maggiejrn 2,099 Views
Joined Aug 30, '09.
Posts: 9 (100% Liked)
I have been in this field for 20+ years and I will tell you now, find a new job!!!!!!!!!!!!!!!!! Those nurses are NOT going to stop because they know they can get a way with it. you can talk to all the administrative people you want but it won't change actually it will probably make things worse.
I do think you are also suffering from your past and add all this anxiety YOU need to take care of you or no one else will. Get up go to the phone make an appt with a GOOD counselor and keep it!!!!!!!!!!!!!!!! There is no shame in needing help the shame is in not getting it. There are other jobs in nursing. Maybe you would do better in a position with less contact with other staff such as home health. The ugly sad fact is working in a female dominated environment is not good. As a woman I hate to say it but women are ------- (rhymes with witches). Men can have an all out battle and the next day eat lunch together not women even the most innocent thing is taken out of context and the war is on. Life is too short to deal with all that crap. You need to realize your own self worth, stop caring so much about what other people say. Unless it is your supervisor you don't have to stand there and let someone berate you. Even if it is your supervisor she is no better than you and should NEVER reprimand you in front of other staff or patients. NO ONE HAS THE RIGHT TO SAY ANYTHING DEROGATORY TO YOU ESPECIALLY IN THE PRESENCE OF PATIENTS AND FAMILY. There is a right way and a wrong way to talk to someone. Offering advice in a kind and sincere way is one thing using you as a punching bag is another.
YOU NEED TO LEARN TO STAND UP FOR YOURSELF. As Dr. Phil would say "You teach people how to treat you"
I have been in your shoes and I feel your pain but only you can do what is right for you!! Better to find your niche in nursing than to let others chase you from a rewarding career.
Good Luck and God Bless
I am not surprised that someone made a mistake even of this proprtion. I am surprised that "mayjor wong" did not report this as an adverse event. Protecting a collegue who not only almost cost a patients life but who would also destroy evidence is the same thing as being an eyewitness to a nurse giving an overdose of Morphine. Now this patient is going to be labeled as having had an arrythmia that he did not. Your coworker obviously learned nothing from this except she can count on you to keep your mouth shut while you look the other way. What if that had been your parent? I worked in Risk Management and frankly I would be afraid to have you on my staff. You are supposed to be the patient's number one advocate but instead you let your patient down and you set a new low for morality in your institution. If this event happened once it can happen again but you just made sure that there would be no education to prevent anything like this from happening again.
Don't get too involved in trying to anticipate what questions you will be asked. Be calm, confident and most of all be yourself. Remember every interview you do is more practice for the next one. It is important to be sure not to have anything on your facebook that you don;t want a prospective employer to see. Keep it professional. Relax and take a deep breath, you will do great.
I applaud troc for being so observant instead of turning a blind eye to what is going on around her. If nurses have seen improper handlimg of catheters for years and apparently not done anything about it means that they are part of the problem. EVERYONE knows foleys in place too long sharply increase the risk of infection. In a perfect society no one would have a catheter and if they did someone would design a completely sterile way to hang the bag but it is not a perfect society and thus any thing that can be done in an effort to eliminate any possible causes of bacteria should be done. Let's say the floor is a fine place to lay the foley bag what does it hurt to put it into a protective barrier? Take a culture of a floor and see what it grows then do the same to an IV pole and I bet you'll find the floor wins hands down for more possible contaminate.
This is precisely the reason that incidents don't get reported. What about the others involved in the preperation? Another tragedy due to overwork, under staffed, and generally under paid. "The JUST GET IT DONE" mentality of employers certainly doesn't help. Every aspect of healthcare should be supported by a PROFESSIONAL UNION!! A definate tragedy for the child and family but also for the Pharmacist and his family. Obama needs to take a good look at these type of issues before he tries to overhaul something he doesn't understand. I am tired of hearing about him being called a LIAR during a discussion on healthcare reform. Especially since it was true!!!!
