Witnessed unsterile procedure and feeling terrible about it - page 7

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... Read More

  1. Visit  anotherone profile page
    0
    Quote from BrandonLPN
    If sterile gloves and betadine are readily available, why *wouldn't* you use sterile technique? To be honest, I have no idea what my facility's official policy is re: sterility vs clean and straight cathing. But since I got a supply room full of sterile supplies, I'm sure as heck gonna use them.With all that said, the OP definetly should NOT report this nurse to his supervisor. For crying out loud, we don't even know if the nurse in question was violating facility policy. Everyone telling the OP to run and tell the DON is giving *terrible* advice. Do you all want the OP to be completely ostracized as a new nurse?!? Maybe, just maybe, the OP could discretly discuss it with the LPN before stabbing her in the back? Just a thought.....
    as a new person i would keep my mouth shut. if it gets brought up, you better do everything by policy 100% of time or expect when you dont emails be sent to management and incident reports for every little thing . sad but true . 30years of experience doing it wrong as i like to say
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  3. Visit  leslie :-D profile page
    1
    Quote from imintrouble
    It would be beneficial if the hospital nurses, outraged over some of these posts, could work in LTC for 6 months.
    here...ltc was my first job out of nsg school, worked there little less than a year.

    when we straight cath'd, we'd grab a cath and a cath kit to get the needed supplies for a sterile procedure.
    the only thing i'm thinking of now, is that i actually didn't need the straight cath and could have just used the cath from the cath kit.
    in our ltc facility, it was definitely a sterile procedure and we'd get in big trouble for not following policy.

    leslie
    Liddle Noodnik likes this.
  4. Visit  leslie :-D profile page
    1
    i'm glad the situation is resolved, glad procedure should be sterile (phew!), and no one got in trouble.

    you may want to post this in your original thread since it is not getting the attention it deserves.

    best of everything and good job, op.

    leslie
    Liddle Noodnik likes this.
  5. Visit  netglow profile page
    5
    Quote from cblake4293
    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...
    Next on your inservice list should be the above
  6. Visit  imintrouble profile page
    1
    Suffice it to say, that each of our realities are not the same.
    Kudos to all of you who have never found yourself working where they don't even have alcohol preps.
    May you never have to.
    leslie :-D likes this.
  7. Visit  cblake4293 profile page
    5
    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...
  8. Visit  JustBeachyNurse profile page
    0
    Threads merged for continuity.

    Glad to see you have an amicable resolution.
  9. Visit  DoeRN profile page
    2
    That's good news. She wasn't singled out and everyone will learn the proper technique. I didn't feel like you were a tattle tail. When it comes to patient safety you need to speak up.

    Even though I'm a middle aged burnt out nurse I still make patient safety a top priority.

    Sent from my iPhone using allnurses.com
    leslie :-D and mariebailey like this.
  10. Visit  limaRN profile page
    0
    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...
    What en excellent outcome for such a tricky situation... You did a great job and sound like a fabulous nurse!
  11. Visit  Liddle Noodnik profile page
    0
    Quote from imintrouble
    Suffice it to say, that each of our realities are not the same.
    Kudos to all of you who have never found yourself working where they don't even have alcohol preps.
    May you never have to.
    that's pretty bad imin ...

    Quote from cblake4293
    ... 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...
    wow excellent!


    Quote from limaRN
    What en excellent outcome for such a tricky situation... You did a great job and sound like a fabulous nurse!
    yep!
  12. Visit  BrandonLPN profile page
    0
    Quote from Liddle Noodnik
    I have worked LTC. Years, not months. I still stand by what I said. I do understand! But, it is still unacceptable I will add though that I have retired from nursing, hopefully for the last time, and I'm only 54. It's a very toughprofession to be in no matter what the specialty. Kudos for those who will continue to do it, and do it right. But when you can't help but take shortcuts suchas these, maybe it is time to leave.
    Well, where I work we do have straight cath kits, fortunately. So, yes, I use sterile technique every time.

    The honest-to-God reality, though,
    is that many nursing homes have minimal sterile supplies and have policies stating clean technique for straight caths. Please don't imply that nurses performing clean caths in such facilities are lazy or taking shortcuts. That's unbelievably unfair. What would you have them
    do? And please don't say they should quit, that's such impractical advice. If every nurse quit Medicaid facilities because of less than ideal conditions, there'd be no one left. Sick people in crappy medicaid nursing homes need care just as much as sick people in posh Medicare homes....

    In any event, kudos to the OP for finding out what the policy actually WAS at her facility and for finding a way to educate w/o putting anyone on the spot. I'm glad everything worked out.
  13. Visit  Liddle Noodnik profile page
    1
    Quote from BrandonLPN
    Well, where I work we do have straight cath kits, fortunately. So, yes, I use sterile technique every time.

    The honest-to-God reality, though,
    is that many nursing homes have minimal sterile supplies and have policies stating clean technique for straight caths. Please don't imply that nurses performing clean caths in such facilities are lazy or taking shortcuts. That's unbelievably unfair. What would you have them
    do? And please don't say they should quit, that's such impractical advice. If every nurse quit Medicaid facilities because of less than ideal conditions, there'd be no one left. Sick people in crappy medicaid nursing homes need care just as much as sick people in posh Medicare homes....

    In any event, kudos to the OP for finding out what the policy actually WAS at her facility and for finding a way to educate w/o putting anyone on the spot. I'm glad everything worked out.
    sorry, my reaction was a little more than it needed to be, I was just upset that people were dissing the new grad who did have a serious and valid concern. She handled it perfectly IMHO, checking on the current policy and suggesting a way that it be corrected. I'm SO glad and I sure don't want that nurse penalized, just, corrected if she is willing.

    and no I pray that nurses don't quit just because it's hard. I need those nurses who are willing and able to hang in there, and so do a lot of other people! and yes all the facilities need them, not just the posh ones.

    I had other extenuating circumstances but I would be right back at it if I could. It kills me that I am one more nurse who cares, but can't

    thanks Brandon
    BrandonLPN likes this.
  14. Visit  leslie :-D profile page
    0
    Quote from imintrouble
    Suffice it to say, that each of our realities are not the same.
    Kudos to all of you who have never found yourself working where they don't even have alcohol preps.
    May you never have to.
    if that is the case, i pray these facilities are the exception and not the norm.
    and, they should be shut down and/or severely penalized...which i'm pretty sure they would be.

    Quote from BrandonLPN
    The honest-to-God reality, though,
    is that many nursing homes have minimal sterile supplies and have policies stating clean technique for straight caths. Please don't imply that nurses performing clean caths in such facilities are lazy or taking shortcuts. That's unbelievably unfair. What would you have them
    do? And please don't say they should quit, that's such impractical advice. If every nurse quit Medicaid facilities because of less than ideal conditions, there'd be no one left. Sick people in crappy medicaid nursing homes need care just as much as sick people in posh Medicare homes....
    skilled nursing facilites are highly and tightly regulated by the state.
    i just cannot imagine those facilities having a policy where clean technique is to be used with straight cathing.
    it makes me wonder how that facility's state views this?
    i would be incredibly surprised to learn that the state okays this.

    the bottom line is our elderly need a hell of a lot more advocacy than they get...
    and poorly-run ltc facilities are just plain unacceptable.
    yes, i agree that we can't all abandon such workplaces...
    but seriously...what kind of support are these residents getting if nsg doesn't even have the most basic of necessary supplies?
    the nurse could be the most competent and compassionate person out there...
    which will do little good when pts are getting infections (et al) because of substandard care.

    leslie


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