Witnessed unsterile procedure and feeling terrible about it

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nurseprnRN, BSN, RN

1 Article; 5,114 Posts

They make nifty little no-touch caths that are enclosed in a sterile sleeve-- kit comes with a prep wipe and the cath is pre-lubed, and no gloves are necessary. Good for people with limited dexterity, and they collect the urine for disposal without spillage, so they're good for SCI, etc. folks who want to be able to spend the day out of the house. They'd save you time and the cost of sterile gloves, too. Have the purchasing people look into it.

AnonRNC

297 Posts

Specializes in NICU.

What does your facility policy say?

You say that next time you'll say something. Think about exactly WHICH words you'll say...practice saying them out loud. It's hard to confront people.

CapeCodMermaid, RN

6,090 Posts

Specializes in Gerontology, Med surg, Home Health.

A nursing home may be considered a "home" environment, but sterile procedure is still required for foley catheter insertion.

lilaclover6984

211 Posts

A nursing home may be considered a "home" environment but sterile procedure is still required for foley catheter insertion.[/quote']

She needs to check the policy at her facility. I know both of the LTC facility's I used to work in ( in BC Canada) required only clean technique for wound care and In/out caths. They were very specific about this. And stated that it was becAuse the facility was considered a home environment since the pt. was in their own surroundings and germs all the time.

I know this is confusing to people that have only ever worked acute.

lilaclover6984

211 Posts

Why didn't you just ask the nurse when she was doing it anyway? It didn't have to be a confrontation like " you're doing that wrong", just a question as to why she was doing it that way.

cblake4293

10 Posts

I know! I wish I had just asked her in the moment! Dont reallly know why I didnt say anything in the moment. I guess I had already intervened alot and felt a little intimidated saying anything else. I did ask her if she had sterile gloves when preparing and looking back, I realize she never answered. I also asked her if she had iodine, she didnt answer. I found it in the drawer and asked her if she wanted me to put it on. I had asked her if she got something to put the trash in. I asked her if she had lubricating gel. Which she did (and touched the packaging with clean gloves and then pulled the foley out of the package and touched that). And I started to doubt myself, thinking maybe its ok since he self caths at home. Next time I will just ask in a nice way! And save myself this headache!

lilaclover6984

211 Posts

I know! I wish I had just asked her in the moment! Dont reallly know why I didnt say anything in the moment. I guess I had already intervened alot and felt a little intimidated saying anything else. I did ask her if she had sterile gloves when preparing and looking back I realize she never answered. I also asked her if she had iodine, she didnt answer. I found it in the drawer and asked her if she wanted me to put it on. I had asked her if she got something to put the trash in. I asked her if she had lubricating gel. Which she did (and touched the packaging with clean gloves and then pulled the foley out of the package and touched that). And I started to doubt myself, thinking maybe its ok since he self caths at home. Next time I will just ask in a nice way! And save myself this headache![/quote']

I think that's a good plan:)

healthstar, BSN, RN

1 Article; 944 Posts

It takes time to build courage , and stand up for the patients ! It sucks when you are a new grad and in orientation it is hard to speak up! Many people do not have the courage to speak up when someone is not following the policy, or when you see something wrong because of fear, fear of losing the job! So sad !

BSNbeauty, BSN, RN

1,939 Posts

OP, you come off to me as a very bright nurse whom really don't want to start any trouble. If in any doubt, clarify this with the nurse or charge nurse if you don't feel comfortable. Shame on other nurses for saying "stay out of it". Yes, you need to pick and choose your battles, however when you are new you don't know what battles to pick and choose. The convo with the LPN could have went something like this" Hey Nurse Nancy, I realize that you are very experienced and I apprecatiate all you have taught me so far, I just need some clarification.... I was always taught to use sterile gloves during catherization is this techinique not used in HH/LTC?"

If she blows you off or is rude about it, go to the charge nurse, not to REPORT but to CLARIFY.

lmacster

1 Post

OP, I remember being a new nurse, and it sounds like you are a smart, wonderful nurse who really cares about your patients. I'm a NP in peds urology (primarily outpatient). We do sterile in-and-out caths when collecting urine to check for UTIs, but all of our children who self-cath on a regular basis do it as a clean procedure both at home and at school. For those who cath via stomas, we even use clean technique in the clinic if they come because they are having difficulty cathing. We also use clean technique in clinic when we are teaching children/parents how to self-cath.

But, if we have an inpatient who is having an indwelling foley catheter placed post-op or while in the hospital for whatever reason, that is always done with sterile technique. Same with children who do not self-cath and are having a catheter placed for a VCUG or other procedure.

Hang in there, before you know it future new grads will be coming to you with questions and I'm sure you'll have great answers and be a great mentor!

kennedy8353

9 Posts

me and my coworkers sing that on the unit!!! hahaha, where no one can hear of course!

DedHedRN

344 Posts

Specializes in Medical Surgical.

One of the hardest things about nursing is to learn to speak up in the moment.

Your going to have to learn it, you are in charge of a lot of staff as a nurse in LTC.

And always speak to the person you have issue with before running to your supervisor, unless there is a compelling reason you cannot.

Each time I've changed jobs, I have asked for clarification on a thousand things before I felt comfortable, no one has ever accused me of being a terrible nurse for it.

"I noticed while we were in the room taking care of that pt, I saw you...."

"Why do you do it that way, I have always seen it done this way.."

"Would you like help with that? I can run and get you some gloves...if you want them..."

"Is there a medical reason we are doing it this way..."

"I just dont feel comfortable doing it this way, because....."

ect ect you get the picture.

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