Advice Please!!

fergus51 · Feb 20, 2002

Ew. That's so gross!

babynurselsa, RN · Feb 20, 2002

At the very least they are violating OSHA stanards, not to mention CDC recommendations for Universal Precautions. They should have latex free products on hand not just for the staff but for the care of any latex sensitive patients.

Gloving protects not only the staff, but also helps you to not transmit disease from patient to patient. Also you should tell that bone head that once or twice a day handwashing is not sufficent. You should wash your hands between any patients.

Was this externship arranged by your program? If so then you should go to your instructors and tell them of this situation and refuse to go back and request another assignment. As far ass the LPN, ask her how she thinks the AMA would feel about her self-imposed title.

Paprikat · Feb 20, 2002

Sorry to ask a stupid question...but LPN stands for Licensed Practical Nurse? I am an LPN and wonder if it means something else where you are. If it does mean licensed practical nurse, where are the doctors? I think you can call the LPN governing body in your state and tell them that she is trying to pass herself as a doctor, which is against the law.

Anyway, if there are doctors there, why don't you ask them to buy you a box of vinyl gloves? My facility buys both, because we do have allergies to latex.

I can't understand how an LPN could even attempt to pass herself off as a doctor....

Ma_girl26 · Feb 20, 2002

Oops that was supposed to be Nurse Pracitioner.. She sees patients, write perscriptions and has people call her Doctor.. I will change that :) sorry

joannep · Feb 20, 2002

If she is a nurse practitioner it only makes the situation even more abhorent. I wonder about her professional qualifications and what educational institution had the dubious honour of training and educating her?

Go back to your educators, tell them what is happening and don't go back.

Joanne

Home Health Columnist / Guide · Feb 20, 2002

dear ma_girl26:

i'm allergic to latex and its not in the budget for the place that im externing at to buy me a box of gloves.. i brought this up to the lpn and she said "oh, nobody her wears gloves anyways just wash your hands once or twice a day and you will be fine" ...
gave a couple of enemas (was told not to worry about gloving for that) assisted with three flexsig's (and i had to clean it.. i wore gloves for that one but my hands swelled up cuz of the latex and there itchy and red.. and after cleaning it three times my hands cant take the gloves anymore.. and, well they don't care) i drew blood and was told "dont worry about gloves you will be fine" ( wore gloves anyways).....
that was supposed to be nurse pracitioner.. she sees patients, write perscriptions and has people call her doctor....
if i ask for non-latex gloves and i cant afford to buy them myself
(i dont even know were to go) dont they have to buy them for me? ....

my blood boiled when i read your post for the insensitive treatment you received at your first clinical site and infection control violations witnessed. what a day.....and learning situation in what should not be happening in an office/clinic!

suggested course of action:

1. do not go back there. discuss these concerns immediately with your clinical instructor. they violated every infection control/ osha rule in the book!!!!! yet alone there insensitivity towards someone with a severe latex allergy (discuss later).

2. document all your concerns objectively in writing and give to your clinical instructor with the expectation that she will discuss them with the management of the clinical site.

e.g. informed nurse practitioner of latex allergy and requested non-latex gloves. was instructed not to wear gloves but wash my hands 2 x.

saw np place speculum in ma's bare hands upon removal from a patient.

if she doesn't report your concerns, you need to call/send letter to administration/management as you observed problem situations. documenting, reporting, problem solving and following-up is part of being a medical assistant---a big part.

why did you just accept the situation?

3. discuss with instructor how the situation could have been handled differently.

you new it was wrong not to be wearing gloves in your post comments. why didn't you contact your instructor immediately for advice??? all instructors should be available via telephone for consultation re situations that occur during an externship/clinical rotation when off-site and instructor not present.

