Confessions of a non-graceful nurse, help!

[zacarias, ASN, RN]

Hello all!

Recently I started working on a tele/med/surg (transitioning to PCU) unit in a large hospital. I haven't had a permanent nursing job in over six months so I'm getting back into it although I did some per diem.

While I like some of what I do as a nurse, I feel incompetent in some things.

For instance, the other day I helped out a nurse, by trach suctioning her patient. Well I opened the package and instead of the sterile cup for saline, it was a little cardboard pop up box!! Well it's got holes and the saline just leaks out. It doesn't make sense of am I missing something?

Also, I started an IV the other week and it had good blood return, but it would leak blood/fluid from the catheter insertion site so much that I couldn't get it clean around there and the patient said she didn't want it all. I'd never had that experience ever in my career where it just keeps leaking around....It was in the vein and had good return...I have no idea what happened!!!

The other day, I checked a patient's colostomy bag and it was really full. Even in an isolation gown, it was a mess!! The stool came out formed and no matter how hard I try, there's always some remaining in the bag. Should I have changed the whole bag? When it's liquidy, it's easier in some aspects. But because of how it comes out, it gets all over the bag. and I had to change gloves like 5 times. And then when I went to dump (no pun intended) the stool into the toilet, it made a big splash and of course got on my scrubs. What a defeat. Any tips?

Give me a difficult tele strip and I'll decipher it for you, otherwise, all the other stuff I suck at and am not so graceful...

Zman

feeling depressed and slightly useless.

[kanzi monkey]

It sounds like you are better than me at doing all those things. Sometimes I can't believe how wasteful I am doing a simple dressing change, or anything sterile. I have bruises from colliding with various inanimate objects. I can barely have a conversation when helping ambulate a patient, I am concentrating so hard. Incontinent patients laugh at me and say "I can tell you don't have children" when I try to change their briefs.

BTW, I think that little pop-up box is supposed to come in a little self-contained baggie. I can't say for sure though, since I call respiratory when I see a trach. (hey, it's not the patient's fault that I stink at suctioning--trachs aren't common on my floor, so no one feels that comfortable with them).

In many ways I'm a good nurse. I'm also sort of a disaster. I work very hard to make up for my faults. I think some of my alzheimer patients think I'm a clown. At least they're smiling.

[PAERRN20]

I too have bruises from running into beds, doors, and IV poles. I have dropped sterile items onto unsterile fields. I have forgotten various items when doing procedures. I have tripped in front of patients. I have had trouble starting IV's on people who have the biggest veins. We all have klutz moments. Sounds like the mistakes you are making are minor anyways. You are fine!

[FLArn]

1.The pop up boxes in the trach kits are supposed to have a plastic liner in them.

2.Not sure what might have happened with the IV site unless maybe you forgot to loosen the tourniquet.

3.If the stool is formed and not coming constantly I take the bag off (if it's the "Tupperware" kind) and empty it in the toilet. If the stool is liquid or coming constantly, I lay the end of the bag in a bedpan and empty it. I make sure to have several diaper wipes handy to clean the end of the bag before re-closing it. If you want to you can gently rinse the inside of the bag using a 60cc syringe (with the end of the bag in a bedpan, of course).

All the tasks and countless other will become second nature to you with practice. We all were "clumsy" at the beginning ( and still are at times, esp. with new tasks):icon_hug:

[HonestRN]

Thanks for posting this Zacarias. I feel better now knowing I'm not alone!

[sleepyRN2]

i just dunno. from my experience, i've seen quite a handful of people who talks about the negatives and somehow forget about the positives that they've done. oh, well, just a thought.

[4jen]

Seriously in the scheme of things I would much rather you splash poop on you or me and be able to read my EKG. I would say you are doing great.

BTW. I have dropped a bag of NS on a pt head. Spiked the nutrition for tube feeding and dumped it all over the pt and myself. Splashed pee in my eye (eewwww). Stuck a foley NOT in the meatus during a code. lol graceful I am not.

[ChristyRN2009]

Question, why are you using the saline? Just curious? Because when I suction, I don't use saline. If the patient needs saline infused to loosen up thick secretions, the respiratory therapist does it with just a flush directly to the trach and then suctions it out. I'm just wondering if I'm doing it wrong, as far as I know no one else uses saline in routine suctioning on my floor either, and we deal with a lot of trachs.

[catlynLPN]

Don't feel bad. I make a mess somewhere everyday, at work.

It just works that way for me. I'm a klutz.

I clean up after myself, tho, alot of nurses don't even do that.

[Virgo_RN, BSN, RN]

Hey, you are not alone. It's a blood bath when I start an IV. By the time I'm done, the room looks like a scene out of a horror movie. I'm getting better, though.

[FLArn]

saline is used primarily to clear the suction tube between passes. A saline bullet would be used to help thin secretions during suctioning. Sterile saline is used to keep trach as clean as possible; for oral suction tap water would be good enough.

[zacarias, ASN, RN]

I want to thank each one of you for your kind responses!!

Now for the plastic lining of the cardboard, when I first saw that I through it away as I thought it was the wrapping!! LOL (Again, not graceful)

I've been a nurse for five+ years and on some things, I well and others, not so well. Some of the "tasks" I think fumble on because I don't do them regularly, or haven't done them regular as I've not worked solidly for a while.

I appreciate you're comments and know that there are other klumsy folks out there :) The TVs that hang from the ceiling for patients, I've hit my share of those! (I'm 6'2") and that doesn't help.

Thanks again and you've lifted my spirits! :)

Zman