Witnessed unsterile procedure and feeling terrible about it - page 6

by cblake4293 14,494 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


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    Quote from 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.
    I learned the same way in school and my facility has the same policy.

    I, the nurse (or student nurse/tech in my case) use a sterile technique inserting a catheter. The pt may use clean technique cathing themselves. I don't get to leave sterile technique behind because the pt does.

    If the pt gives themselves a UTI, it's "on" the pt. if I give them a UTI, it's on the hospital. And therefore, me.
    anotherone, GadgetRN71, and cindjo717 like this.
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    Let your unit educator know that you have witnesses unsterile/improper cath technique and suggest an inservice... Or fill out an anonymous variance and don't dont don't name the nurse in it. This is a good balance between making sure she and others know it is wrong and not letting everyone know you snitched.

    I mean seriously people we work with mostly women and i can understand fearing retaliation haha...

    I can't tell you how many times I've seen caths inserted like 5 times, in the wrong hole or meeting resistance etc etc only to have them pushed right back in after they have coiled up in the vagina. I've done it in exasperation and it's not right when it comes down to it.
  3. 0
    Quote from lilaclover6984
    Sterile technique?

    "Ain't nobody got time for that"

    <img src="http://allnurses.com/attachment.php?attachmentid=12293"/>

    Lol I'm kidding btw
    Lmao!!!
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    Your concern is why you are a nurse and a good one, more people like you are needed in the field, if it's not right it's not right I don't care who is who and how long they been where or who is going to look at me wrong, I'm not there for them I'm there for me and the patient, I would rather go to sleep at night peacefully than to be worrying about someone that I was in care for could possibly get sicker or actually gets sicker than they already are because I didn't stand up for them and do what was right. If State was in the building she would've put on those gloves. Personally I would've stopped her and provided her with the sterile gloves. People get too wrapped up in worrying about how someone is going to treat them or if they are going to talk about them. So What, they talked about Jesus. If you lose your job or they try to slander you they have layers for that, but trust and believe you will find something bigger and better.
    GadgetRN71 likes this.
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    LTC residents are already at higher risk for UTIs d/t their age & immune status; UTIs are one of the most common infections among LTC residents. If someone wants to complain a/b the cost of using sterile gloves for each straight cath, think of the potential cost savings from preventing UTIs & unnecessary antibiotic use.
    I think you should not stay out of it; it needs to be addressed because it affects patient care.
    GrnTea likes this.
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    Can you find out what the statistics are for your facility pertaining to HAI? Also how long has this LPN worked there - it would seem to me if she has worked there for years, and does a lot of caths... they would have been on to her by now.
    nursel56 and GrnTea like this.
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    Also nursing homes are much different than hospitals.. I did my clinicals at nursing homes, and it is a chore just to find sterile gloves! They did not perform sterile technique to my knowlege.
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    Quote from NewbieNeedsHelp
    I can't tell you how many times I've seen caths inserted like 5 times, in the wrong hole or meeting resistance etc etc only to have them pushed right back in after they have coiled up in the vagina. I've done it in exasperation and it's not right when it comes down to it.
    Time to reprint my handy-dandy, never-fail, no-vaginal-contamination Foley-insertion trick.

    When you are prepping the woman, tuck the last betadine-soaked cotton ball into the introitus. Not deep, just enough so it blocks the vagina. Then when you are trying for insertion and you miss, the cath only hits the sterile cotton ball and you can keep trying (ask for a cough and look for the "wink" or a little urine output) because it isn't contaminated. Retrieve the cotton ball when all is secure and cleaned up.

    I never went vaginal with a Foley again after learning that. Works every time.
    jmll1765, mazy, AnonRNC, and 3 others like this.
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    If you report every nurse for not doing it the way you were taught in school you are going to have a very long career..
  10. 1
    Quote from GrnTea
    Time to reprint my handy-dandy, never-fail, no-vaginal-contamination Foley-insertion trick.

    When you are prepping the woman, tuck the last betadine-soaked cotton ball into the introitus. Not deep, just enough so it blocks the vagina. Then when you are trying for insertion and you miss, the cath only hits the sterile cotton ball and you can keep trying (ask for a cough and look for the "wink" or a little urine output) because it isn't contaminated. Retrieve the cotton ball when all is secure and cleaned up.

    I never went vaginal with a Foley again after learning that. Works every time.
    Thanks for the reprint. Wish I'd known that a week ago.
    GrnTea likes this.


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