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cindjo717 1,660 Views

Joined: Sep 26, '12; Posts: 22 (27% Liked) ; Likes: 10

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  • Feb 28 '13

    My agency also supplied everything we needed but I opted to stick with my Littmann stethoscope which I HIGHLY recommend if you're in the market for one!

  • Feb 14 '13

    I think the first thing I would do is read the policies to make sure that my own personal practice was in line with the policies. And then I think I would speak to your manager or educator about doing some follow up education. All you need to say is something like: "I have been observing and working on my skills with several people, and I have seen many things done different ways. Would it be possible for us to get a refresher on this? Just to make sure we're putting our patients' safety first?" The other thing is, if this is a patient that usually self caths, and they prefer not to break out the betadine and all, I would document their refusal of you providing nursing care at the "standard" per policy. They have the right to refuse care (they may need more patient education and coaching, but that's not the immediate matter of concern).

    Ultimately, if you are ever called into court, they will examine state law and facility policy. Remember that. Make your practice fall in line with your policies, and you won't have a problem with that respect. Also to think about, when a lawsuit is brought, the legal team representing your facility will sit down with the involved staff and determine if you followed policies/procedures. Just a handy dandy FYI for future reference for you. The other thing to consider is what are your responsibilities regarding delegation. You are an RN, in LTC/SNF - how many LPNs are you working with? Yeah, they have to practice to their scope, but if you are delegating, you are responsible for supervising and/or "following up" on what you've delegated... Just some food for thought.

    And the last comment the original poster wrote, your conscience will never fail you. If you have a gut feeling something isn't right, it probably isn't. It will get better. Really it does

  • Feb 14 '13

    Quote from cblake4293
    I am a new grad and have been working as an RN for 5 months. Everyone I work with is very experienced and I am definitely the newbie. Yesterday I witnessed an LPN with 30 yrs experience straight cath a male without using sterile gloves. I asked if she had sterile gloves and the iodine that is necessary (we didnt have a kit so all items had to be gathered seperately). I found the iodine and brought it to the bed side. She then asked for a packaged wipe on the bedside to clean the insertion area. I asked her if she wanted me to do the iodine and she replied that she was just going to do the wipe but I could if I wanted to. I did and realized that she never put on sterile gloves only clean gloves. She completed the procedure without ever applying sterile gloves and I am feeling absolutely awful that I didnt stop her and tell her she needed sterile gloves. The whole procedure was totally against what I learned in nursing school. I am thinking about going to the nurse in charge of training and telling her what happened in confidence. Thinking maybe she can hold in inservice on proper techinique. I do not feel comfortable talking to the nurse who did the procedure about it. It would not go well. I have been stressed about this for the last 24 hrs! Any advice? I'm afraid I could be held responsible for not intervening as well.
    I learned the same way in school and my facility has the same policy.

    I, the nurse (or student nurse/tech in my case) use a sterile technique inserting a catheter. The pt may use clean technique cathing themselves. I don't get to leave sterile technique behind because the pt does.

    If the pt gives themselves a UTI, it's "on" the pt. if I give them a UTI, it's on the hospital. And therefore, me.

  • Feb 14 '13

    Sterile technique?

    "Ain't nobody got time for that"

    Attachment 12293

    Lol I'm kidding btw

  • Feb 14 '13

    Quote from leslie :-D
    really guys?
    stay out of it???

    sure why not.
    we nurses needn't be accountable to anyone but ourselves, right?
    let's look the other way, even if the pt becomes septic because we chose not to advocate for them.

    grntea is 100% right.
    in the hospital setting, sterile technique IS the standard of care, for the very reasons she cited.
    it would be totally the nurse (who chose to remain silent) fault if pt became infected.

    op, yes, you are in a tough, tough situation and it would eat at me too.
    in the home setting, the same rules do not apply...
    but in an acute setting such as the hospital, sterile technique should always (always, always!!) be done.
    i suppose you could have asked this nurse (privately), why she chose not to use sterile gloves, and share your discomfort?
    i really do sympathize with you, and i hope you always aspire to the highest standards of nursing care as long as you're a nurse.

    you need to follow your heart and act accordingly.
    nosocomial infections are disgustingly high, partly because of apathy and shabby habits.
    and who pays for all this?
    our pts of course, but in the larger picture, we all pay.

    "stay out of it", imo, is dangerous and irresponsible...
    and is a big problem in u.s. society in general.
    so many people would be much better off, if bystanders were moved to respond proactively instead of indifferently.

    God bless you, op...
    and stay on the high road.

    This is the kind of thing that new nurses get eaten for.I am not saying it is right, but she needs to look out for herself too. If the other nurse has been there for 30 years and gets in trouble, who do you think is going to be odd man out?

