Latest Comments by hherrn

hherrn 15,216 Views

Joined: Jun 13, '07; Posts: 1,260 (74% Liked) ; Likes: 4,949

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  • 1
    brownbook likes this.

    What are your thoughts on the matter?
    What is the context of the question?

  • 5
    TheAnonOne, subee, NurseSpeedy, and 2 others like this.

    Quote from Sour Lemon
    My only "experience" is second-hand. A nurse I worked with forgot to scan IV narcotics multiple times. She didn't waste it, either. She was allowed to come in and chart it late. My involvement was to act as a cosigner for the waste so that she didn't get reported.
    She did eventually get fired, and perhaps reported ...but that was after multiple incidents at at different times. Reporting you to the DEA over one missed scan seems ridiculous.
    If it were me, I would seek legal advice and take a drug test since I've seen how messy these things can become. A proactive approach is probably best.
    If, in the future, management asks you to lie on official documentation to cover for a likely drug diverter, I would recommend declining. I am no lawyer, but it seems like there could be a rule against that.

    OP: DEA? Again, not my field of expertise, but DEA is a law enforcement agency. You did not break any laws. Imagine a federal law enforcement agency getting involved in a failure to follow a hospital policy. As likely as the National Guard showing up if your car is in patient parking. Is there any chance that whoever told you this is an idiot?

  • 10

    I am pretty sure OP is gone by now. Maybe following the thread, but not super likely to become a regular poster. At least under that name.

    Unless, this is a truly brilliant troll. I am really on the fence on this.

    In my imagination, some really bored nurse educator out there conjured jax, taking components from various orientees and new nurses to make the OP. Born not made, never made a mistake, and resented for being so darn cute.

  • 3
    macawake, Sparki77, and TriciaJ like this.

    Quote from Ansell
    Hi Adelinna,

    The GAMMEX PI Glove-In-Glove system offers many benefits. Primarily, it provides dedicated breach detection notification. The two gloves are not combined; they are two individual gloves pre-donned and aligned at the finger tips, making the process of double gloving faster and easier. With the top glove being semi-transparent and the bottom glove being dark green, if the top glove is compromised, the wearer will immediately be able to see this breach and be able to promptly change their gloves. This is in addition to providing a thicker level of barrier protection as you alluded to, providing the protection of two gloves for improved patient and healthcare worker protection.

    For more information, please visit ansell.com/gloveinglove.
    Joe-
    Thanks for the link to your website.

    You have posted on a nursing website, advocating a change in practice.

    What we really need to see is the evidence that we should change our practice. When should I double glove? Every time? When am I at risk using the currently accepted practices taught by nursing schools, and mandated by infection control policies?

    Are schools and infection control departments behind on the current research?

    I went to your website, and could not find the evidence that we, as nurses, should change our practice. I can understand how this product might benefit those who double glove for certain procedures. But, I saw no claims that there should be more double gloving happening.

    But, your OP states "Yes, it's tough to break old habits, but facts are facts. Personal protective equipment (PPE), properly used, provides the safeguards for which it is intended - keeping the worker and patient safe. It's time for double gloving to be a necessary practice, not only a convenience."

    So- please show the specifics of when and why. As you said, "fact are facts". Clearly facts are facts. So- what are the facts?

    Two separate issues:
    1- Double gloving is now a "necessary practice".
    2- Your product is what should be purchased now that there is a new necessary practice.

    For the sake of discussion, lets assume #2 is correct.
    Please expound on #1.

    BTW- I am pretty sure double gloving has never been a convenience.

  • 1
    Mystiquex likes this.

    Every test question and practice question in the ENA book, and every rationale- unless it was dead easy and obvious.

    A live Solheim review. Helpful. And, psychologically, having paid out of pocket, good incentive to test.

    And I tried some apps, free or reasonable. Sorry, can't remember which. Some included test taking strategies. ENA will onpy give technical rationales, but understanding certain strategies can help. For example, let's say you are given a question that hinges on a lab value you just don't know. Rule out the high and the low, pick one in the middle. That sort of thing.

  • 7
    canoehead, audreysmagic, TriciaJ, and 4 others like this.

    Quote from CharleeFoxtrot
    As a paramedic I learned to double glove on messy scenes, one pair gets gacked up you strip to the second one. As an RN I would still double glove sometimes, usually for wound care or an ostomy change. Putting them on is easy, don't see a need for a handy dandy device or special glove design for everyday use.
    You are missing the point:

    "PPE innovations are the answer to developing a double gloving system that provides the best protection possible. What if a pre-donned glove-in-glove system that uses proven, existing non-latex glove technology were available? Simply unwrap, one don, and you're done, eliminating the lag in donning time."

