Witnessed unsterile procedure and feeling terrible about it - page 11

by cblake4293

14,370 Views | 106 Comments

I am a new grad and have been working as an RN for 5 months. Everyone I work with is very experienced and I am definitely the newbie. Yesterday I witnessed an LPN with 30 yrs experience straight cath a male without using... Read More


  1. 0
    Quote from PediatricRNTX
    This happened to me...I was a new rn w a preceptor. I tried to Cath and missed (embarrassing) ...so my preceptor did what she had to do to get the urine...UNSTERILE!!!... The pt was a healthcare wker familiar w the procedure....my manager called us n a mtg the next day!...anyway,protect your license. But realize real world nursing, sometimes u do what u gotta do.
    I trust you aren't saying that you mean that "in the real world" it's OK to do an unsterile bladder intubation with a contaminated catheter. It surely is not. If your instructor was modeling that behavior, put it out of your mind immediately and don't do it.
  2. 0
    You could play dumb,
    "RN, when should I use sterile technique vs just clean technique?"

    Afterall you are a ''new'' nurse
  3. 3
    Quote from cblake4293
    Thank you to all who responded to my post about the unsterile cath I witnessed. After a couple of sleepless nights, I did what I felt I could live with. Talking with the nurse directly was not an option for me. I was not going to see her for another week and I felt that too much time had passed. She is somewhat confrontational and I predict it would not have gone well. I should have said something in the moment but you know what they say about hindsight. Lesson learned. Some nurses I have developed a good relationship and we often txt outside of work asking how pts are or bouncing things off each other. I would have definitely gone to one of these nurses if they had done it. So....I went to the nurse educator and asked her about the facility policy and if there were any exceptions. She said no. Straight cath is always sterile. I told her what happened and suggested an inservice without pointing anyone out. I also said we dont have kits which would have made the gloves readily available. She didnt realize we were out of kits . The end result is she is ordering kits, attaching a memo about correct technique and has no plans to single this nurse out in any way and my name stays out of it! To those who talked about being a tattle tale....yes I do feel like one! But this is about safety, and if this is how she always caths someone is going to get sick and I wouldnt want it to be my grandmother. I see shortcuts taken everyday at work, we have to somehow get a million things done in 8 hrs! I had clinical instructors say "this is how we do it in school but this is how its done in the real world". Loved those clinical instructors! Trust me I get it...
    You did the right thing, OP.

    There are a lot of cases where keeping your head down and your mouth quiet is a good choice; but anytime it interferes with patient safety, it is not and I'm a little appalled at how many people advocated that here.

    You got things across in a way that identified a problem, suggested a solution, and ensured that management was aware of the situation without naming names.

    Kudos.
    GrnTea, Tait, and DebblesRN like this.
  4. 1
    Quote from PediatricRNTX
    This happened to me...I was a new rn w a preceptor. I tried to Cath and missed (embarrassing) ...so my preceptor did what she had to do to get the urine...UNSTERILE!!!... The pt was a healthcare wker familiar w the procedure....my manager called us n a mtg the next day!...anyway,protect your license. But realize real world nursing, sometimes u do what u gotta do.
    What do you mean? What "u gotta do" is run to supply and grab a new kit.
    GrnTea likes this.
  5. 0
    While I agree that a nurse deciding what is sterile or clean is not acceptable, sometimes you have no choice. I had a pt who had chronic, constant (I.e. steady STREAM) diarrhea who needed a foley inserted. She was a renal pt so not having a foley was not an option for her. I had to insert a foley while trying to keep stool at bay. I had three pairs of helping hands and was cleaning her over and over. My charge finally said "it isn't going to stop and I know it isn't ideal but you have to get it in any way you can". I kept the pt as clean as I could and kept the supplies as clean as I could and inserted it. It was not the way I wanted but there was no other choice in the matter. Circumstances matter. I routinely follow sterile procedure. This was the only case I've had in which I couldn't but it does happen. Sometimes you have to do what's necessary. Good job to the op for standing up though!
  6. 0
    Quote from RNikkiF
    While I agree that a nurse deciding what is sterile or clean is not acceptable, sometimes you have no choice. I had a pt who had chronic, constant (I.e. steady STREAM) diarrhea who needed a foley inserted. She was a renal pt so not having a foley was not an option for her. I had to insert a foley while trying to keep stool at bay. I had three pairs of helping hands and was cleaning her over and over. My charge finally said "it isn't going to stop and I know it isn't ideal but you have to get it in any way you can". I kept the pt as clean as I could and kept the supplies as clean as I could and inserted it. It was not the way I wanted but there was no other choice in the matter. Circumstances matter. I routinely follow sterile procedure. This was the only case I've had in which I couldn't but it does happen. Sometimes you have to do what's necessary. Good job to the op for standing up though!
    I agree, people are not being completely realistic here. What about the extremely confused and aggressive dementia patient? Which on my unit makes up about 95% of the patient population. Ever try to put a catheter in someone who is kicking and biting and flailing around and maintain 100% sterile technique?
    This very situation happened with me last night. 3 of us holding the pt. down. I tried 3 times with no success. My coworker tried another 2 or 3 times and it wasn't happening. That "sterile field" was being kicked everywhere. Eventually we got it in but I can tell you without a doubt that it was no longer sterile technique. Sometimes ya gotta do what ya gotta do.
  7. 0
    Quote from Miiki✿

    What do you mean? What "u gotta do" is run to supply and grab a new kit.
    What I am saying is I have yet to see many nurses do things by the book. The goal is obviously to do it as best as possible. But no one is perfect.


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