grrrrrrrrrr......... - page 2
:madface: :madface: My dad is in the hospital and is getting IV antibiotics...the cannula became dislodged, so he needed a new IV. This "nurse" (and I use that title loosely with this person) came... Read More
Sep 8, '06Trying to be light hearted here, but I can imagine a day when you are working on the floor and will have a compariable experience to putting in an IV. And that might be the BEST thing you do that day!
Cut the nurse some slack. On a busy floor, you're gonna have much bigger fish to fry.
Sep 8, '06I know that when I have had family members in the hospital, it is very hard for me to be the visitor. I constantly re-think things that are being done. THis is a very stressful experience for you. It is sometimes better to just sit back and/or leave the room. This nurse certainly should have used gloves. As to the technique - I'm not commenting on that because I don't know what your father's veins looked like, nor why he was in the hospital. (Both of these factors would influence where I would for a vein).
I hope your father gets to feeling better soon. Take care and good luck in school.
Sep 8, '06Lori,
I am not sure what to say here, but I really feel like I need to respond. My Dad as well has had a hospital experience recently. He was in for about 6 weeks. It is extremely difficult to sort out my feelings through this experience. What we are taught in school is quite different from what happens in the "real world" and we both know that. We are students. Yes, we have knowledge, and we are pounded with the way things "should" be done. It is really tough to keep perspective through a personal time.
How many times in your clinical experiences have you seen nurses cut corners, or do things not exactly the way you were taught in class? Were you this upset when you saw something like that? I am not saying your feelings are out of line, because when it is a family member, it is quite different.
I do feel for you, and I have watched my own Dad go through some things that I didnt feel were quite right. He was dropped on the floor, he was given a pill that was picked up off the floor, he was not given safe D/C instructions. The list goes on and on.
I have had to sit back and truly reconsider my even becoming a nurse after this. But I am moving forward, and determined to make myself a nurse that will make the time to do things to the best of my ability.
This is a difficult field, and the pressure is astounding. Starting an IV a different way then you were taught is tough to watch. But we cant put ourselves in their shoes until we are there.
From both sides of the fence this is a difficult situation. Keep your compasion, for your Dad, as well as the nurse that was working with him. We are all really on the same team.
Hope your Dad is well on his way to health, and hope you are feeling better about this experience.
Sep 8, '06Quote from traumaRUsOnce when my dad was in the hospital, I was there in the room when his nurse was trying to restart an IV. He looked over at me and I said; "Don't look at me, I don't work here!!"It is sometimes better to just sit back and/or leave the room.
I hope your father gets to feeling better soon. Take care and good luck in school.
My parents always did the "my-daughter-the-nurse" thing which I'm sure drove the nurses crazy. I never wanted the nurses to feel that I was critiquing their performance; I wasn't working in their shoes, in their hospital, with their patient assignment.
However, I did once intervene when my husband was in the hospital. He'd had surgery and the surgeon wrote an order for a different siezure medication than what he'd been prescribed by his neurologist. I'd told the surgeon and the nursing staff both what he was taking. When the nurse came in with the "wrong" medication I stopped her before he took it. No, she hadn't made an error, the surgeon had ignored what I'd told him. I insisted that she call the doc and told her that I'd talk with him if she wanted, but that my husband was going to take the correct medication. I was polite to the nurse but firm and made sure she knew that I wasn't blaming her. He got the correct medication.
Sep 8, '06Ditto what Trauma said. And i might add that it is OK to start a IV distal to an old site if it is in a different vein. If you keep pushing proximal to a start each time you have to restart,, you can, depending on how long the patient is there use them up very quickly.
Please try not to be to hard on the nurse. She is working in an imperfect world just like you will after you get out of school. Be assured that you can learn 100% of what your taught, but 100% of what your taught wont necissarily be 100% true in the real world of nursing.
I hope your dad recovers soon.
Sep 8, '06Yes, the nurse should have worn gloves when starting that IV. Yes, we now know how dangerous blood borne pathogens are. However, when this nurse went to school and started working the only gloves available were either sterile or lock up in the exam room. Sometimes when stressed or having a difficult time you revert back to the way you were originally taught. It took me along time to learn how to start an IV with gloves on and with really difficult ones I may still strip off the gloves and pray. After 20+ years I still can't retape an ET tube with gloves on. While you cringe at some of the things older nurses do that differ from training I cringe at some of the things young nurses do. People need human touch. Especially those who live alone or are in LTC facilities. I watch some who won't even touch the shoulder of a non-isolated pt without gloves and cringe. Early in the days of HIV I touch the arm of a AIDS pt without gloves. He started crying. Many people wouldn't come around him let alone touch him. He said the skin to skin contact reminded him he was still human and that at least one person saw him that way and wasn't afraid of him.
