Stool around femoral line: How do I get the nurses to listen to a student?

[SNB1014]

Hello, I'm a nurse intern in my last semester of RN school at a large community hospital on a neuro/ med-surg unit. As a tech/ intern I am doing a lot of diaper changes and peri care.

I've seen a disturbing trend: pts who are 5 days or so into their stay, or worse, about to be d/c with a femoral line in place with stool creeping into tjr iv insertion site!! Gross? Yeah. Unsanitary? Absolutely!

I do my very best to clean it. I alert the RN and show her the site( if possible) and hint / play dumb and ask that she might call the Dr and get an order for a new site location etc....after three months here, no one has listened to me. Doesn't ebp say to switch to a cleaner site as soon as a pt is stable? For peetes sake, there has been poop under the transparent dressing....aren't we begging for an infection? How do I be taken seriously?

Or am I being naive?

Thanks!

[OnlybyHisgraceRN, ASN, RN]

The patient should use a flexi-seal. A tube placed in the rectum to collect stool. We use these alot for patients with incont. that have decubs or femoral lines.

Sometimes the femoral line is the best access or they may have had it placed en route to the hospital.

Good for you for wanting to make sure the patient has a better outcome. Just keep in mind that it is not as simple as you think to just d/c the femoral line. As others stated many factors play in.

[JZ_RN]

They wouldn't place a femoral line except as a last resort, and if a patient is A+O they should be able to call for a bedpan, whether one gets there in time or not is a whole different story. I agree with you that it's unhygienic, however, what can you do? They would have placed a central line if it were possible or the patient would tolerate it most likely. They could use a rectal tube. There's a lot of factors that come in to this but pulling the line is probably not feasible, even though this is a negative in the situation to have stool there.