"Latex Lunacy" or "Latex Liason"

[RiverNurse]

Hello all,

The above is meant to be an attempt at humor. I have a situation I would like to discuss - it has to do with my performance as a nurse -and professionalism.

I have been on a clinical rotation in a mental healthcare environment. One of the patients had been c/o of abdominal pain for the two days I'd been working with her. I'd been told that she had opioid related constipation. As a student nurse and their guest - I let it go and assessed and reported her pain but did not "push" the issue.

Forward to day three - the pt had not seen a therapist or psychiatrist during that time and still c/o pain. This time, I went deeper with my questions and assessment. Her pain level was 8 sitting up and 6 when reclining. I was wary because of some other issues, but knew that as a nurse, I should assess - and she finally stated that she had chronic pancreatitis. That was not in her chart - so I decided that when she went in to see the psychiatrist - I would alert him to her pain and this new information. With that, he ordered amylase, lipast and an LFT.

I was off the unit and during that time a tech tried to draw her blood but reportedly was unsuccessful. When I returned, tech #2 was attempting draw blood but couldn't find a vein, either. He asked the charge nurse for a pair of gloves. The only size they had available was small. He asked for large - so - the charge nurse and I went to the children's unit to get a pair. She asked the nurse behind the desk for a pair of gloves. The nurse got them out of the box and I asked, "Are those latex?" She said, "Yes." I said to the charge nurse, "Those can't be used." She said, "She's [the patient] is not going to be wearing those, he [the tech] is." She walked back into the adult unit.

I was stunned. That didn't ring true with what I'd been taught over and over in class - but - the patient "did" have a tourniquet on her arm which has latex in it... but... she did say she had an allergy and I had to be true to that - I thought.

So, being a student nurse and being a guest, I wasn't sure how to handle this appropriately, so I talked to a fellow student nurse. We both agreed that it would be best for me to find our clinical instructor immediately. I walked around the units looking for her and could not locate her.

Then I walked back into the adult unit, at that point, not sure of what had transpired while I was gone and decided to talk to another student nurse/classmate of mine - I was not sure what to do if the tech decided to use the latex gloves that had been laid on the table next to the patient.

I told my classmate what had happened. She said, "Listen, you're over reacting - he's not going to use the gloves." I asked how she knew that. She said, "The charge nurse put them on the table and the tech said if those were latex, he wouldn't use them." Since I had been out of room during this exchange between the tech and the charge nurse, I didn't realize the tech had already refused to use them. So, all I saw at that point were the gloves on the table next to the tech and patient.

When I tried to explain to my classmate that I didn't have all the information and was basing my actions on the information I *DIDN'T* have - she interrupted me and said, "Well, he's not going to use them anyway."

I was just trying to be an advocate for my patient - and having seen some corners that had been cut during this time, I wasn't sure if this tech would do the same.

But the point was - I didnt' know that for sure - and as a student nurse I didn't know what action would be appropriate to take in a setting like this... and I was trying to get input from another person. Right now I feel inadequate, inept and that maybe I did, indeed, overreact. I guess I am just looking for input. Somehow, I feel I did exactly the right thing - and that my classmate was rather inappropriate with her judgement. I guess it is correct when they say, "Nurses eat their young".

I am just cynical now - my attitude will improve - so please be patient.

I'll be talking with my clinical instructor later about this.

Thanks for any input... and for "listening"

Shawna

[Medic/Nurse, BSN, RN]

Definite LUNACY.

Hey, we have all done strange things - even with the best of intentions.

And we know what the road to H@&& is paved with!

Let it go.

Never mention it again.

This is how a cluster starts - just let it be a lesson learned.

FORWARD!

[psalm, RN]

Speaking as a person with a latex sensitivity, not a full allergy, I think you were right to check it out. If a person has an allergy to latex, sometimes just being in the same area where there has been powder from the gloves can be risky. Most gloves are now powder-free, but not all.

My dentist has to use latex-free gloves or my lips begin to swell. If there is any question, HOLD treatment, in this case it was a blood draw.

[DusktilDawn]

No, it's not correct that "nurses eat their young," in fact you've applied this inappropriate antiquated stereotype incorrectly to start with. Instead of having the conversation with another classmate when you couldn't find your instructor, you could have sought out another nurse on the unit. Your classmate may not necessarily have been inappropriate, you even said that maybe you were over-reacting, perhaps she may have realized this conversation was occuring at the wrong place.

You are right about the latex, the nurse was wrong. The tech was right about not using those gloves, wrong about using the tourniquet. You could discuss the incident with your instructor and allow her to handle it. It does sound like staff need an education regarding latex allergies on this unit. Again this would be an issue more appropriately handled by your instructor.

