I am new to the OR. I have taken initiative and asked to put in foleys on my patients when I am circulating if they are ordered. Usually the nurse I am circulating with (a different one each time as I don't have a set preceptor) hovers over me, questioning things the whole time. The questions are insignificant and have nothing whatsoever to do with the actual foley insertion, they just question why I am not doing it the exact step by step way THEY do it. They nit-pick where I put the lube and how I soak my cotton balls with betadine, to the point where they get annoyed and ask "why do you do that" or "who showed you how to do that?" More often than not they are questioning things that have been shown to me by nurses I worked with on different days.
Some have even gotten impatient (when I am doing nothing wrong) and put on gloves and try to take over. That just ends up with extra hands in my way, an increased chance of contamination, and me doing it how THEY say. I can understand if they see me violating aseptic principles, or if I can't find the right hole, or if I am about to contaminate something. Putting in a foley is a skill we all learned in nursing school. I have done it independently MANY times as a medsurg/capstone student with my preceptor watching and saying my technique was good.
I have no problem doing things the way the regular nurse in the room likes them done, but I get annoyed when they don't let me insert the foley in the way that I am comfortable, and try to get me to do it their way. It seems foolish to question me over things such as soaking cotton balls vs. dipping and lube staying in syringe vs. being squirted into the tray. I wouldn't mind them saying "I have found it works better if..." or "maybe next time you should try this..." As long as the foley gets inserted properly using aseptic technique, isn't that the most important thing?
Now instead of having my own way, I find myself doing it the way whichever nurse I am working with does it which is usually awkward. Concentrating on doing it THEIR exact way usually makes me forget something, and then they are quick to point out that I forgot a step. I wouldn't have if I had just been allowed to do it from start to finish myself. It also takes me longer because I spend time trying to remember their exact sequence so I don't get berated.
The bottom line is...everyone has a method, and I'm trying to develop my own, but I know what works for me and what doesn't. How can I advocate for my autonomy in foley insertion without stepping on their toes and having them take over?
Quote from aubgurl
Also, you don't learn sterile technique in nursing school. You learn to put on sterile gloves and how to open a sterile package but in the OR, there is so much more to it than that!
Not trying to be mean, but please don't to tell me what I learned in nursing school, since you were not there with me. I did learn sterile technique in nursing school. And I learned how to use sterile technique to put in a foley, suction a patient, and change dressings. I also took a course in perioperative nursing at the ambulatory surgical center of my nursing school's affiliate hospital where I had education and experience in sterile technique, scrubbing, and circulating. AND I did my senior rotation in the perioperative unit. And I have a Bachelor's Degree in Nursing. I think it makes me qualified enough to put in a foley catheter without being made to feel like an idiot.
Last edit by sugarik13 on Jan 26, '13