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.

The Changing Vision of Nursing

†Today nurses face challenges in the nursing world their predecessors never did. The slightest mistake can end up on YouTube. A crotchety patient might become a vexatious litigant. And worst of all, you could make a career ending mistake.

Newly licensed LVN nurses and RN nurses can safeguard their careers by following the best practices of their facility and the standard operating procedure of conventional nurses.For nurses to stay ethical and keep their noses clean, vigilance and propriety are necessary.

Good manners toward patients is the best practice. But for peers and other staff as well. Managers can appreciate the benefit of a new hire who is a good example. The spectrum of nursing careers can always include a nurse who is polished,perfect, and professional.

The stereotype of s nurse can be from a TV show or from examples people see over time. A paunchy, chain-smoking nurse tapping away at their phone is dividing their attention span before they clock in. The oversexed stereotype nurses who spends most of heir time socializing will often end up the subject of complaints.And nurses given supervisory roles when their performance is substandard will always suggest unfounded favorirism.

Additionally, nurses can look for good ways to stay motivated and meet personal goals. The stability that a career in nursing can offer provides financial security, as well as a few “chicken soup for the soul” experiences.These are often priceless insights into the human condition.

The payoffs of a career in nursing can be concrete and financial in nature or they can be as abstruse as angels dancing on the head of a pin.But each nursing professional needs to decide for themselves where monetary goals stop and vocational goals begin.

Many nurses find their vocation in helping people. Others ate looking for a way to migrate to another career, such as teaching or business. But the toll that care giving occupations take is becoming more difficult to ignore. Statistics on addiction, drug abuse, Petty crime and white-collar crime in the field of nursing is a well kept secret. Nurses often admit to feeding an addiction while on the job. Nurses fight smoking habits made deadly by their sheer casualness masking a dependence. Nurses can have delayed reactions to many of the experiences by they see and encounter PTSD later.

And some nurses worry about if there will be a nursing field in the future. Technical issues are turning the field of medicine into an adjunct of the insurance industry. How much nursing benefit can decades of dialysis provide? How can pacemakers and stints and implants improve the quality of life?

Decisions are being made every day to extend and lengthen life using equipment and materials foreign to the body’s natural makeup. The safety and longevity of many of these methods requires backups of conventional nurses to oversee and treat complex medical conditions.

This type of scientific leap forward will always need development and monitoring by medical professionals. And as long as people age and have health crises, a nurse ( or several hundred thousand) will be needed. Therefore the future of any nursing career is wide open.

 

Patient Care is the Prime Directive

Once a new student nurse gets minted into the professional health care world with a diploma, he or she can look for work in various institutions like hospitals, long term care, or home health. Once hired, nurses may notice that some nurses move through the ranks faster than others. This isn’t due to some unknowable formula, but success in patient care. This is true the world over in nursing environments.  No other single factor will advance a nurse’s career than skills in direct patient interaction and patient care.
Patient feedback is a good way to proctor your progress as a working nurse. While administrators and preceptors are supposed to train new nurses, it is patients themselves who are the “customers”. In today’s healthcare systems, the daily tasks and medication passing routines lose sight of this fact. Even when charting, nurses should be mindful that family and conservators, and other nurses will read what medical information you write and inform a patient if you are contributing errors into the medical record. These are costly errors to make, and the price for such carelessness could be points against your nursing license.
A patient looks to a nurse for simple things. All of which add to their impression of their nurse. Is your name tag legible? Do you announce what your role is and what your nursing responsibilities are? Is your hair out of your face, do your clothes smell clean, and are your jewelry/piercing/tattoo sleeves arranged in convention with public healthcare norms? Are your scrubs clean and do your hands and arms remain clear of fungible odors or harmful bacteria? The patient-to-patient transmission of certain bacteria is becoming a more common method of patient infection every day. Patients know when a risk is presenting itself in the form of a nurse.
Infection control includes microbe-level cleaning to assist patient’s recovery and everyday well-being. Nursing staff should be guarded against other patients with medical conditions that can affect their patient’s own conditions. Housekeeping staff should notify nurses when regular cleaning routines are disrupted by the patient’s attending-physician consult schedule, appointment schedule, or sleeping schedule. Clean water carafes should be brought by nursing assistants with washed hands and/or gloves. Make sure the charge nurse during each shift orientation stresses the need for room checks and water and linen changes when the patient is usually awake.
A charge nurse must take his or her responsibilities seriously. A good professional nurse should review every aspect of patient care, especially with respect to infection control. If a patient is diagnosed with contamination or a new infection, survey the patient’s environment. Sloppy cleaning or inefficient housekeeping could be a health threat. A charge nurse can order the baths or showers closed and cleaned, completely disinfected. A charge nurse or desk nurse can order new linen provided for the patient, clean towels or pillowcase provided, even assistance bathing or grooming to put the patient in a better frame of mind.
Patient care when equipment and medication administration is involved should be perfect. A nursing student should think about bringing his or her own stethoscope, blood pressure monitor or “bracelet”, and a convenient way to take notes and remember statistics between desk visits. Charting ten or twelve patients at the end of the shift becomes easier or a nurse with notes to look back on. An around-the-neck stick-it holder can help. And many vitals-cart monitors are unusable or to sensitive for regular use. Think about the ease added to the job if you bring your own. A nurse should learn how to use her or his own equipment and derive reliable data from it across different patient samples.
Any hesitation or memory flop during a tube insertion or IV start should be assertively reported and a more competent nurse assigned.

