Bad Habits Nurses Develop

Daye · Mar 5, 2005

I love your suggestion !!!!! It really is easy to start a vibe weather it is comparing test grades, who got the best assignment, excluding someone b/c they wash different or whatever. It really does get started in school. So i want to contribute an applause for the RN who was so good to me on my clinical rotation who taught me w/o intimadating me.

She taught me alot about meds, one thing I will always remember that she said...."I am a scaredy cat nurse when i give meds b/c once you put them down a pt it is too late to double check"

Bad habits are hard to break but good habits are hard to break too :wink2: : )

MattsMom, you're right! We spend a lot of energy beating ourselves and others up over what we see as bad habits - never mind that there is usually more than one way to accomplish a good outcome (although the no gloves thing is a bit unsettling) . How about if we start a new thread for great habits that nurses develop so that we can share some good news and support ourselves and each other? No offence meant to the nurse who started this thread.

manna, BSN, RN · Mar 5, 2005

I'm always amazed at the number of staff I see during clinical starting IVs/doing venipuncture with no gloves on... but then I'm just a student still, what do I know? :chuckle :chuckle

KacyLynnRN · Mar 5, 2005

throwing dirty linen on the floor...a personal bad habit I've slipped into, and trying to decrease the incidence of...

mamanurse13 · Mar 5, 2005

Look here, Toots. I don't call not gloving for a quick cleanup "bad medical care." Either you're not a nurse or you haven't been one for very long.
If you were or had you read anything about the history of nursing and/or infection control in healthcare, you'd learn that it's only been since the "Age of Aids" that we were able to use gloves at all for anything but sterile procedures. We were formerly taught that gloves were too impersonal and their use would offend the patients.
Quite a debate raged about how to use protection without offending the patient. We then went to Universal Precautions. Now it's "Standard" Precautions and offending the patient is not even factored in.
Some people find that horrifying, considering the messes that we have to clean up. It's hard for me to imagine that back then I recall ASKING to use gloves--and being refused because except for sterile gloves, there were NONE in the building!
PS The next thing we touched was the sink to wash our hands.

After 23 years in this profession I think I have earned the right to say:

YOU GO GIRL!!!!

Can't remember the pre-glove times I have had to clean a dirty orifice then head straight to the sink.

I repeat

YOU GO GIRL!!!!

NurseFirst · Mar 5, 2005

After 23 years in this profession I think I have earned the right to say:
YOU GO GIRL!!!!
Can't remember the pre-glove times I have had to clean a dirty orifice then head straight to the sink.
I repeat
YOU GO GIRL!!!!

Fear and Loathing in the Clinic and the Hospital

---------------------------------------------

People get a little too hysterical when it comes to gloving. Think it through. First, most gloving, and protection is for the caregiver. In the pre-hospital care arena, we call it "Personal Protective Equipment" or PPE for short. Everything has to be balanced. Am I gonna stop to glove up if I see someone choking in a restaurant--probably NOT. If a newborn is choking in a nursery? Dunno, but my guess is, probably NOT. (I'm admittedly not hugely speedy in putting on gloves--which is a factor.) Would I not give breaths to person who wasn't breathing because I didn't have a protective mask? I'd probably weigh the cost/benefit analysis, for myself and for that person.

Remember, people are exposed to germs constantly. Your money is probably dirtier than most people's hands, although pathogenic bacteria are less likely to be there since it's not the right temperature. But Hep B, Hep C viruses can live for DAYS outside the body. Have you ever been to a small restaurant where the food preparer was also the money taker? (That actually was too much for me, and stopped going to that restaurant.) Does the person at the bakery, or Mrs. Field's Cookies or wherever always wear gloves or doesn't use their hands? Have you ever eaten your french fries (or, fill in your favorite finger fast food here____) right after getting change? There are a lot of fairly healthy people walking around every day who do these things.

A friend of mine told me how one EMT she worked with required the patient to wear gloves before signing whatever it is that patients in ambulances sign when signing for services. That's a bit ridiculous.

The statistics for people who come down with AIDS after having been stuck with a needle which had been used on an AIDS patient is under 1%. So, what is my chance of getting AIDS if I give "unprotected" mouth to mouth on an AIDS patient? Well, let's see--do I have any open sores in my mouth?

And, lest we get too germ-phobic, it's now hypothesized that some kids get asthma because they aren't exposed to enough germs!!! Does our immune system need to be "exercised" in order to be healthy? Interesting question. There are no answers as of now.

How many people are denied care because of the money spent on gloves? (Please think this through before responding.) What is the balance? How many are protected vs. how many suffer? Hospitals initially balked at using "protective" needles and needleless systems; only until OSHA got into the picture did that happen.

