I knew it was not a correct Technique - page 4

by FutureRN_NP | 4,498 Views | 35 Comments

My co-worker showed me how to do a PICC Line dressing change yesterday. I knew it was an incorrect technique because I reviewed the skill in youtube before. All my co-worker did was just removed the tecoderm and replaced it with... Read More


  1. 1
    Good question Leslie. To the OP. I would ask your clinical educator to review the policy/procedure with you because you have some questions about how you saw it done. Let her know that there was a discrepancy between the way you were taught to do it and what you were shown and you want to make sure you are doing it the absolutely correct way. It's best to use your most innocent puppy dog eyes when you say this. You needn't even mention the culprit. This should alert her to the problem that she will need to address with the entire staff.
    leslie :-D likes this.
  2. 1
    Quote from ruby vee
    you're new? your co-worker isn't? leave it alone. read the policy and procedure for your hospital, do it correctly in your practice and if you're ever in the position of being a preceptor of course show your orientee the correct way. but leave your co-worker alone.

    i disagree. central lines and picc line infections are a big deal. they put the patient at risk of sepsis and increast hospital stay. i think the op was caught off guard, but in the future i would have been like "dont we need to cleans it with chlorhexidine?". if she says no, say "oh thats what we learned in school, wouldnt want to risk a line infection". if your coworker disagreed, let her do it her way, but you could have looked up the policy of your hospital and said "by the way, i double checked the policy because i wasnt sure, but we should be using chlorhexidine". it should be done using sterile technique. i think its ok to politely point out she was wrong if you can find the policy. also "scrub the hub" for at least 15 seconds. people underestimate that too.
    sapphire18 likes this.
  3. 2
    and still, the question remains:
    how does one address bad practice of an experienced nurse?
    i agree that a new nurse shouldn't be addressing it...unless it was put in the form of a question, i.e., "why are you doing it this way?"
    but if a nurse is doing a task that puts the pt at notable risk, should we be looking the other way...minding our own business?
    this question is for all (experienced) nurses...
    how do you handle it when you know pt harm will likely be forthcoming?


    i'm not a brand new nurse, and i have some advantages in the part time teaching position i hold. i educate. if i see enough people doing the same thing incorrectly, i educate the whole unit. if i run into someone who won't be educated, i have a talk with their preceptor or evaluator.

    there are some experienced nurses whose practice you're not going to be able to change. if the practice is dangerous enough (pulling chest tubes, pacing wires and central lines while the patient is sitting up in the chair, for example), i go up the ladder as high as the vice president for safety. they educate, put out new policies and procedures and educate some more. and the experienced nurse may persist with the unsafe practice. then it's documentation and more documentation. but there's no way to absolutely ensure that everyone complies with best practice every time.

    i save my education, however, for occiaisons when the patient is at notable risk, not just for those occasions when someone is doing something differently than i would. (i've learned a lot over the years from nurses who do things differently than i would, and have changed my practice accordingly.) an experienced nurse who won't use gloves may be disgusting to most of us, but the person she's endangering the most is herself. it's probably not worth making an enemy to force her to use gloves.
    Last edit by Ruby Vee on Jan 31, '12 : Reason: Added the quote
    GrnTea and Meriwhen like this.
  4. 0
    Pertaining to some people who says YouTube something you shouldn't be trusted. I use it to confirm what I've learned from school. Actually, it is a good place refresh what you already knew. I remember you suppose to replace everything, not just tecaderm. I am new and the person is also new. We both new but I am newer per se, but I already knew the technique was not correct. That is all!
    Last edit by FutureRN_NP on Jan 31, '12
  5. 1
    You must point out their incorrect technique. Nicely but firmly.

    We are talking about preventing infection.. a very basic nursing goal.

    Grow some cojones.
    DookieMeisterRN likes this.
  6. 1
    It's really shocking to hear *some * (not all) experienced nurses tell a new nurse to basically mind her business (and not confront an "experienced" nurse) over an imperative infection control procedure. I'm not a new nurse nor old enough to personally know Florence Nightingale but a new nurse looking for tips on something this important should be given moral sound advice, maybe I'm just a fuddy-duddy though.For Pete's sake would you want your mothers PICC dressing changed like the OP's scenario? ☣
    Flatlander likes this.


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