daconlon

There is no simple reason for this problem. But there are some contributing factors that I can identify. It seems that nursing schools, especially universities have little or no interest in producing a clinically competent graduate nurse. They focus on academic and higher level nursing concerns at the expense of real time in the trenches. I am now in grad school for nursing education and I am convinced that the professors feel that practical training is beneath them, and they have abdicated this responsibility. As a result, new grads do not have a clue about the day to day for a bedside nurse and they are shocked and disappointed. At my university, there is tremendous emphasis placed on the idea that new nurses move quickly to nurse practitioner role and leave the bedside. They seem to not care about training nurse educators or undergrads, either. There is value for the student to work as a CNA for a few months, just to get acclimated to a busy med-surg environment, and to develop a comfort level with patients. It is not the same as real nursing but is one big component of it. At a conference several years ago, a PHD nurse professor made a big point about the difference between "training" and "education". This is just more conceit on the part of the universities. This distinction helps no one at all. I am very fortunate to work for MD Anderson in Houston. They have a nurse residency program, which is sort of an extended hand holding period. The new grads love it and stay at the bedside longer. They are actually pretty good. Other hospitals don't always have such a thing. Good luck David

The big risk of drawing labs from any central line, PICC, porta cath, sub clavian etc is the risk of infection caused by poor technique. This is very manageable, however. Just clean the cap properly and use aseptic technique. I work at MD Anderson in Houston. Hundreds of times per day labs are drawn from central lines ( PICC lines included ). The claim that the PICC will collapse is totally incorrect, never happens. Just keep it clean and saline or heplock flush per your hospitals policy. I do not want to minimize the infection risk ,but think about all of the chemo that we deal with as well as infection control issues with isolation patients. We are professionals and just have to do it right. So your doctors are wrong. Hope that my comments are helpful. David

Regarding the bedpan liners: I am guessing that most of the bedpan contents are placed in the toilet and the liner is placed in the red bag ( hazardous waste) . Is this correct? Any idea about the expense? Also, I am still interested in reading about or doing a study that demonstrates that the use of the sprayer type bedpan washer is probably causing disease. Any thoughts? David

I have been a bedside nurse for 13 years. I have on a daily basis been sprayed by bedpan washers. I am talking about the Sloan valve Company Slimline bedpan washer. Zurn company makes a similar product. And of course other vendors make the kind that are on a hose. In any event these devices are mounted on the toilet in the patients bathroom. When used to clean a bedpan or urinal or specimen hat; the aerosol goes everywhere. I have black light photos from 2004 that are quite dramatic. Other countries in western europe, south africa, Japan and Canada have other ways of dealing with this problem. In general they take the bedpan to a remote location and use a cabinet style bedpan washer ( looks like a dishwasher ) . It is not a perfect solution but at least you are not getting soaked in stool laden water and then going from one patient to another . Very unsanitary!!. I have looked on Pubmed for years for research on this topic, looking for infection control studies. There are none that I can find. It is an important infection control issue and nothing is being done, as far as I know. I have been thwarted by my own hospital and even the school of public health was not helpful. OK Nurses , You must have comments on this. I want to start a diaglog. Thanks David Conlon RN Pearland Texas