Sep 8, '06I often put the tourniquet on and then set up, to let the veins plump up. Sometimes the best looking veins are the hardest to start. In school we learn the "perfect" way, then in the real world although we may not be able to be perfect, we know what we should strive for.
Hope your dad is better soon, it is very difficult to see our loved ones in the hospital.
Sep 8, '06Quote from jmgrn65... I know that school teaches you differently but school doesn't always teach the real world..
jmg.... I just finished a PN program and took/passed the NCLEX in Aug. I also just started working on my RN this week.... That said, I had to chuckle when I read this part of your post...... I heard comments on that vein numerous times in school...
In the last several weeks both my father and son have had surgery. They had excellent care all around. I just found it odd that the nurses weren't wearing gloves during things like FSBS (dad's IDDM) and my son's IV removal.
Sep 8, '06Having a parent ill is such an emotional thing, and of course you want everything done not just right, but PERFECT!
My dad passed away the night before my orientation. He had cancer and had been on hospice, and I had visited him in Louisiana several days before. The first class I took was Pharm, and my professor was a former hospice nurse and was big on pain control. As I learned about pain control, I found myself getting very angry at one of my dad's hospice nurses. His pain was never controlled until just before his death (which I think finally gave him the peace to let go). The nurse seemed to not take his pain seriously, and when we asked her about what the beeps meant on the PCA pump, she did not have an answer. Another nurse finally told us that if it beeps immediately, the MS did not go in, if there is a delay, it did go in. My dad had been getting half the pain med he needed because we thought any beep meant it went in!! Besides this, he should not have been on PCA anyway becuase he was unable to push the button himself, his wife had to stay up all nite to push it q 15 minutes - and we told them this!!!
Anyway, my point is that you love your dad, and obviously want the best for him. Had this been an anonymous patient and you were just observing this incident, you might have shook your head about the gloves, but I doubt it would have triggered anger. I learned from my experience that being angey was only hurting me, and keeping me from dealing with his death. I know my situation is different, but I learned that like everyone, nurses are human. I do not blame this nurse, but I try to learn from her and use her "mistakes" to better my own practice.
Sep 8, '06Everybody has a bad day, a moment when they are flustered and do things a little out of order, but not wearing gloves? That speaks volumes more than anything else she did. If she doesn't wear gloves to protect herself, how can we expect that she will observe aseptic technique to protect the patient? The hospital system that I work for would fire her on the spot for not wearing gloves during a blood draw.
Sep 8, '06Quote from bbboomerWhe I was in the hospital I noticed a lot of the nurses that had been nurses for years did not wear gloves to start IV's or they would tear off the fingertip. That is something they had been use to and I guess it's hard to change your ways. But yes they should wear gloves.Everybody has a bad day, a moment when they are flustered and do things a little out of order, but not wearing gloves? That speaks volumes more than anything else she did. If she doesn't wear gloves to protect herself, how can we expect that she will observe aseptic technique to protect the patient? The hospital system that I work for would fire her on the spot for not wearing gloves during a blood draw.
Sep 8, '06Km5v6r....... i was thinking of my aunt when i wrote,, but hesitated.. You put it well. Her philosophy sounds very similar to yours. And i have to admit,i strip a glove now and then for a tough stick and other things too. Sometimes you just have to.
Sep 8, '06She should have worn gloves.
Otherwise everyone has a bad day in IV land.
However, a flash means the tip is in the vein, what she did with the saline is try to float the cath furthur in; the saline would open the valves ahead of the more dense tip.
The tourniquet is to obstruct venous flow so the vein distends. Arterial flow should still continue.
Opening the equipment should take about 10-15 seconds including putting on the gloves.
Distal starts are OK providing the vein used earlier isn't proximal to the attempt.
Sometimes veins "clamp down"after a stick. And I too have left an earlier cath in so this wouldn't be the case on the second attempt. And BTW 2 attempts should be all.
I don't leave my patients looking like porcupines sprouting Jelcos.
OK I've said all that.
Been there done that:
(1) FIL in midst of 2nd acute MI they put him in the rig and didn't leave.....I walked out and asked what was the delay. Medic [and I don't think he was a paramedic, but an EMT] said "we can't go til we have an IV access." ME: "get out of the way and I started an 18g."
(2) MIL small town ER sick as a dawg nurse can't get IV
ME: see #1
(3) MIL in same small town ER ......nurse can't get a foley
ME: see #1 except it was a 16g foley.
Family should allow the staff room. They are trained, they are experienced. It is agony watching family members in pain. I felt like an (insert term for donkey) butting in, but the staff had given up and relative was in agony.
I hope things are better for you now. I absolutely know how you felt.