Suctioning and wound packing, dialysis and needle sticks should all be rock-solid before putting the patient’s nerves or skin at risk. These procedures are too important to risk on a nurse that barely remembers the nursing school training or had a poor experience during practicals. Some nursing supervisors during nursing school barely look at what the nursing students are doing. This will not help the professional nurse in the working environment. Nursing students who know they are short on skills should find a way to polish them, rapidly.

Peer review and policing is a responsibility that nurses should consider part of their job. Good relations with oversight and compliance agencies demands fulfillment of these programs. Nurses should review the facility’s Policy & Procedure manuals to inform other staff concerning these norms. If a nurse should notice that Standards of Care Practice regulations are not being observed, the institution nursing administrator or facility manager can schedule an orientation to supplement staff training on the matter. Patient care remains the ultimate quality product in nursing service.

3 Myths About Long Term Care Nurses

3 Myths About Long Term Care Nurses

1. Nurses Have Adequate Training

Low cost nursing homes typically hire new grads for nurses with no nursing experience. Fourth-rate nursing homes will hire at the lowest pay possible, guaranteeing only nurses of very little upward mobility will fill the position. In many cases, new nursing school graduates have very little experience and little to no maturity as a practical nurse. Young nurses are very dependent on community standards and peer advice in nursing situations, most of which they have never faced before.

Patients who want good nurses or friendly nurses usually get dour, overworked, non physically fit or otherwise employed nurses looking to fill their time with shifts at the lowest possible end of the labor spectrum. A low cost facility looking to shave every nickel will not hire any nurse with long term records of gradual pay raises and salary increases. Not only do many new hires have little to no experience with any job, their practical nursing experience may be limited to a textbook or a private nursing situation. These nurses lack even a modicum of case history

2. Nurses Are Adequately Rested

Many nurses and nursing assistants routinely work double shifts and overtime as a matter of course. Since many low-rent long term care facilities save every dime, they will likely not pay overtime if an employee waives their requirement. If they want to keep their job, they will likely waive the requirement.Older nurses may have physical impairments that prevent them from sleeping or moving about at work except for slowly.

Many nursing facilities with poor records and many validated health department complaints will simply not be able to hire anyone because the hiring pool has no individuals willing to work at such a place.

Often a low-rent nursing home will not want to risk “new” people without proven loyalty (slavery) to the current administration. Such facilities will not place paid ads or even list the openings at the employment development department, because of the current claims of abuse, poor management, physical abuse, and overwork attested to by previous employees.

Nursing homes running at a low ebb will only find labor outside their desired low-cost zone, or not lacking enough in experience for their needs. Such nursing homes do not want any more whistleblowers and use “short-staffing” as an excuse simply to not do any hiring. Hiring and training takes times and money, and drains effort from already overworked resources.

3. Nurses know how to function in a working environment

Some of the growing pains a first time nurse has on the job is growing accustomed to work. Many younger nurses may not have held other jobs. Without experience getting through a work day, domes nurse may become irritable and patient. They may never have had to put in a full day delivering services to anyone.

Functioning as a full time nurse for the first time can be daunting enough, but learning new skills, new patient cases. and how an office works can make them face all the things they don’t know how to do.Working a fax machine, computer, copier and printer can make the day ho much more smoothly. Learning how people work together may be the biggest shock of all.