Remember, Hep B was around long before AIDS, but it was AIDS that created the impetus for PPE and "safety" needles and needleless systems. Hep B is a far more robust virus. It was the lack of knowledge (and trust in the knowledge that was out there) about the transmission of AIDS, and AIDS being a nearly uniformly fatal diagnois at the time. (Although I'm not sure when Hep B moved out of the "fatal diagnosis" to "chronic illness"...)

PPE -- for you, well, if you can't use it--are you healthy? Do you exercise and eat well? Do you have open sores? Are you happy? (There's research out there that shows people with "bad" physical data -- high cholesterol, overweight, etc., are more likely to land on "good outcome" part of the statistics; having strong support systems helps as well.)

PPE -- for you to use to protect one patient from another? Certainly, an argument can be made for this. How much more effective is PPE than handwashing? How many people don't wash between patients because they'll use gloves? Is that better, or worse? How many people wipe down their stethoscope (or other equipment -- e.g., dynamap machines) between patients?

I think we are better off to have gloves, and I realize that the campaign to use PPE is needed, some people need to be a bit frightened in order to have the motivation to change their behavior. However, to blindly criticize someone for not wearing gloves is not usually warranted. Personally, I wish more people would just wash their hands. Healthcare folks AND the public, who doesn't generally have access to gloves.

I'm trying to provide some food for thought here because I think some people need to relax a bit when seeing someone else not using gloves. Certainly, if I forget, I don't mind being reminded; but, at the same time, it's also not always the disaster that some people make it out to be, especially if the risk of contact with bodily fluids is extremely small.

It's just like, now, if you see someone checking circulation without checking a pulse (out in the public)--they are not doing it wrong, they are probably doing what they have been taught; those are AHA guidelines for "friends and family" and also for "Heartsaver" CPR. Is it better to check a pulse? Depends upon how skilled you are at finding pulses...

NurseFirst

AMY30 · Mar 5, 2005

throwing dirty linen on the floor...a personal bad habit I've slipped into, and trying to decrease the incidence of...

I do that too, but then I always wonder - where are we supposed to put them? Any suggestions are welcome - our hospitals have linen bags in the hall that are shared between 8-12 pts. During am care or hs care it is not practical to take the bag out of the hall. Let me know what you all think.

Mommy2Katiebaby · Mar 5, 2005

Maybe someone is claiming to be supernurse and that is the bad habit. .. :)
steph

Yup, that's it!

General E. Speaking, RN, RN · Mar 5, 2005

pulling caps off tubing and needles with my teeth

ditto- For a while I worked in the Immunization Program @ TDH- we gave a lot of vaccines!!!

UM Review RN, ASN, RN · Mar 5, 2005

I do that too, but then I always wonder - where are we supposed to put them? Any suggestions are welcome

I always taught trainees to use a sheet or bath blanket as a "bag" by putting it at the foot of the bed, putting all the linens onto it, and then rolling it up so that no soiled linens were out.

Because back in the old days, we weren't even supposed to carry soiled linens out into the hall.

Oh, and Nurse First is quite right when she noted that there were times that you simply didn't have time to properly glove before getting into a problem, because the actual gloving procedure entails handwashing before and after gloving.

And sometimes I've seen people forget to glove before they reposition a patient and get a little surprise. **It happens.

You then wash.

My only beef about gloves was that I'd wear the gloves only to get BM on my elbow or my shoes....or worse. Now THAT's yukky. Plus, your Unit Manager will probably not spring for opera-length gloves, nor will they supply face shields before entering the room of a patient having a bowel prep.

So very unfortunate.

kellyo, LPN · Mar 5, 2005

[

Checking the obits, I am REALLY bad about this. In fact, it's usually the first section that I turn to when I pick up the local paper every day. Doesn't help that the obits are RIGHT ON THE SECOND PAGE of the paper!

I'm only a student, and I'm already checking the obits. Always had a curiosity before school (who died young, why, etc), but now I look for people I may have come in contact with--esp after my nursing home rotation!!! :uhoh3:

grimmy, RN · Mar 5, 2005

i'm always amazed at the number of staff i see during clinical starting ivs/doing venipuncture with no gloves on... but then i'm just a student still, what do i know? :chuckle :chuckle

don't get into the habit of discounting the knowledge that you have. no, you don't know everything, but there are plenty of nurses (and we all know some) who have not updated their skill set for the past few decades! keep your wits about you, and back up what you do with scientific evidence, not just because everyone does it that way. you know a lot. don't forget that.

NurseFirst · Mar 5, 2005

don't get into the habit of discounting the knowledge that you have. no, you don't know everything, but there are plenty of nurses (and we all know some) who have not updated their skill set for the past few decades! keep your wits about you, and back up what you do with scientific evidence, not just because everyone does it that way. you know a lot. don't forget that.

that's a really good point, grimmy!!! in case anyone got the idea that i think they should discount their knowledge, that is far from the truth!!! perhaps the interesting discussion would be "how to say to another nurse..." (that maybe what they are doing is not the best thing for the patient...?)

nursefirst