Changing a nephrostomy dressing

[Blackcat99]

At my other agency, they have a patient who needs a weekly nephrostomy dressing change. They NEVER EVER have the required supplies such as Tegaderm film, cover sponges and Chlora-prep to clean it. All they have here is normal saline and ABD dressings and tape-that's it. If you complain about anything at this agency you are taken off the work schedule. They had been doing it on a day that I wasn't working. Now it has been scheduled to be done on my one day a week work schedule. What would you do? Would you just clean it with normal saline and apply ABD? Or should I chart that tegaderm film, cover sponges and Chlora-prep are not available therefore dressing was not done? At this same agency, I also had to sign a paper stating that I understood that I must always wear my company issued ID when I am working. The fact is that they do not even issue company ID here!!!!

[tothepointeLVN, LVN]

Do the dressing change the best you can. How have the other nurses been doing it? I wouldn't refuse to do the change because the supplies aren't there because that may be view as not being in the best interest of the patient.

Re the ID if they don't issue it don't worry. I have to admit my ID expired in September but I have noticed none of the other nurses from my agency wear one. Probably not to draw attention that we are agency and not regular staff.

[Blackcat99]

Thanks tothepointeLVN. I think the other nurses are "borrowing" 4x4 dressing supplies from a different patient in order to do that part of the dressing. Either that, or they are going to the store and buying thier own dressing supplies.

I haven't seen anyone using ABD dressings on it so they must be getting their supplies elsewhere. My other patient does have a surplus amount of 4x4 dressings. I quess I will just clean it with ns like everyone else.

It sure is frustrating not to have the correct supplies.

[tothepointeLVN, LVN]

Didi you bring it up with the family. Usually what supplies the family has is not controlled by the agency even if they care but by the patients supply company. If the family will let you call the supply company. The company will send it to you if the insurance will pay they don't might. Hey more money for you.

The companies that supply the equipment are also awesome. Coming out at 2am in the morning to bring a new suction machine = awesome service in my opinion.