Sunday Post-it 4/16/23-tacit approval

The post-it reads “tacit approval gleaned from new nurses watching old nurses go against policy.”

That means the new nurses are watching experienced nurses go against procedure, or outside of their scope of practice, or go against policy and getting away with it.

And the new nurse goes against procedure, outside their scope of practice, or against policy.

There are two ways this can end.

  1. they get away with it
  2. they get caught and can’t understand why everyone including the experienced nurse is mad at them and not mad at the experienced nurse


Do we need a primer on why that stuff exists?

Policies and procedures do not exist to make a nurse’s job harder. They exist, in part, to lay out steps for a procedure the nurse might need to do. They also exist, in part, to protect the patient and the nurse both.

There is a reason that the nurse somewhere in the Midwest got in major trouble when they cut off a necrotic foot of a patient, instead of the proper channels. Remember that? I think that is one of the most extreme cases. And what it that nurse had gotten away with it. All of a sudden the patient has no foot to assess. All’s good, right? I would hazard a guess that the nurse had seen someone else get away with something more minor and thought to themselves, oh, I guess I can do what I want to patients.

At least that is how it goes in my head.

Fact number 1- just because someone else gets away with bad behavior there is no reason to believe that yourself will get away with bad behavior.

Fact number 2- sometimes healthcare is monkey see, monkey do. Actually, that is how we teach how to do procedures with the famous see one, do one, teach one mantra of medical school. But if you are doing something against policy, scope of practice, or procedure and think that no one is paying attention, this is me telling you that absolutely people are paying attention. And we don’t want to give the wrong message to be perpetuated.

Just follow policy and procedure. And stay within your scope of practice. The license you save may be your own, or your new trainee who doesn’t know any better.

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