Decay, degradation and dissipation all take a toll no matter how or where they occur. Certified Legal Nurse Consultants see this in cases they review regarding hospitals and other facilities. It starts with finding a shortcut to performing a task, and then a shortcut to the shortcut, followed by another shortcut. Soon, instead of following established protocols for treating a patient, the parties simply take their temp, give them a lollipop to raise their blood sugar and send them on down the chain.
Sadly, I must admit I even find this occasionally happens in my own company. Working with one of my departments, I found that a process I’d put a lot of time into developing had been transformed into something I didn’t recognize. I suspect it didn’t happen overnight – it wasn’t like someone came to work one day and said, “Let’s do it like this, the heck with Vickie.” Instead I imagine it happened over a period of time, slipping a little further each time the procedure was performed, so that five years later when I reviewed the process, the patient (in this case my sanity) was lucky to survive.
Standards are called standards for a reason. Quality matters in every second and in every decision. You can be too close or “in the moment” to notice when it starts to slip – but that’s exactly when you should notice.
Think about it this way – ask that surgeon who’s on his phone during surgery – “Would you want your proctologist on her phone while performing this procedure on you?” or that mom in the car next to you with her cell phone in hand – “Would you be texting and driving if your children were playing on this street?” Once the standards slip, even a little bit, the avalanche begins.
Standards start where we’re standing. Either you’re all in or you’re just sucking the lollipop.
I’m just sayin’
P.S.Comment and share how, or if, you intervene when you see standards starting to slip.
5 thoughts on “Are You All In or Just Sucking the Lollipop?”
Yes, I think standards are slipping in the hospitals, rehabilitation centers and nursing homes, but the important thing is to speak up when we see the slip. I am aware nurses have to be continuously guided and instructed. However, the facility assumes that you know all and can do all because you have the RN credential behind your name. Many of these nurses are trapped by their jobs – if they speak up and admit they need more education or training in one area or procedure, they are disciplined and not taught the missing skills. It’s as if the charge nurses don’t want to admit they don’t have the knowledge to teach new nurses, and instead they hand them over to the stupid administration police.
Thank you, Vickie, for bringing awareness to the specialty of legal nurse consulting. I am working towards my CLNC® Certification. Thank you for letting me air my view of standards.
Guess what? You, the nurse, are there as the patient advocate; not the doctor’s handmaiden or squire. As far as I am concerned if you do not address an impropriety or a behavior that you know is wrong when you see it then you are just as guilty.
After removing a surgeon due [who responded to a trauma in the small ER where I was working] due to obvious intoxication, I was amazed to hear that this surgeon’s intoxication had been previously detected by OR nursing staff. Since he was an orthopaedic surgeon in high standing with regards to his reputation and status, he had never been called on it.
I was older when this occurred, but I would hope that in my younger day I would not have hesitated to make the call. It is important that we teach and mentor our colleagues so that they are able to do the hard thing when it presents itself. It is not a question of if because it WILL happen.
I recently quit my job so I can give this business more of my time, yea!
The last time I spoke with the more seasoned nurses at work, the conversation was about how the new nurses were cutting corners in giving care. We as Certified Legal Nurse Consultants have seen the devastating results of “Just sucking the Lollipop.”
Hello Nurses: I have been a nurse for 36 years and unfortunately, I must agree with Vickie’s scenario. I believe as nurses our profession becomes our life and most certainly our passion if we want to make a difference. When i was working one of my 3-11 shifts as well being in charge in a super busy ED, a patient walked in from triage when she saw me coordinating x-rays, labs, etc., for all of our patients. Our emergency director’s protocol was “get them in and out or to a bed” within 1 hr and don’t leave your post. Our patient began to tell me she had chest pains and I wasn’t busy at that moment so I took her to one of our cardiac rooms to start our cardiac workup. Like many of my colleagues we never took anything for granted and our patients were our first and only priority – not breaks or lunch – just our patients. My workup was completed and sent when a new physician hit our unit. While doing my workup the patient confided in me she was to have an abortion on Friday and this was Sunday. I presented the patient’s history to our new physician. He did a”quick” H & P and handed me her discharge with a script for Valium. I questioned why the chest x-ray or the remainder of the cardiac wasn’t completed. His response was “she’s just nervous due the abortion”. I politely but firmly refused to discharge her, however he found someone who did. The following Wednesday during my shift, my patient returned via squad, grey from her chest up and expired of a pulmonary embolus. I cried when I had a moment as she left 2 young boys with no guardian. My life and my profession, just as all of my undertakings, are my passion. No corners cut and no lollipops given out!
At the last entity I worked at, they overloaded the seasoned nurses with acuities, and then used nurses that had only as little as 6 months experience to train new nurses. The patient factory was kept in motion, however, the trend over time was a gradual degradation of the values, skills and work ethic. It did not happen overnight. This degradation happened over time.