Looking For a Nursing Job

Looking for a nursing job involves really evaluating your own personal job strengths. Applying at the same places as your friends or peers doesn’t always work. Working from newspaper ads only ads you into the mix with a huge bank of competitors. Occupational employment in nursing is an ongoing challenge for even the most senior and highly paid RN and LVN workers. Building  a lifetime network of people to consult and exchange information with about job opportunities and local trends starts now. A decade from now these will be peers working in places with new openings or new departments.

One strategy is to apply for weekend or part-time work at a long term acute care facility or long term care facility, to put some nursing hours and experience on your resume, without burning out from a heavy schedule and the stress of a full time work week. Limited interaction with key players can allow a new nurse to learn the job responsibilities without getting caught up in the vortex of a facility or nursing institution out of step with the nursing world at large. By limiting the scheduling availability, a nurse can allow for ongoing interviews during their off-hours in the full-time nursing employment space.

The first job of a nurse should be to absorb as many skills and workplace nursing abilities as possible. Making the transition from nursing student to nursing employee is not always as easy as the textbooks would suggest. The nurse candidate may interview with a Director of Nursing, or Human Resources Director, who has little or no idea what terms and in actual nursing job for an average shift is really like. The job description may not tell the whole story in a nursing position. Only the training preceptor can get a feel for what the new nurse is actually capable of doing.

Working part-time to start allows a nurse more time to evaluate if a new working environment is right for them. It takes time for a new nurse or new nursing school graduate to understand which parts of the working environment are fixed and which can be changed with experience and skill improvement. And the gradual build-up of skills and orientation will length the learning curve and leave a new nurse less likely to be overwhelmed. Thus a nurse can investigate what a facility or nursing department is like before committing to full-time availability.

A part- time schedule can allow you to burn in to a new place and absorb their rules and standard operating procedure, without trying to perform a full week of work at the same time. This kind of stress can affect how you learn all a facility’s rules and how you interact with all the staff. instead of burning bridges by becoming a moving target, start slow and begin to learn the ways of a new place slowly. interaction wit staff can remain minimal, so as not to get involved with any personality conflicts.

Part-time work generally begins with assignment of a preceptor. Today, nursing people call this “shadowing” a worker to learn their job. Nurses need to learn their preceptor’s ideas and functions before allowing a full time work schedule to break down the lessons and training. And sometimes a preceptor may not “fill in the blanks” as well as they should. But a part-time nurse can observe others at a nursing department and long term care facility and select whom they want to imitate in practice.

If a new part-time nurse blends in with the group and adheres to the institution’s policies and procedures, the director of nurses or nursing supervisors will schedule the candidate in for more hours and shifts. This is a good time to set limits for the availability. A nursing employer will not always respect the availability limits a nurse gives, and this is the best time to set the rules in stone. The ongoing battle for a nursing supervisor to staff the facility fully must co-exist with respect for a working staff of nurses and their need to rest and conduct their life in the off-hours.

The nursing job search includes a lot of phone calls, a lot of emails, and a lot of application forms. Job fairs and newspaper sections for jobs available aren’t always going to be the pathway to the best jobs. Many nursing homes and long term care facilities don’t have time to post individual job ads, and don’t have the staffing to vet the responses. If there is an area you want to work in, or a specific place you want to work, walk in and directly submit your application. By bringing your resume, three letters for character reference and your nursing school transcript , you will complete the application without the staffer having to do any work. The nursing supervisor or the director of nurses may decide to do an interview right then and there, and keep your application on file.

Newly minted nurses can’t always rely on the people at the other end of the line understanding nursing terms, medical courses, and departmental specialties. Many recruiting firms now do a lot of the screening for key posts. It’s best to get your dates and information about past work places straight, in the format of a general work application, because you’ll be filling them out almost constantly. Make sure your version of these events remains consistent, and be sure to have at least three character references from business and personal life at all times. If you feel that your contacts are being mined for marketing purposes, mark them “available upon request”.

If you feel your work experience is thin, write a cover letter describing your strengths on the job.  Talk about your individual abilities that make you unique to the nursing desk, hospital department, or long term care facility floor. Keep a list of the agencies, companies, nursing homes, and facilities you have applied to. You may want to look for older positions advertised or wait for another cycle or hiring to begin. Some larger companies wait and restart a cycle of interviews and training at the beginning of the first quarter and second , certainly not at year-end. if you are flexible to moving to begin a work assignment, say so on your voice mail message or the last sentence of your cover letter.