    Think of the huge time consuming task it is to put that first pair of gloves on. Why with this system, in the course of a year, you could easily save 5 minutes.

  • 32
    Kallie3006, canoehead, cayenne06, and 29 others like this.

    Quote from JaxsRN
    Let me clarify since you want to be so literal. I have never made a med error, never hurt a patient, never had a patient code, never had to call a MIT, never had to elevate to ICU. And also, I also stated that I will, but until that happens units should recognize when they have a good one on their hands.

    How would I know this ? Well I suppose there would be evidence.
    I know good nurses who are relatively inexperienced.
    I know experienced nurses who aren't very good.
    I don't know any good nurses who could claim to have gone a year without making a mistake.
    Or, at least I didn't until you introduced yourself.

    Being human, I know I am not immune from human error. So I look for my own mistakes. Really hard. And when I find them, I try to figure out why I made them, and prevent recurrence. I have no idea if I make more or fewer mistakes than some of my colleagues, but as you know, confirmation bias has a huge role in this process.

    Regarding the evidence of your errors, had you made any mistakes in your first year of nursing-

    Medication errors are not all that well understood, and difficult to study as they rely largely on self reporting. Regardless , expert consensus is that many errors go unnoticed.

    Some patients decline despite excellent nursing. Some thrive despite crappy nursing. Prevalence of codes and ICU transfers may not be the best gauge of nursing skill. I am an ER nurse. A lot of my patients die, or get admitted to the ICU. More frequently than many of my peers. Percentage wise, I would guess I have a lousy average. Statistically speaking, if you are inexperienced, or seen by your charge and peers as being not all that competent, you probably have a better batting average than me. Maybe I really suck at this- after all, I know for a fact I make mistakes. OTOH, maybe charge nurses give me these challenging patients because of my abilities, not despite them.

    I am sure you know about the Dunning Kruger Effect.
    As a reminder:

    In the field of psychology, the Dunning-Kruger effect is a cognitive bias in which people of low ability have illusory superiority and mistakenly assess their cognitive ability as greater than it is. The cognitive bias of illusory superiority comes from the inability of low-ability people to recognize their lack of ability; without the self-awareness of metacognition, low-ability people cannot objectively evaluate their actual competence or incompetence

  • 7
    brownbook, NurseBlaq, Kitiger, and 4 others like this.

    Quote from canoehead
    I started nursing in 1990, and made mistakes daily. Not mistakes that you'd write someone up for, but trying to patient teach and getting mixed up, or offering milk and sugar in tea to a diabetic, then they remind me, or missing a step in a protocol and having to back track. So a year without mistakes sounds like a miracle to me. OP, you aren't realizing your errors, that's all. I suggest you not repeat what you just said to your coworkers, they might start finding your errors and pointing them out.

    Well the OP joined July 9, so my troll alert has gone off.
    Me too. But around here I often think that, and am proven wrong.

  • 5
    TriciaJ, NurseBlaq, meanmaryjean, and 2 others like this.

    Quote from AnnieNP
    A sales pitch?
    Yes.
    Nothing wrong with it, apparently part of the way the site makes money.

    But, given that it is presented as an article, I think it is reasonable for the poster to actually back his claims up, same as any other article on this site.

    "Writer Joe Kubicek is the president of the Healthcare Global Business Unit at Ansell, a global leader in protection solutions. Ansell offers a variety of healthcare and double gloving solutions, including the new GAMMEX® PI Glove-in-Glove™ System, which offers pre-donned and aligned outer and inner gloves for doubling gloving in half the time. For more information, visit ansell.com/gloveinglove.

    This is a sponsored article brought to you by allnurses.com in conjunction with the advertiser. The views expressed in this article are those of the advertiser and do not necessarily reflect allnurses.com, its parent company, or its staff."

  • 39
    evastone, brandy1017, saraleigh, and 36 others like this.

    " I have NEVER made any sort of mistake on my floor"

    How could you possibly know this?

    Next question- Are you real, or trolling?

    Either way, thanks. I read this forum for a combination of entertainment and information. i am taking a wild gues that I won't be gleaning much information from this thread.

  • 10
    TriciaJ, JadedCPN, NurseBlaq, and 7 others like this.

    "Sponsored article" is a great term I just learned, so thank you for that. I did have to read it a couple of times to realize what it meant.

