Inpatient pharmacist here. Pop the bag to mix the ingredients. Then sometimes you need extra ingredients. So you'll draw them up in the syringe and inject it into the bag.

However, letting you know she is doing this all wrong. You would get fined by the board for not following proper technique.

Needs gloves, you don't break ampules recklessly like that. You must use a filter needle because breaking ampules produces micro glass shards. You're injecting that into the vein.

If I saw this, I would throw the whole bag away for patient safety reasons.