[RiverNurse]

Yes - it's referred to as "self doubt" r/t inexperience. As far as "nurses eating their young" as antiquated and stereotypical - I certainly hope so... But - I've had several nurses use this phrase in class - and it was initially a foreign concept to me - and hope that I am indeed mistaken in using this phrase. It obviously offended you as a nurse, and I regret having said that. However, I have had classmates tell me that nurses are very hard on each other due to the oppressive environments they have encountered in the past and that the end result is lateral violence - and that phrase refers to that. There is a book entitiled "Nursing Against the Odds" by Suzanne Gordon that touches on this - not nurses against each other - but the environment that generates such stress on the nursing community.

Regarding having a discussion with another nurse on the unit - well - there wasn't another nurse available on that unit except the one that procured the latex gloves to begin with - and even if there were - I did not feel equipped as a student nurse to take it any further than I did - and felt that discussing the situation with my peers was appropriate for feedback as these two peers have a history of prior experience in a hospital environment, whereas, I am going to be a nurse graduate - coming in from a completely different industry with no experience other than the clinical environment.

I appreciate your input - and - once again forgive my usage of such an offensive statement.

shawna

[DusktilDawn]

Yes - it's referred to as "self doubt" r/t inexperience. As far as "nurses eating their young" as antiquated and stereotypical - I certainly hope so... But - I've had several nurses use this phrase in class - and it was initially a foreign concept to me - and hope that I am indeed mistaken in using this phrase. It obviously offended you as a nurse, and I regret having said that. However, I have had classmates tell me that nurses are very hard on each other due to the oppressive environments they have encountered in the past and that the end result is lateral violence - and that phrase refers to that. There is a book entitiled "Nursing Against the Odds" by Suzanne Gordon that touches on this - not nurses against each other - but the environment that generates such stress on the nursing community.

Regarding having a discussion with another nurse on the unit - well - there wasn't another nurse available on that unit except the one that procured the latex gloves to begin with - and even if there were - I did not feel equipped as a student nurse to take it any further than I did - and felt that discussing the situation with my peers was appropriate for feedback as these two peers have a history of prior experience in a hospital environment, whereas, I am going to be a nurse graduate - coming in from a completely different industry with no experience other than the clinical environment.

I appreciate your input - and - once again forgive my usage of such an offensive statement.

shawna

Hi Shawna,

It's not that I was offended, it's just just that the phrase tends to perpetuate a negative stereotype. What the phrase means is that experienced nurses bully new nurses, which is not necessarily true. There's also a difference between an oppressive work environment that does not foster mentoring towards new nurses and bullying, although such an environment can be the opportune playground for a bully.

Bullying can happen in any work environment and it is not necessarily done to new people coming into that environment, and it's not necessarily always lateral. Anyone can be a victim and anyone can be bully. Bullying is a form of abuse, it is persistent unwelcomed behavior that can take the form of constant nit-picking, unwarranted or invalid criticism, exclusion or isolation, constant fault-finding, humiliation, distortion or fabrication of underperformance, being singled out or treated differently, being shouted at, and a myraid of other things. Unless there's more to the story, I don't see where your classmate was bullying you.

[RiverNurse]

Thanks for all the feedback. Here is what I learned from my experience:

1. I should always wait until I cool off and think

2. I have moments of "lunacy" that I need to work on - these are not ultimately productive for myself, patient or peers

3. I need to cut some slack to my peers

4. I would "delete" or "edit" my original post, but it might help a new nurse read about "how not to handle" a situation like this (I know I am not the only one to overreact!).

Lastly, as I walked out of the unit on the last day of my clinicals - I noticed a brand new box of "non-latex" gloves had been purchased for the unit. I was glad to see the situation addressed.

Thanks for whipping me into shape - until the next time :-D

Shawna

[tddowney]

Lastly, as I walked out of the unit on the last day of my clinicals - I noticed a brand new box of "non-latex" gloves had been purchased for the unit. I was glad to see the situation addressed.

Thanks for whipping me into shape - until the next time :-D

Shawna

Your questioning of what could be a dangerous situation for both patient and staff (drawing blood w/o gloves) made a change in how things are seen on the unit. Well done.

I've recently been in your position, and I think one of the things people with a bit of age and experience bring to nursing is the ability to speak up when necessary, and to have a good sense of when it is necessary. I'll bet you did it in your previous jobs.

Clearly, we have to balance our inexperience in clinical knowledge and expertise before "making waves." It's best to be humble and recognize that just about everybody on the clinical unit has more practical knowledge about patients than I do. After all, I'd expect a similar willingness to learn from a newbie in my former area of work.

I think you did the right thing in first seeking direction from your clinical instructor (who should be available without having to send an S&R team to look for him/her).

Bouncing ideas off classmates is usually a good idea. They may very well rememeber something you didn't from your study.