4. is your school/instructors aware of your latex allergy?? that needs to be discussed up front before starting at any clinical site/ job/doctors office visit.

what did you learn about latex allergy in your program? based on the symptoms reported above you do have a latex allergy.

because you are not an employee, they are not legally obligated to provide you with gloves; however ethically they should be.

additionally, what do they do for their clients who has latex allergy---which is becoming an increasing problem; i'd guess nothing. they are sitting ducks for a lawsuit.

if you are not aware, each exposure to latex puts you at risk of anaphylaxis--wheezing is a sign of airway sensitivity and inflammation with the potential for airway collapse and death.

common latex products include tourniquets, gloves, foley catheters, balloons, condoms.

you must protect yourself from latex exposure.

vinyl gloves can be bought at most pharmacies for less that $8.00 per 100 count box. keep a box in your car/home. place two pair in a zip-lock type sandwich bag in your handbag for your use or to be used by someone caring for you at all times. consider seeing an allergist for need of desensitization.

educate yourself with these resources:

to die for

http://www.9-1-1magazine.com/magazine/1997/1197/columns/ems.html

extensive latex allergy resource list at dianne brownson's "brownson's notes" website:

( i pick up something new there from each visit..first class site)!

http://diannebrownson.tripod.com/latex.html

american latex allergy association

http://www.latexallergyresources.org/educational.html

5. re comment "nurse practitioner.... she sees patients, write prescriptions and has people call her doctor." is it possible this person is a physician's assistant and not an np? if she is a

nurse practitioner---she is a poor example, should be shot, quartered and reported to nursing board for poor practice standards....don't know if you want to go to that length. patients will repeatedly call np's/ pa's doctor, even when they have been reinstructed in the role repeatedly and told to call them np.

love and trust my pcp's nurse practitioner sue---complete opposite of every thing you have described, even having another staff in the room while performing pap to comfort me.

6. kudos to you for coming here to ask for advice....that's what we excel at here (along with kvetching). please consider and act on all the good advice given.

let us know how things have turned out, please. come back to vent or seek advice anytime.

mario_ragucci · Feb 20, 2002

What does OSHA mean to you? What is a Universal Precaution and how should it be applied when preparing to touch potentially broken skin? How should a barrier be used in the interests of mankind (womankind).

EMaas · Feb 20, 2002

First of all, as an MA, you work ONLY under the MD's license, not the nurse practitioner. MA's only work under an MD's license, so you should not be doing anything under the NP that seems questionable to you.

Secondly, your facility has to accomidate you and any "special need" that you may have, as should be stated in their externship contract with your school. If they won't abide, go somewhere else.

Thirdly, don't start out your career learning BAD medical practices! Always wear gloves, always, always, and don't let anyone tell you otherwise. It's your body, your health and your career. I agree with the OSHA comments. You must abide by OSHA standards. Do only what makes you comfortable...and another thought is that you should only be doing skill you are allowed to do under state and your school policy. If the NP is asking you to do something you don't think you are supposed to, DON'T.

Most of all, report all of this to your instructor or the person regulating your externship experiece. Sounds like you need a new externship site.

Lisa, CMA/EMT

Brownms46 · Feb 20, 2002

Dear Ma_girl26,

I can totally understand your confusion in that situation! I M H O it "seems", you knew universal precautions from what you were taught in school. But in this situation you were told by a supposedly more educated person, that this wasn't the case. Sometimes people in unfamiliar situations can become intimidated by others in positions of authority. But something just didn't sit right with you in this matter, so you sought out help from others in the field.

I can see very well how in your position, you might have been intimated into going along with what your were told by this "doctor". Thinking maybe she knows more than I do as student MA. Never let this stop you from listening to your guts!

Once an OB doc friend of mine asked me...."What do you call a Doctor who graduated at the bottom of his class? "Doctor" His meaning was...not every doctor is a good one...and that goes for any other profession. Some people are just sorry...and I definitely have to wonder about the NP who told you those things, as to whether she has some real mental problems going on. Her statements really boogles the mind!

Please do as has been stated above, and run not walk out of this externship. I wish you all the best.

sajaha · Feb 20, 2002

I've been out of nursing for several years now. Could you please tell me what is an MA in the realm of nursing? :)

Sara

Brownms46 · Feb 21, 2002

Hi Sara,

An MA is a Medical Assistant.