Dilemma about reporting some no-no's

[DogWmn]

I'm currently working in a hospital as a patient sitter (let my license lapse in this state) and I've recently observed some real problems and I'm not sure if I should say something or just keep my mouth shut because of my current "lowly" position.

What I saw:

1. Phlebotomist recently came in and drew blood on a patient WITHOUT using gloves - and didn't wash/clean hands before leaving the room. This was a new admit from the ER so diagnosis was not yet updated and just before the Phlebotomist came in the patient told the nurse he had Hep C. I would have said Oh can I get you some gloves but didn't realize what he was doing until after the fact as he was drawing on the other side of the patient from where I was sitting. The policy for Phlebs at our hospital is gloves ALWAYS.

2. Time and again I'm seeing Techs not using proper protection or cleaning equipment before leaving the room, BP cuffs not cleaned, even though there are isolation signs posted at the door, handling patients without gloves/gowns as indicated by isolation signs at door, not washing/cleaning hands. Just plain **** poor or non-existant technique.

As a sitter I'm not supposed to "touch a patient" only observe and the requirements for our job are a high school diploma - no medical knowledge/background necessary. I've been at this job for 5 months now and it's the first one I could get after being unemployed for 3 1/2 years so I'm very very hesitant to say anything to anyone. We work all over the hospital so we don't make a lot of contact with the "locals" - we show up and sit in the room. I have better rapor with the hospital shift supers who we get our assignments from. I don't want to become a "tattle tail" but yeesh, some of the stuff I see is down right scary. Sooooooo do I just keep my yap shut, I'm so far down the food chain, often I'm ignored when staff comes and goes and I soooo need this job and have hopes of getting a full time job at the hospital in some capacity - like unit secretary but my concern is if I rat someone out now (and they'd know it was me) my chances of getting full time work would go down the drain.

[DixieRedHead, ASN, RN]

You let your license lapse in another state?

You haven't been able to renew in 3 1/2?

There is more to this story than " Just plain **** poor or non-existant technique"

[sissiesmama, ASN, RN]

????

Anne, RNC

[EmergencyNrse]

Well, I see your dilemma but why do you feel doing what's right will reflect negatively on you?

If someone is doing something improperly right in front of your eyes you feel you can't say anything? I might ask the person drawing blood if there was a policy change in wearing gloves while obtaining specimens. Make a point to tell them that they missed the sink or hand sanitizer when leaving.

There is a lot about a person's CHARACTER that I get from the posts on this website. Grow a spine. If you don't say something who will? YOU observed the impropriety YOU need to find someone to report it to...

[DogWmn]

You let your license lapse in another state?

You haven't been able to renew in 3 1/2?

There is more to this story than " Just plain **** poor or non-existant technique"

I left nursing after 20 years, let my license lapse in the state I'm living in and due to financial considerations - I can't afford the refresher course, it would require me relocating to another part of the state for 4 months and keep up my place here (I own) and pay for an apt plus the program, so I'm working as a patient sitter.

FYI I do maintain my license in OH via online CE's, but in GA where I live right now that was not an option.

My lack of nursing license in the state I'm living in right now really has nothing to do with what I'm observing working as a patient sitter.

While you say I should "grow a spine" remember, as a patient sitter I'm considered "non-medical" and if I do report what I'm seeing, they will know who saw the incident as I'm the only other one in the room. My patient sitter peers are all non-medical background people, so in theory, they/we/me wouldn't know, we are only supposed to sit in the room and observe the patient and call a nurse/tech for anything.

This is the first job I could get after being unemployed for 3 1/2 years and I'm very greatful for it, I live in a rural environment so job opportunities are rare - our unemployment rate in my area continues to soar at 11+%. The regional hospital I work at is the only game in town.

[mindlor]

Report this in writing to the person in charge of infection control.....most every hospital has one.

[vashtee, RN]

I think if this happens again, you should simply hand a pair of gloves to the phlebotomist and say, "trust me: you should wear these".

[Kooky Korky, BSN, RN]

If the phlebotomist doesn't wear gloves, that doesn't harm the pt. The worker will be harmed if stuck by a dirty needle or getting pathogen-carrying bodily fluids into his body. Wearing gloves won't prevent a stick. In fact, gloves often fit so poorly that they make it harder to work, has been my experience. If your pt isn't being harmed, let the phlebotomist fend for himself.

EmergencyNrse, you sound naive. You're right that OP should be brave and fearless and speak up for the patients. But you seem unaware that she stands likely to make enemies of those she reports.

Also, I have seen those reported TO become angry at the reporter for making them aware of problems. So reporting isn't as easy or simple as you seem to think.

I vote for the anonymous report if at all possible.

Or just do as vashtee suggests or something akin to that.

not existAnt, but existEnt - your pal, Spelling Police. Sorry, it's my curse to have this bugaboo about spelling. Please don't take offense, I just need to spell correctly myself so I don't forget correct spelling. I read errors so often that I am sometimes unsure any more how to correctly spell and am fighting this as best I can.

As for techs not doing proper cleaning, maybe you can engage them in a conversation by asking what cleaning technique, solutions, products, and procedures they use in a particular situation. They either don't know the right way or are being lazy. This COULD harm the patients and should be brought to light. But do it as a learner if you can, not a policeman/woman. Maybe you could just clean the items yourself, letting the techs know that you are worried about people getting sick if the items are not cleaned?

I wish you luck. Your position is not an easy one.

[mindlor]

If the phlebotomist doesn't wear gloves, that doesn't harm the pt. The worker will be harmed if stuck by a dirty needle or getting pathogen-carrying bodily fluids into his body. Wearing gloves won't prevent a stick. In fact, gloves often fit so poorly that they make it harder to work, has been my experience. If your pt isn't being harmed, let the phlebotomist fend for himself.

EmergencyNrse, you sound naive. You're right that OP should be brave and fearless and speak up for the patients. But you seem unaware that she stands likely to make enemies of those she reports.

Also, I have seen those reported TO become angry at the reporter for making them aware of problems. So reporting isn't as easy or simple as you seem to think.

I vote for the anonymous report if at all possible.

Or just do as vashtee suggests or something akin to that.

Ummm, are you a nurse?

Not wearing gloves, then not washing hands could darn well harm the next patient?

Seriously?

[PsychNurseWannaBe, BSN, RN]

Ummm, are you a nurse?

Not wearing gloves, then not washing hands could darn well harm the next patient?

Seriously?

Actually not wearing gloves can harm the current patient as well as the next. Gloves protect us from them, and them from us.

[canoehead, BSN, RN]

I vote for silence, based on years of seeing nitpicking wars started this way. If you report the lab do you plan on reporting everyone that comes into the room and doesn't wash their hands? This could get very messy, in more ways than one.

If you didn't notice in time to stop the action is it possible you didn't notice them using an alcohol rub?

[SuesquatchRN, BSN, RN]

Kepp your head down and your powder dry. These folks know what they're supposed to do. The PTB know they're not doing it. Don't let your patient fall outta bed.