Just When You Think You've Seen It All....

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Specializes in Gerontology, Med surg, Home Health.

I was doing wound rounds today. Entered a patient's room to look at his wound. Looked at the person in the bed next to his and saw a long piece of white tape on her arm upon which was written "Please do not use this arm for IVs, blood draws or blood pressures.":uhoh3:

I asked the woman if I could remove the tape and she said "Of course,dear".

I brought the tape out to the nurses station and asked the nurse who was standing there who in the world would ever put a piece of tape on a patient's arm like that. She said "I did". I was practically speechless which is very unlike me. "What ever possessed you to do that???" I asked.

"Oh" she replied "How else would we know that she has a new dialysis shunt and we're not supposed to use that arm?"

I've been a nurse for 25 years and thought I'd seen it all but this sinks to a new low. I calmly explained to her that we have many ways to pass along information...the MAR, the TAR, the ADL care cards, the care plan. She is NOT a new nurse.

Oh but I have a lot of work to do at my new facility!!!!

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Specializes in home health, hospice.new hospital nurs.

Sounds like you are over reacting. The patient was not harmed.

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Specializes in CICU.

They write on pts before surgery.....

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Specializes in Case mgmt., rehab, (CRRN), LTC & psych.

No harm, no foul.

Still, this nurse could have been more productive by posting a sign above the patient's bed that states, "Do not use this arm for IVs, blood pressure readings, or blood draws." At my facility, signs are posted on the wall above the patient's bed that remind staff of certain precautions such as, "Always keep HOB elevated 30 degrees or greater," and so on.

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Specializes in LTC, Hospice, Case Management.

Well... I get it (to many years answering to state surveryors for this kind of stuff!)

For the others without lots of long term care experience, This would be a HUGE dignity violation which most surveyors look at as negatively as if you had beat the person. It is considered actual harm and you can be cited for such.

I would also expect a "seasoned" nurse to have better judgement.

PS: The commuter - we aren't allowed to post any signs at all due to HIPPA violations (but I agree this would often be very useful)

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Specializes in LTC, Hospice, Tele, ICU.

I can't believe she placed a piece of tape on the resident.....LOL. I've seen signs above beds and I've seen residents with colored bracelets on the applicable wrist that states 'do not use this arm for ......'

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I give the nurse credit for stepping up to the plate and taking the responsibility of preventing an error. It was such an obvious piece of tape you noticed it at the next bed. Bet no one took a BP in that arm that day.

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Specializes in LTC.

I can't believe some of you are shrugging this off as "no big deal."

As someone else said, this is a big dignity issue. And a piece of tape on a person's arm? Come on. They might as well have it tattooed on their forehead or wear a sign around their neck!

Writing on someone prior to surgery is different. Surgery requires a map, and only for a short period of time. How long did this nurse plan to have the tape on the resident's arm?!

What if this person had skin issues and led to a skin tear or something? Wow, what a dumb thing to do. There could have been a sign in the person's room, it could be charted .. it could be on the care plan! I'm only a CNA, so I don't know what charge nurses chart collectively, but I know there is a better way of preventing this than just blatantly posting it for all to see. Plus, it's not like 100 nurses are going to be working on this resident -- only a handful need to know about the condition.

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i still see signs, just not with the why....

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Specializes in Cardiac Telemetry, Emergency, SAFE.
Well... I get it (to many years answering to state surveryors for this kind of stuff!)

For the others without lots of long term care experience, This would be a HUGE dignity violation which most surveyors look at as negatively as if you had beat the person. It is considered actual harm and you can be cited for such.

I agree with the dignity thing...:yeahthat:

And yes they right on pts before surgery but whole sentences? Usually its the Doc's initials and an "X" maybe, but not "I, Doctor Y, will be making my incision here."

My facility uses Blank Armbands on which you can write with a sharpie (before putting on the patient!!) "NO PRECEDURE LEFT (or right) ARM". Better than tape, IMHO.

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Specializes in Float.

What is a TAR?

We put a big sign over the pt bed and also on the door "No BP or IV Stick R/L arm" Of course we tell the next nurse but you also have lots of people coming and going: phlebotomists, assistants, intern nurses...lots of people who might take a BP. In my experience most of the patients are pretty alert to anyone messing with their site too...I teach my patients "I have put up this sign and let others know, but if anyone tries to use it be sure to tell them NO"

Edited: didn't realize LTC forum..yea I can see where that would be a different situation. STill curious what is a TAR lol

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Specializes in ICU, PICC Nurse, Nursing Supervisor.

tar is the treatment record.

what is a tar?

we put a big sign over the pt bed and also on the door "no bp or iv stick r/l arm" of course we tell the next nurse but you also have lots of people coming and going: phlebotomists, assistants, intern nurses...lots of people who might take a bp. in my experience most of the patients are pretty alert to anyone messing with their site too...i teach my patients "i have put up this sign and let others know, but if anyone tries to use it be sure to tell them no"

edited: didn't realize ltc forum..yea i can see where that would be a different situation. still curious what is a tar lol

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