Witnessed unsterile procedure and feeling terrible about it

[cblake4293]

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 sterile gloves. I asked if she had sterile gloves and the iodine that is necessary (we didnt have a kit so all items had to be gathered seperately). I found the iodine and brought it to the bed side. She then asked for a packaged wipe on the bedside to clean the insertion area. I asked her if she wanted me to do the iodine and she replied that she was just going to do the wipe but I could if I wanted to. I did and realized that she never put on sterile gloves only clean gloves. She completed the procedure without ever applying sterile gloves and I am feeling absolutely awful that I didnt stop her and tell her she needed sterile gloves. The whole procedure was totally against what I learned in nursing school. I am thinking about going to the nurse in charge of training and telling her what happened in confidence. Thinking maybe she can hold in inservice on proper techinique. I do not feel comfortable talking to the nurse who did the procedure about it. It would not go well. I have been stressed about this for the last 24 hrs! Any advice? I'm afraid I could be held responsible for not intervening as well.

[klone, MSN, RN]

I would guess, like me, this LPN thought that for patients who self-cath at home, sterile procedure is not necessary. I knew that at home, clean technique was fine. I did not know there are different standards in that situation for in the hospital (I work in OB, don't see too many people who have to self-cath). It sounds like this is a good learning opportunity for the staff at large. Good luck to you!

[beeker]

really guys?

really???

stay out of it???

sure why not.

we nurses needn't be accountable to anyone but ourselves, right?

let's look the other way, even if the pt becomes septic because we chose not to advocate for them.

grntea is 100% right.

in the hospital setting, sterile technique IS the standard of care, for the very reasons she cited.

it would be totally the nurse (who chose to remain silent) fault if pt became infected.

op, yes, you are in a tough, tough situation and it would eat at me too.

in the home setting, the same rules do not apply...

but in an acute setting such as the hospital, sterile technique should always (always, always!!) be done.

i suppose you could have asked this nurse (privately), why she chose not to use sterile gloves, and share your discomfort?

i really do sympathize with you, and i hope you always aspire to the highest standards of nursing care as long as you're a nurse.

you need to follow your heart and act accordingly.

nosocomial infections are disgustingly high, partly because of apathy and shabby habits.

and who pays for all this?

our pts of course, but in the larger picture, we all pay.

"stay out of it", imo, is dangerous and irresponsible...

and is a big problem in u.s. society in general.

so many people would be much better off, if bystanders were moved to respond proactively instead of indifferently.

God bless you, op...

and stay on the high road.

leslie

This is the kind of thing that new nurses get eaten for.I am not saying it is right, but she needs to look out for herself too. If the other nurse has been there for 30 years and gets in trouble, who do you think is going to be odd man out?

[lilaclover6984]

Sterile technique?

"Ain't nobody got time for that"

Lol I'm kidding btw

[cblake4293]

Thank you for your advice! I work at a nursing home not the hospital but UTIs are common and I would feel horrible if the patient got one or worse. I'm hoping I can talk to the nurse in charge of trainings in confidence and she can hold an inservice on it. I am definitely one to mind my own business so this is really hard for me. I have never been in a situation like this and I have learned an important lesson. Next time I will ask the person right away why they are doing something a certain way( in a nonconfrontational way).

[lilaclover6984]

Thank you for your advice! I work at a nursing home not the hospital but UTIs are common and I would feel horrible if the patient got one or worse. I'm hoping I can talk to the nurse in charge of trainings in confidence and she can hold an inservice on it. I am definitely one to mind my own business so this is really hard for me. I have never been in a situation like this and I have learned an important lesson. Next time I will ask the person right away why they are doing something a certain way( in a nonconfrontational way).

A nursing home is considered a "home" environment. Clean technique is all that is required though in my practice I do personally feel better using sterile technique...

I don't think ratting out a senior nurse for something this minor is a good way to get started nor is it a good way to improve things. Set an example with your high standards and hope others will follow. Running to the manager on this nurse is only gonna cause you problems and not likely change anything about her practice anyway. If it really bothers you just talk to her one on one.

[loriangel14, RN]

I have a pt in the hospital that straight caths at home.When we help him it is just clean technique.I guess everyone will do it differently. I wouldn't report it if someone chose to do it clean instead of sterile.

[MJB2010]

I would ask the training nurse to clarify for you what is required, clean or sterile. In the hospital where I work sterile is required. But in the nursing home it may be different. Before telling on someone else, make certain you know the proper policy and what is required.

[cblake4293]

Good advice. I think that is how I will initially approach it. I will ask for clarification and take it from there!

[SoldierNurse22, BSN, RN]

This is the kind of thing that new nurses get eaten for.I am not saying it is right, but she needs to look out for herself too. If the other nurse has been there for 30 years and gets in trouble, who do you think is going to be odd man out?

You're right. But fear of retribution is not a good reason not to do the right thing.

[kkostelnikPN]

A nursing home is considered a "home" environment. Clean technique is all that is required though in my practice I do personally feel better using sterile technique...

I don't think ratting out a senior nurse for something this minor is a good way to get started nor is it a good way to improve things. Set an example with your high standards and hope others will follow. Running to the manager on this nurse is only gonna cause you problems and not likely change anything about her practice anyway. If it really bothers you just talk to her one on one.

I work in LTC and sterile technique is still required at all times whether the person is being straight cathed or not This nurse is using poor practice and I think you need to speak up. Don't be a nurse who just doesn't care because its "minor" (which I don't consider it to be) if they will straight cath with clean gloves and a wipe for Pete's sake what won't they do????? Lazy people disgust me

[nurseprnRN, BSN, RN]

There's a difference between the SNF being the patient's home and it being a health care facility. In your own house/apt you are, theoretically, exposed to your own bacterial load and those of your immediate environment, to which you are tolerant. Even then, nowadays the old "clean" standard is going by the boards.

In a care facility you are exposed to the bacterial load of many people coming and going, not just staffers but other residents, visitors, and more. See the difference? I'm with kkostelnikpn, lazy people disgust me too.

Besides, you can get sepsis at home, too. I once had a pt with a spinal cord injury who went for six years being straight cathed every four to six hours at home and never once had an infection until a new nurse came and reused a catheter against his direction (they teach SCI patients all about their own care and how to give direction to caregivers, and he really knew). Yep, he got sick, and never again had sterile urine, and never again was able to live without periodic UTIs and sepsis. Sterile means sterile, and sterile is better. That's why it's the standard now.

[CT Pixie, BSN, RN]

I work LTC and we still perform caths with sterile technique (cath kits have the sterile gloves in them).