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.

[wlkinmyshuz1st]

Please let us know how that works out for you; turning that nurse in to your supervisor for not wearing sterile gloves but instead wore clean gloves.

[lilaclover6984]

Ahh new grads lol

Yes this was poor practice but seriously? Lol

[klone, MSN, RN]

Do you know for sure that this person isn't someone who routinely self-caths, and as such, no longer requires it to be a sterile procedure?

You, a student, will not be held responsible for what a bedside nurse did.

[Fiona59]

When I worked with day patients who lied in the community it was a clean procedure. Many time the men didn't want the betadine wash and would clean themselves with a washcloth.

What's the entire story?

[cblake4293]

Yes this person does self caths at home! So this doesnt have to be a sterile procedure? That would be a weight off my shoulders! I am not student, I am now a new RN. The person doing this was an LPN with 30 yrs experience. My supervisor had done the procedure in front of me two weeks prior with the same patient and had used sterile technique.

[beeker]

Try to worry about what you do and how you do it. I would stay out of the other nurses business. I would not under any circumstances report her to the charge nurse. That is going to open up a whole can of retaliation towards you and no one is going to want to work with you for fear you might "see" something else you don't like. If she did something wrong that is on her not on you. This is not likely to kill the patient. Worst case scenario? The patient may or may not get a uti. I would not lose any more sleep over it. It is pretty hard to stay completely sterile while putting in a cath but we do try on my floor to do it that way. But if you are new, you should keep your head down and try not to make waves. Was what she did right? Nope! Should you take it upon yourself to but in? Nope! Stay out of it and keep your mouth shut.

[cblake4293]

Being a new nurse is really not fun! One of the hardest parts is differentiating between what you learn in school and the real world. So I guess your saying this is not a big deal and I should move on?

[nurseprnRN, BSN, RN]

Do you know for sure that this person isn't someone who routinely self-caths, and as such, no longer requires it to be a sterile procedure?

You, a student, will not be held responsible for what a bedside nurse did.

While the last is true, the first is not and has never been standard of care in the hospital where there are more bugs around.

Medicare used to pay for four-- that's four-- sterile catheters per month for self-cathing. Amazingly, people got UTIs (not just colonization, infection, and yes, I know they're different), and a lot of them got sepsis. You can buy a helluva lot of sterile caths for the cost of one episode of sepsis. Now, Medicare pays for 200-- that's two hundred-- per month, and sterile is standard of care everywhere. I'll grant you that a lot of people don't know that yet, or don't give a damn, but it's true. That LPN, at very least, needs re-educating.

[leslie :-D]

Yes this was poor practice but seriously? Lol

Try to worry about what you do and how you do it. I would stay out of the other nurses business. I would not under any circumstances report her to the charge nurse. That is going to open up a whole can of retaliation towards you and no one is going to want to work with you for fear you might "see" something else you don't like. If she did something wrong that is on her not on you. This is not likely to kill the patient. Worst case scenario? The patient may or may not get a uti. I would not lose any more sleep over it. It is pretty hard to stay completely sterile while putting in a cath but we do try on my floor to do it that way. But if you are new, you should keep your head down and try not to make waves. Was what she did right? Nope! Should you take it upon yourself to but in? Nope! Stay out of it and keep your mouth shut.

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

[leslie :-D]

Being a new nurse is really not fun! One of the hardest parts is differentiating between what you learn in school and the real world. So I guess your saying this is not a big deal and I should move on?

it may not be a big deal with this patient.

but then again, it may be.

do you want to take that chance?

if not this pt, another pt will be affected by nursing's (and all hcws involved in pt care) mediocrity.

i am not being dramatic, just look at the rate of secondary infections because of poor hand-washing or some other risky habit.

if you are in touch with any of your nsg instructors, you can always approach them...

or someone you trust as a mentor, if you have one.

best to you.

leslie

[Prairienurse1989]

I like your suggestion of an in service preferably mandatory. As for " stay out of it" That's not very sound advice, they pay you to advocate for, use and be held accountable to a standard, not look the other way, even if a patient wasn't harmed.