NOn Compliant Nurse Manager

[JEKA]

I am the infection control nurse at my hospital and the nurse manager refuses to enforce the contact precautions. She says she has "bigger fish to fry" !!!! What the #@!*? Unbelievable isn't it? Just had to vent.

[Liddle Noodnik]

I am the infection control nurse at my hospital and the nurse manager refuses to enforce the contact precautions. She says she has "bigger fish to fry" !!!! What the #@!*? Unbelievable isn't it? Just had to vent.

Like what, for instance?

I have had concerns about that too, when people are lax.

[NRSKarenRN, BSN, RN]

If you have documented info re lax contact precautions, send it up the food chain. When the facility gets FINED for failing to enforce it's own standards, you want the appropriate person accountable for their LACK of action, not you.

From an ad re compliance education:

When a healthcare organization identifies a potential compliance problem that could lead to civil or criminal liability, it is necessary to conduct an internal investigation.

Compliance officers must know which steps to take when confronted with these issues, and how to anticipate and deal with the many practical considerations that arise in connection with an investigation

[JEKA]

Alright, get this. I just asked the NM if she discussed the staff's noncompliance with hand hygiene. Currently we are at 88%. She said she did and the staff said the alcohol dispensers weren't in convenient locations in the patient's rooms or they didn't want to wash their hands in the patient bathroom so they exit the room and "go right up to the nurse's station without touching anything" and wash their hands. When asked if she told them this was unacceptable practice she became defensive and said no because she had done that herself and sees nothing wrong with it. She also said physicians do the same thing!! I can't win here. If I don't have the support of the management team, what good is an infection control program/nurse? Any advice? Am I overreacting?

[JEKA]

Alright, get this. I just asked the NM if she discussed the staff's noncompliance with hand hygiene. Currently we are at 88%. She said she did and the staff said the alcohol dispensers weren't in convenient locations in the patient's rooms or they didn't want to wash their hands in the patient bathroom so they exit the room and "go right up to the nurse's station without touching anything" and wash their hands. When asked if she told them this was unacceptable practice she became defensive and said no because she had done that herself and sees nothing wrong with it. She also said physicians do the same thing!! I can't win here. If I don't have the support of the management team, what good is an infection control program/nurse? Any advice? Am I overreacting?

When a healthcare organization identifies a potential compliance problem that could lead to civil or criminal liability, it is necessary to conduct an internal investigation.

Compliance officers must know which steps to take when confronted with these issues, and how to anticipate and deal with the many practical considerations that arise in connection with an investigation

Where did this come from? It's pretty interesting, isn't it?

[Liddle Noodnik]

...

Compliance officers must know which steps to take when confronted with these issues, and how to anticipate and deal with the many practical considerations that arise in connection with an investigation

Where did this come from? It's pretty interesting, isn't it?

Something I had to look up the other day -

Cognitive dissonance is a psychological phenomenon which refers to the discomfort felt at a discrepancy between what you already know or believe, and new information or interpretation. It therefore occurs when there is a need to accommodate new ideas, and it may be necessary for it to develop so that we become "open" to them. Neighbour (1992) makes the generation of appropriate dissonance into a major feature of tutorial (and other) teaching: he shows how to drive this kind of intellectual wedge between learners' current beliefs and "reality".

Beyond this benign if uncomfortable aspect, however, dissonance can go "over the top", leading to two interesting side-effects for learning:

if someone is called upon to learn something which contradicts what they already think they know — particularly if they are committed to that prior knowledge — they are likely to resist the new learning. Even Carl Rogers recognised this. Accommodation is more difficult than Assimilation, in Piaget's terms.

and—counter-intuitively, perhaps—if learning something has been difficult, uncomfortable, or even humiliating enough, people are less likely to concede that the content of what has been learned is useless, pointless or valueless. To do so would be to admit that one has been "had", or "conned".

from: http://www.learningandteaching.info/learning/dissonance.htm

This nurse is obviously old-school ... I wonder what her infection rate is compared to other units, is this something (the stats for her unit) you could look up and provide for her as incentive?