  • Feb 14 '13

    Try to worry about what you do and how you do it. I would stay out of the other nurses business. I would not under any circumstances report her to the charge nurse. That is going to open up a whole can of retaliation towards you and no one is going to want to work with you for fear you might "see" something else you don't like. If she did something wrong that is on her not on you. This is not likely to kill the patient. Worst case scenario? The patient may or may not get a uti. I would not lose any more sleep over it. It is pretty hard to stay completely sterile while putting in a cath but we do try on my floor to do it that way. But if you are new, you should keep your head down and try not to make waves. Was what she did right? Nope! Should you take it upon yourself to but in? Nope! Stay out of it and keep your mouth shut.

  • Feb 14 '13

    Ahh new grads lol

    Yes this was poor practice but seriously? Lol

  • Feb 14 '13

    Throw them under that bus and don't look back.

  • Feb 14 '13

    You can say what happened truthfully and without throwing anyone under the bus; for example, "I put in a lot of effort on the group project, and between being sick and not getting the most support from my group members, I was not adequately prepared for the test." It also helps if you can say specific things, e.g., "My partners did not finish parts X, Y, and Z by the deadline we had agreed to, so I ended up completing those instead of studying." It's not to put the blame on your group, because you are the one who allocated your time, but just so your prof can get a good idea of where your efforts were being directed, i.e., still to class assignments.

    Good luck!

  • Feb 12 '13

    Quote from monkeybug

    What in the ever living heck gives you the right to declare burnout and the need for career changes for so many experienced nurses? I'm sorry, but you are as wrong as wrong can be. There are many families that thrive on making life difficult for nurses. They are wastes of oxygen, they have nothing better to do, and it entertains them. When a nurse walks in a patient room for the very first time, and the family whips out a cell phone and starts recording, muttering to each other about lawsuits, then they are absolutely trying to make life difficult for a nurse. When they lay, two and three at a time, all over the floor and flat out refuse to get up, causing an obstacle course for the nurse every time she needs to approach the bed, they are absolutely making life difficult for the nurse. When a labor nurse attempts to get a blue, limp baby to a warmer to start bagging and compressions, and the family physically blocks her in order to get a "first picture with granny!" then they are intentionally hindering care. None of these situations are hypotheticals, they all happened to me. I DO NOT CARE if it is the first exposure someone has had to hospitilzation and illness, people should still know how to act in public. I'm talking about basic human courtesy! Just because one is a nurse does not mean one has to, in the interest of professionalism, lay down and become a door mat.

    Just recently in Birmingham, AL, a man shot 3 people because he was ticked off at a nurse. I'm sure you, in your infinite wisdom, would probably blame the nurse for being burned out and uncaring(poor, poor homicidal maniac, he didn't understand healthcare, was scared, and the nurses were sooo mean to him!), while the rest of the sane people in the world realize that this is the exact kind of family nurses get frustrated with all the time. The family that is threatening you one day because you won't bring them a snack is the the family that's actually acting on the threat when they see they can get away with all sorts of appalling behavior.
    Love this post!

  • Feb 9 '13

    Although unprofessional, I don't see where a HIPAA violation was made.

  • Feb 8 '13

    Quote from Bringonthenight
    It won't happen in USA. Maybe Canada. . .

    Please do research on LPNs and who actually hires them. Too often on this site we have LPNs that think they are going to work in ICUs and ERs when they graduate when in reality LPNs are even struggling in some areas to secure work in LTCs or doctors offices as magnet hospitals are even refusing ADN graduates only accepting BSN applicants.

    It's sad but true. I'm not even american but through research on this site I've learnt a lot.
    You do realize that Canada is a first world nation with some cutting edge medical/research centres?

  • Feb 8 '13

    Move to Canada! We do!

  • Feb 8 '13

    It won't happen in USA. Maybe Canada. The only place I could think of LPNs getting hired in the ER would be in a VERY rural area. Hospitals don't want LPNs anymore due to most places seeking that coveted magnet status.

    Advice: work in an LTAC (different from LTC) where you will get critical care experience and learn time management (essential ER skills) while you work on your RN. LTACs readily take LPNs from what I've read.

    Please do research on LPNs and who actually hires them. Too often on this site we have LPNs that think they are going to work in ICUs and ERs when they graduate when in reality LPNs are even struggling in some areas to secure work in LTCs or doctors offices as magnet hospitals are even refusing ADN graduates only accepting BSN applicants.

    It's sad but true. I'm not even american but through research on this site I've learnt a lot.

  • Feb 7 '13

    Did you say that the residents do not wear any ID? Plus many are nonverbal? That place is setting everyone up for med errors!