DISHES: Thank you for the questions and understanding this was more than an opportunity to critique my experience. I believe it was the foley care being done q shift along with all the other hard work by staff that brought our infection rate down. Too many doctors just don't think about things such as foley related infections. There are a lot of nurses out there that would prefer to keep them in just for convenience of less bed changes. If no one is out there advocating for the patient the foley is not going to come out. CDC guidelines were used to determine an active vs colonized infection and at the time we used PHC4 guidelines to determine who "owned" the infection since most of our patients came from acute care hospitals.
After reading all the comments I realized again just how difficult it is to work in a female dominated profession. Yes, I am a woman so it pains me to say this but instead of either pulling out any information that you might have found usefull or just skip it entirely 3 out of the 4 posted replies were negative and petty.
P-RN: My very first paragraph addressed the need to get the foleys out asap. Unfortuneatly this actually ends up falling to the nurse admitting the patient. When you call to give report ask if the foley can be removed. It is everyone's job to ensure what is best for the pt. The "prize" was meant to show positive reinforcement since all too often we only hear the NEGATIVE.
Morte: I am sorry if you were offended by the "rewards". This was my first stab at management and trust me I was lower than low on the totem pole. When you can not get management buy in I am not wasting my time on them. They are not the ones out there on the front line" performing the care. If you remember this was a TEAM effort led by CNA's with a few LPN's and RN's. If this upsets you how do you think a patient who is already extremely ill feels when they unnecessarily end up with a UTI?
hypocaffienemia: What difference does it make what acronym you use as long as the staff understand it. You do realize your suggestion sounds like CRUSTI? As a pt if I heard staff using the word CRUSTI around me I would be offended. The information offered really had nothing to do with the acronym. It was about team work and coming up with a successful plan to decrease infections.
The biggest was NOT getting catheters out as soon as possible. If the doctor doesn't address it then the nurse should ask if there are any reasons the patient still needs the catheter. If not ask for an order to remove it. However, if the foley is needed then it is of the utmost importance that foley care is done at least once per shift.
Our policy was revised to include clear guidelines for care.
Along with q shift peri care, staff was educated on importance of having a leg strap in place below the Y port to prevent tension on it, proper placement of the bag, never opening the closed sterile system and close observation of patient for any symptoms of a UTI. One of the most difficult issues was that many of out patients were placed into Low Boy beds due to high risk for falls. These beds had no place to hang the bag that did not have it touching the floor.
To keep it off the floor it ended up being higher than the bladder.
I called the manufacturer of the beds and the catheters to see if they had any suggestions. They were both completely baffled. I realized it was going to be up to me to figure this one out.
I considered blue pads but felt this would be a fall risk and would easily be kicked aside. I came up with a temporary plan until we could come up with something more permanent.
The foley bag was placed into the small plastic disposable bath tubs. They were less than 50 cents each, much less than the cost to treat an infection. I then set out on my quest to find a fluid impermeable cover for the bags.
Since they would touch the floor no matter where it was placed, the only solution was to protect it from allowing any contamination from the floors. It took a great deal of searching but I finally found just what we needed. The last step was that after each time the bag was emptied the spout was to be cleansed with alcohol wipe then placed back into the holder.
With a clear plan it was now time to not only educate but to get staff "buy in". I asked for volunteers and since the CNA's performed most of the foley care the majority of the team was made up of them with a few LPN's and RN's.
We decided that staff along with myself would police each other. To keep it positive, we decided that when one of the staff observed another correctly performing foley care they were given "tickets" to issue to the person "caught" doing a good job.
Once a staff member acquired a predetermined amount of tickets they were able to turn them in for a small "prize". From start to finish it took about 6 months for our infection rate to drop. We had a Pizza Party to celebrate our accomplishment. Even after we discontinued the prizes staff continued to be vigilent about the foley care and in the end it was the patients who were the real "WINNERS".
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