Published Apr 14, 2001
I need some advice on jugular dressings. Any interest? My supervisor wrote me up today because I put a 2X2 under the Opsite. Our careplans say to use a 2X2 but when she transcribed the order she only wrote "alcohol X3, then apply Opsite." I'm so upset. I've been an RN for alm,ost 20 years and no one ever wrote me up before.
[This message has been edited by mrshayzel (edited April 13, 2001).]
I'm not quite sure I follow what happened. Did the doctor specifically write an order for the dressing change to be done without a 2X2? Or did the order simply get transcribed incorrectly?
I'd do some investigating. Some doctors are kinda anal about the way they want things done. We have a one doctor in particular at our hospital who doesn't like his CVL lines changed with a 2X2. I got my butt chewed out by him personally once when I was a new grad. If that wasn't the case and the order was not taken off correctly, then I don't think it's your fault. Anyway, it sounds like your nurse manager might have overreacted and didn't discuss what happened with you first. I know it's very upsetting to get written up, especially if you think it occurred unfairly.
You can write an explanation of your side of the issue and request that it goes into your record along with the write-up from your supervisor. Keep it short and factual, point out that you went according to posted hospital policy. Then, even if the order was written differently, there's an explanation from your point of view indicating the reasoning behind what you did.
Even if the doctor wrote for the dressing to be a certain way if it is not in compliance with the policy and procedure manual you can get in trouble with not following the standards of care set forth by your facility.
And by the way as someone who does many central line changes a day, if you do not use a 2x2 or non adhere pad you run a greater risk of pulling the line out or the sutures out whjen you just apply an opsite. I have seen many jugular lines pulled out by opsites with no 2x2 when a dressing change was done.
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