobbies can pay off in certitude that a patient can rely on the nurse to note variations in their condition.

Some hospitals and nursing facilities have incentive programs for cross-checking symptoms
The manifestation of certain symptoms can be easily missed unless the nurse has established a rapport with the patient. A nursing supervisor often looks to key nurses who can be trusted to “handle” patients who have special interventions indicated in their care plan. Patients need guidance and instruction how to do things good for their conditions. Even if the nurse thinks the patients already know, reminders keep the patient focused on best habits for their own health.
Nurse should encourage patients on how to best elevate legs, attend community activities, perform approved exercises, work well with therapy professionals and stretch their muscles. Some patients may get in a “rut“ and need to motivate themselves towards physical therapy. But some patients just droop and drift into a pattern of inaction. The pattern of interaction should not be allowed to fall static. Just asking a patient what they are watching on television or what they are reading can bolster a patient’s attitude.
Regular familiarity with the patient, good understanding of their conditions and medications, a working knowledge of how to relate verbally to the patient and make them feel at ease, and an ability to confront your own fears and deal with people in a respectful manner that meets their expectations of an institution are all the traits of a successful modern vocational nurse. It is each nursing student’s responsibility to evaluate their own strengths and weaknesses, and to critique themselves and their peers for the benefit of all.

Welcome to Nursing Study

Welcome to Nursing Study!

Transforming a Nursing education into on-the-job professional nurse training
Nursing students often fail to make the connection between practical nursing performance and the run-up to a job nursing from the education emphasis on book-learning. New nursing employees often grapple with learning the pace and combination of skills needed to get through the day. Multi-tasking takes on new meaning, as nurses are expected to juggle answering phones, charting patient progress, doing rounds, performing needed bedside services, and dealing with physicians and family members. Not to mention the idiosyncratic needs of the patients themselves.