    I can certainly understand why, from the authors perspective, that "It's time for double gloving to be a necessary practice, not only a convenience."

    But, as a nurse, I need a little more information before I make decisions. Also, around here, a lot of us like to see evidence to back up claims. As somebody actually trying to sell something, you have an even more substantial burden to back up your claim with evidence. Increased double gloving might be be an evidence based practice, and your product might be a safe, efficient, cost effective way to implement that practice.

    "It's a fact: studies indicate that double gloving reduces the risk of inner glove perforations by 71 percent over only single gloving." Great. Helpful if you show the links. Bonus points for studies not sponsored by glove manufacturers.

    Also, assuming that is true- how does that affect me?

    I have a product proven to reduce your chance of being hit by a meteorite by 71%. Even for my low price of $2.99 a month, you will probably save the money, and take your chances. Though Gerrit Blank might disagree with you.

    On the other hand, a product that can reduce your chance of colon cancer by 71% might be pretty appealing.

    So, what are my risks right now of a negative outcome related to a glove puncture? Considering the type of procedure most nurses don sterile gloves for, what are the real risks and benefits of the change in practice you advocate?

  • 1
    DeeninNurse likes this.

    Congrats on finishing school.

    I'll join in with the crowd advising you to look at this as a job, not a call to self sacrifice.

    When it is needed, I work my a** off. I wasn't called, I am not selfless, etc. It is what I signed up for.

  • 3

    Quote from mzsuccess
    I'm asking because I also work at a LTC facility and I see nurses do this all the time and was just confused and wonder how many nurses actually do it.
    So, there are really two questions-

    1- How common is it?
    2- Is it OK?

    I think it is pretty common. Especially in the example you gave, in which it is standard to order Narcan kits, and the doc overlooked it. When I worked in the ICU, if somebody had a headache, I might write an order for Tylenol, then get it signed. At least I would with our regular docs in which there was mutual respect. If I there was a jerk covering, or a doc I didn't trust, I would definitely call. At 0200. If he was a real dick, I might give him enough time to fall back to sleep, then call back and explain that we have 325s, and I can't really figure out how to cut 1/13 of a tylenol to make a gram. Covers my butt, provides me some amusement, and helps train the docs. A win all around.

    Is it OK? I don't know. Definitely not OK to claim to have a verbal order, unless you have a verbal order. Probably not OK to write any order without a protocol specifying what you do, and how you do it.

    Look at it this way- Docs make mistakes. We make mistakes. Everybody makes mistakes. Lets say you fabricate a verbal order, and there is a negative outcome caused by your mistake, do you think the doc is going to sign the order? PT is allergic to Narcan. Says so on the chart, but you made a mistake, and did not check. PT is given Narcan, goes nuts and kills the kid who gave it to him, then dies of an anaphylactic reaction. (Yup, a far fetched, extreme example.) You think Dr Lazypants is going to rush in to validate your lie and take a hit for the team?

    We all pick our battles. If you work in an environment that has a culture of doing stuff you think is wrong, or are uncomfortable, you can accept it, try to change it, or leave. I think the least likely to succeed would be to try to change it.

  • 11
    psu_213, JadedCPN, RainMom, and 8 others like this.

    Quote from mzsuccess
    I'm currently at work and say the Dr forgot to add something. Do you think its feasible to write out an vo and have the Dr sign later? or call on call? (our on call charge $150 an call) so the nurses really hate using it due to the company trying to save money. The client is D/C and the drug of choice is heron, usually we give narcan kits but the dr usually write an order. Any advice? I know it sounds like a stupid question. But I;m currently the on;y nurse on.
    The fact that you are asking must mean that this is a practice where you work. But, as you know, there are rules against making stuff up. So, no, it is not OK to just fabricate an order. (You must already know this.) The fact that nurses actually do this is what keeps the docs and management from creating a protocol that would allow you to take certain actions.

    The more calls you make at $150 a shot, the more likely management pushes for reasonable protocols.

  • 1
    Davey Do likes this.

    When you are off, prepare large quantities of healthy food.
    Take the time to eat. This is entirely different from taking an actual break. It is extremely rare that there truly is not enough time to eat.
    Look at it this way- If you were really busy, and you had to poop, what would you do? Would you just let loose in your scrubs, or would you take as much time as needed to do the job right, including the paperwork? Rhetorical question, I am quite sure I know which choice you would make, but you get the point.

    Looking at it a different way- any time you go into a room, you could end up taking 5 minutes longer than expected. And nobody dies as a result. (usually.) You spend the five minutes needed, because it is needed. So is your eating right.


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