The seasoned nurses faced “burn-out” even faster, and the stress on the job became so heavy that middle management considered it to be a “transition point for nurses”, therefore lending a shelf life to a new nurse on that unit to only months to a couple of years. With a “they would have left anyway” attitude, the cycle continued. One by one the “seasoned” staff fell off the brink of the staff roster. It was becoming evident and ugly that the priority was to be compliant, with less and less regard to professionalism. This compliance was not done so much to reach the objective of process improvement and heightened learning, as much as it was to just appease regulatory agencies and the like.
Becoming a Certified Legal Nurse Consultant has embraced my professional priorities as well as my love of nursing. I am the best patient and healthcare advocate I can be.
At the end of the day, I am thankful for the career I have had, and thrilled with the one I have now. Thanks Vickie!
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The National Alliance of Certified Legal Nurse Consultants (NACLNC®) is the largest and oldest association of legal nurse consultants.
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*The opinions and statements made by Vickie Milazzo, the founder of Medical-Legal Consulting Institute, Inc. are based on her experiences and expertise, should not be applied beyond the specific context provided, and do not guaranty or project actual results. Vickie Milazzo is no longer involved in the operations or management of the business, but is involved as an independent education consultant.
Yes, I think standards are slipping in the hospitals, rehabilitation centers and nursing homes, but the important thing is to speak up when we see the slip. I am aware nurses have to be continuously guided and instructed. However, the facility assumes that you know all and can do all because you have the RN credential behind your name. Many of these nurses are trapped by their jobs – if they speak up and admit they need more education or training in one area or procedure, they are disciplined and not taught the missing skills. It’s as if the charge nurses don’t want to admit they don’t have the knowledge to teach new nurses, and instead they hand them over to the stupid administration police.
Thank you, Vickie, for bringing awareness to the specialty of legal nurse consulting. I am working towards my CLNC® Certification. Thank you for letting me air my view of standards.
Guess what? You, the nurse, are there as the patient advocate; not the doctor’s handmaiden or squire. As far as I am concerned if you do not address an impropriety or a behavior that you know is wrong when you see it then you are just as guilty.
After removing a surgeon due [who responded to a trauma in the small ER where I was working] due to obvious intoxication, I was amazed to hear that this surgeon’s intoxication had been previously detected by OR nursing staff. Since he was an orthopaedic surgeon in high standing with regards to his reputation and status, he had never been called on it.
I was older when this occurred, but I would hope that in my younger day I would not have hesitated to make the call. It is important that we teach and mentor our colleagues so that they are able to do the hard thing when it presents itself. It is not a question of if because it WILL happen.
I recently quit my job so I can give this business more of my time, yea!
The last time I spoke with the more seasoned nurses at work, the conversation was about how the new nurses were cutting corners in giving care. We as Certified Legal Nurse Consultants have seen the devastating results of “Just sucking the Lollipop.”
Hello Nurses: I have been a nurse for 36 years and unfortunately, I must agree with Vickie’s scenario. I believe as nurses our profession becomes our life and most certainly our passion if we want to make a difference. When i was working one of my 3-11 shifts as well being in charge in a super busy ED, a patient walked in from triage when she saw me coordinating x-rays, labs, etc., for all of our patients. Our emergency director’s protocol was “get them in and out or to a bed” within 1 hr and don’t leave your post. Our patient began to tell me she had chest pains and I wasn’t busy at that moment so I took her to one of our cardiac rooms to start our cardiac workup. Like many of my colleagues we never took anything for granted and our patients were our first and only priority – not breaks or lunch – just our patients. My workup was completed and sent when a new physician hit our unit. While doing my workup the patient confided in me she was to have an abortion on Friday and this was Sunday. I presented the patient’s history to our new physician. He did a”quick” H & P and handed me her discharge with a script for Valium. I questioned why the chest x-ray or the remainder of the cardiac wasn’t completed. His response was “she’s just nervous due the abortion”. I politely but firmly refused to discharge her, however he found someone who did. The following Wednesday during my shift, my patient returned via squad, grey from her chest up and expired of a pulmonary embolus. I cried when I had a moment as she left 2 young boys with no guardian. My life and my profession, just as all of my undertakings, are my passion. No corners cut and no lollipops given out!
At the last entity I worked at, they overloaded the seasoned nurses with acuities, and then used nurses that had only as little as 6 months experience to train new nurses. The patient factory was kept in motion, however, the trend over time was a gradual degradation of the values, skills and work ethic. It did not happen overnight. This degradation happened over time.
The seasoned nurses faced “burn-out” even faster, and the stress on the job became so heavy that middle management considered it to be a “transition point for nurses”, therefore lending a shelf life to a new nurse on that unit to only months to a couple of years. With a “they would have left anyway” attitude, the cycle continued. One by one the “seasoned” staff fell off the brink of the staff roster. It was becoming evident and ugly that the priority was to be compliant, with less and less regard to professionalism. This compliance was not done so much to reach the objective of process improvement and heightened learning, as much as it was to just appease regulatory agencies and the like.
Becoming a Certified Legal Nurse Consultant has embraced my professional priorities as well as my love of nursing. I am the best patient and healthcare advocate I can be.
At the end of the day, I am thankful for the career I have had, and thrilled with the one I have now. Thanks Vickie!