I&D...sterile procedure?

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I work for an urgent care facility and cannot locate an exact policy on this scenario. Patient comes in with cyst, doctor performs I&D for culture. I&D tray is set up using sterile technique. Sterile field, all instruments are sterile from autoclaver. Doc says he does not need sterile gloves because "this isn't a sterile procedure." I'm a little skeptical of this practice. Can someone with more experience please give me their opinion? Thanks

Wow.. so you gave up on snark, to become completely hostile?? Gosh, hopefully I'll never run into you in real life. You simply can't deal with others dissagreing with you. Smh..

Ha, if you call that hostile you have a much different view of hostility than most people do. And disagreeing with what? Your opinion? Opinions mean nothing. There are people that have linked peer reviewed nursing and medical literature published in medical and nursing journals. Those are facts. Please get yours straight. Either that or lip off to a doctor about his practice and see how far that gets you. I'm certain they'd love to correct you in front of the other nurses and the patient / family.

Plus who says Gosh?

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Specializes in EMS, ED, Trauma, CEN, CPEN, TCRN.
Plus who says Gosh?

I do! Lol. Been known to throw in a "golly gee" from time to time. It keeps me from cussing in front of people who would find it objectionable. :D

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Plus who says Gosh?

I too say "Gosh" all the time. Normal where I live. :up:

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Lol, ok. :)

The most important thing you can do to start off on and remain on track is to acknowledge what you don't know. Nursing school prepares you to take and pass NCLEX, but there is no way they can teach you everything you need to know to be competent in a given specialty. Be prepared to learn tons this year from experienced nurses who actually do know a whole heck of a lot more than you do, don't let pride keep you from asking questions, and for goodness sakes, don't waltz in there acting like you know everything already, or you won't last long on the unit.

Congrats on your job offer, and good luck on the NCLEX. Report back on how things are going if you feel like it.

Since I actually assisted in quite a few I&Ds , and was TOLD by the PAs and MDs that is was a sterile procedure, I do think I had a say.

This is not about who knows more about NURSING profession as whole, it was a question about a certain type of procedure which I happen to be very familiar with, hence I gave my 2c. I have never said i know more than an experienced nurse, I was only talking about this procedure in particular, since I happen to encounter quite a few in fast track..

I didn't deserve the personal attacks, period. The OP addressed everyone who had experience with said procedure, not "experienced licensed nurses" only.

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Plus who says Gosh?

A lot of people say it. Smh..:facepalm:

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Ha, if you call that hostile you have a much different view of hostility than most people do. And disagreeing with what? Your opinion? Opinions mean nothing. There are people that have linked peer reviewed nursing and medical literature published in medical and nursing journals. Those are facts. Please get yours straight. Either that or lip off to a doctor about his practice and see how far that gets you. I'm certain they'd love to correct you in front of the other nurses and the patient / family.

Plus who says Gosh?

:whistling:

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Specializes in Family Medicine, Tele/Cardiac, Camp.
I have never said i know more than an experienced nurse...The OP addressed everyone who had experience with said procedure, not "experienced licensed nurses" only.

If you read her original post, it actually says "more experience". Now whether she means more experience than her 4 years as a RN or more experience as in those who have clocked more I&D's than she has done is up for interpretation.

I think what has everyone bothered is that you continue to insist that they are sterile procedures despite the fact that other more experienced nurses, and NP's, have stated otherwise and provided articles to the contrary.

Whether you believe they should be sterile and you continue to do them as sterile procedures is up to you, but insisting that you are right when you haven't even entered into practice yet (no matter how many clinical hours you have) doesn't lend you any credibility and isn't going to win you brownie points with the AN community. BostonFNP asked questions of you regarding the I&D's that you saw. Did you ask questions as to why they were performed sterile? Does the fast track have an official policy? What is it? Coming onto here and answering those questions, showing that you understand the rationale behind why they are being done that way, will cause others to take you more seriously. Opinions with evidence, articles, and rationale just hold more weight. Saying that there are kits for I&D's (when there are kits for everything including myriad nonsterile procedures) and that they are done sterile because that's what you are taught, frankly aren't good enough reasons.

I sincerely wish you the best of luck on your NCLEX in a few weeks. Take care and have a good day.

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Specializes in Adult Internal Medicine.

I think it is important to remember that while research has demonstrated it is safe to perform minor surgical I&Ds with clean gloves and without sending a culture or scripting abx there may be facility policy and/or provider preference for using sterile gloves and/or culturing and scripting empiric coverage. Just because it is seen/done one way doesn't mean that that is the only correct way.

There have been times I have performed I&Ds and used sterile gloves, scripted empiric coverage, and sent a culture based on the patient history and presentation.

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Comparing imbedded hardware closed with sutures to an I&D of an encapsulated abscess that is left open to drain is apples and oranges.

Ugh. Embedded.

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Specializes in Pediatrics, Emergency, Trauma.

At my ED, most of our I&D's are clean procedures; if they are going into the OR, of course the pt is undergoing a sterile procedure; otherwise, we LMX (or EMLA) them, a warm compress (if applicable) use an angiocath or blade, drain, send for a culture, and the pt is prescribed antibiotics-depending on the whole picture

One kid kid came in today abscess open-I set up the culture, a bandaid; pt was done within 20 mins with a clindmycin script.

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Specializes in Infusion Nursing, Home Health Infusion.

If I were doing the procedure I would would wear sterile gloves for my own protection in that that surgical gloves are thicker and offer greater protection in terms of pore size.

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Specializes in Research & Critical Care.
If I were doing the procedure I would would wear sterile gloves for my own protection in that that surgical gloves are thicker and offer greater protection in terms of pore size.

Sterile gloves protect the patient, not the provider. It would be a costly and strange utilization of resources to don sterile gloves every time you worked with a patient on contact precautions.

Basically, if it's good enough for cleaning C. diff, it'll be ok for an I&D.

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