Our Senior Leaders have been trying to reduce infection rates, as everyone in Nursing is. Recently, a memo was sent to all employees that if anyone witnesses an unsafe practice it is their reponsibility to immediately take measures to stop the unsafe action, document the incident (including time, date and location), and report it to their supervisor/manager for potential discipinary action. As a manager I've received very negative feeback that this is "tattling", and will only create animosity among the varied departments (Nursing, Lab, Therapies, Housekeeping are all included.) I've explained that the incident reports need to be completed, and when the "offending" empoyee is redirected they should know they will be written up; no suprises. Has anyone else experienced this in thier facility? If so, how did you, or your manager, handle the backlash? Thanks!
Oct 13, '12
I see unsafe practices all the time and as a new nurse I am reluctant to speak up. I am trying to develop the courage and aplomb to do so effectively. I like Ruby's advice above. It sounds like her staff are all mature adults with a collegial attitude. My last attempt to bring up an issue of safety with the person whom I thought was appropriate was met with a dismissive statement that let me know my concerns would not be addressed or even briefly considered. It was quite clear that if I wished to maintain my employment, I had better conform, and go with the flow. Other nurses I consulted, involved in the same procedures, had concerns too, but also had decided not to question the practice. I feared for my job. I will address it further, but not til I am certain I'm not the proverbial bull in a china shop or the deer with the target painted on its flank.
Here are the latest: Injection preparation -- people seldom careful about not touching the parts of the syringe that are to be kept sterile -- i.e., hub, connector, plunger. Even in so-called educational videos, people are grasping the syringe by the plunger, not the flange on the plunger, as I was taught and my research confirms is correct.
And this one: drawing up multiple syringes from a multidose vial by leaving a needle in the septum, then detaching and reattaching that needle to successive syringes, with bare fingers touching the hub of the resident needle and syringe connector, occasionally and unavoidably, touching the needle itself and the septum. (No handwashing facilities or hand sanitizer in sight.) Since this needle will eventually be discarded, I can see why someone might assume no harm is done. But CDC forbids the practice, stating that it allows direct entry of microorganisms to the vial, if I understand the guidelines correctly.
Filling multiple syringes of liquid suspension without first shaking the bottle to remix the suspension. I was trained "do not shake the vial," when the package insert clearly states "must shake the vial before each dose is drawn up."
And several other violations of recommended practices.
These are my latest concerns. Am I overreacting? What is the appropriate response?
Last edit by Flatlander on Oct 13, '12
: Reason: additions