Things I noticed as a patient...

[theantichick]

I just got home from an overnight stay at a prominent facility in my area. I had a cardiac ablation procedure, and because they didn't have a Tele bed available, I got to spend 24 hrs in the CCU.

Overall, my experience was a good one, but I kept noticing things that I probably wouldn't have noticed before I became a nursing student. And I have to wonder why some of them are allowed since they're obviously against the hospital's policies, and if some of them are as big a deal as they seemed to be to me.

1. At least 3 different people who stuck me for bloodwork did the following actions in this order: Put the tourniquet on, felt for a vein, swabbed the area with alcohol, put on their gloves, RE-FELT THE AREA OF THE VEIN WITH THE GLOVED FINGER, and then stuck the needle in. Part of me thinks this isn't as bad as it seems to be, and part of me is squicked by it.

2. Four of the six nurses and two of the techs I encountered from pre-op through CCU (though not anyone in the cath lab) had on multiple rings with gemstone settings.

3. Two of the six nurses and three of the techs I encountered (again not in the cath lab) had LONG fake nails on, and one of them had badly chipped fake nails.

4. I developed phlebitis from the IV, not too horribly, but I had a marked reddened, hot, and hard area extending about 2 inches up from the catheter site and out about 1/4 inch on either side. When I showed it to my nurse she didn't even palpate it, and said my skin was just so fair that everything shows up on it, and not to worry. I didn't make a fuss since I was at that time waiting for my doc to come and release me, but I would have thought she'd have at least examined it and personally I think it should have been d/c'd immediately.

I know that things aren't always "best practice" like they teach us in school, but aren't some of these pretty blatant violations of infection control procedures?

And given some of these issues, should I contact the hospital administration with any of my observations? I don't want to score them badly on the surveys because I know hospitals are going to be living and dying on those scores.

[nursel56]

Having Ashley take care of my critically ill child (if I had one) would be like hitting the lottery.

[PetsToPeople]

It's interesting how much you know about the real world when you're still in nursing school yourself.

And my next favorite pet peeve...when someone can't adequately dispute my reasoning (or that of any other student) then they pull the "your not a real nurse yet card, so you can't possibly have an opinion". I have seen and heard the use of the "real world vs school" ideology from the first hour of my first clinical, and have seen it used each and every clinical since.

But to add to that, I also have over a decade of experiance as a Vet Tech, and we have the exact same issue going on over there, except we do not have quality control teams, or infection management, etc. Things are much less regulated and as a professional if you do not manage your own high standards, they slip fast and there is no one to care about your level of standards but yourself. Once you make that first excuse of "I'll just cut this corner this one time because I'm busy" then it just goes down hill from there, because you are always busy!

[Hygiene Queen]

And my next favorite pet peeve...when someone can't adequately dispute my reasoning (or that of any other student) then they pull the "your not a real nurse yet card, so you can't possibly have an opinion". I have seen and heard the use of the "real world vs school" ideology from the first hour of my first clinical, and have seen it used each and every clinical since.

But to add to that, I also have over a decade of experiance as a Vet Tech, and we have the exact same issue going on over there, except we do not have quality control teams, or infection management, etc. Things are much less regulated and as a professional if you do not manage your own high standards, they slip fast and there is no one to care about your level of standards but yourself. Once you make that first excuse of "I'll just cut this corner this one time because I'm busy" then it just goes down hill from there, because you are always busy!

Oh, I suppose you can express your opinion, but don't expect it to be taken seriously if you haven't had the experience.

I could rip on doctors all day and all night in the spirit of lending my opinion, but I doubt they would care much, as I could only have no clue.

[PetsToPeople]

I was referring mainly to the issue of washing hands....I didn't realize I had to be a graduated RN with five years of experience to understand basic hygiene issues and how they relate to transfer of microorganisms! My bad, I must have lost my mind for a moment, I thought I had learned a little about this stuff in micro class and nursing fundamentals, but I am sure experianced nurses must know so much more about hand washing and fomite issues that little ol' me!

[PetsToPeople]

And a doctor (or atleast most) wouldn't take heed of your opinion not because it was invalid, but because they have superiority issues.

[Hygiene Queen]

I was referring mainly to the issue of washing hands....I didn't realize I had to be a graduated RN with five years of experience to understand basic hygiene issues and how they relate to transfer of microorganisms! My bad, I must have lost my mind for a moment, I thought I had learned a little about this stuff in micro class and nursing fundamentals, but I am sure experianced nurses must know so much more about hand washing and fomite issues that little ol' me!

No.

You were trying to tell experienced nurses what they should be doing without fully understanding what they do and why.

When they attempted to explain the rationale, you called it a "lame" excuse.

That's not going to sit too well.

[Hygiene Queen]

And a doctor (or atleast most) wouldn't take heed of your opinion not because it was invalid, but because they have superiority issues.

And there could be some truth in that.

[nursel56]

And there could be some truth in that.

A little, but nuance in this case will probably be lost.

[dudette10, MSN, RN]

About PetsToPeople's hand hygiene comments: The only thing I really take issue with is calling it the habits of "lazy" people. We're not lazy, but we do acquire not-so-good habits in the rush of our days.

Even students have valid points sometimes.

[OnlybyHisgraceRN, ASN, RN]

I know how you feel. I can kick myself every time I let a nurse touch me without them performing hand hygeine. We need to be better advocates for ourselves.

[Aliakey]

i may flamed to hades for this, but wow. if nurses are that rushed where appropriate hygiene cannot be applied, then how do you find time to assure fall-risk patients make it to the bathroom, perform effective patient teaching, etc.? maybe it doesn't happen. shoot, i'm just a lowly nursing student now (that's my card)... but also an even lowlyer ems paramedic with a few years under my belt and before that, one of those knuckle-dragging blood-drawin' ed techs in a busy hospital (insert sarcasm please). but, no matter what the patient already has floating around in his system, i sure tried to avoid adding new critters into his bloodstream. not exactly the souvenir a person wants from the hospital. patients with cancer, hiv, and other immune compromises might agree. i have a family member with cancer (stage 3) undergoing chemo; yeah, i'm very scared of the infections she might obtain.

it doesn't sound like the original poster was at the grim reaper's beckoning and undergoing a critical/emergent iv with each needle introduced in her arm. sounded like routine blood draw stuff to me, and i don't see why a simple scrubbing with alcohol has to result in a heated discussion like this? routine venipuncture stuff here. not the meth-head tearing nurses to pieces.

i would hate to be an infection control nurse, knowing the rates of preventable nosocomial infections and how thankless the job probably is. i currently dislike taking away the angiocatheter of my emt students because they learned to just "swipe real quick" with an alcohol prep pad from their last hospital clinical preceptor/nurse. no mr. wide-eyed-student, you will not infect my patient. i will teach you the right way now. but, i guess we're not rushed in the back of an ambulance either (sarc).

for those who disagree... i'm wearing my super-duper fire-retardant big-girl panties now, lol! :flamesonbotherwise, can we agree to at least try to do what's best for our patients?