between a rock and hard place.....

[ortess1971]

Hey everyone, I need some input. I am starting my Maternity rotation at the same hospital where I work as a surgical tech. At my hospital, they will send one of us upstairs to scrub a C-section if they are short staffed. Most of the time though, it's because they don't want to do it( we got asked if we could send someone up once, because "our call people don't want to come in") I digress though. My main problem is that their sterile technique is asbysmal. Some examples include 1)they had saved open suture from a previous section and brought it to me to use. I , of course refused, and insisted on them opening fresh replacements-they looked at me like I was crazy. 2) They will try to get away with not covering a mayo stand-they instead just heap linen on top because "we don't touch underneath the tray" My question is this? How can I tactfully point out a break in technique if I see one as a student? For the good of the patient, it would be my responsibility to say something but I will undoubtedly piss off someone when I do. Should I ask my instructor how to do this? I don't want to come off as a snot. I could tell her that I don't really need to observe a section but that in itself would make me look like I think I know it all. I don't know what to do...

[Marie_LPN, RN, LPN, RN]

How can I tactfully point out a break in technique if I see one as a student?

It would be better if your instructor took care of this if it would occur. Is it possible for her to be present, just in case?

Kinda makes me wonder what their infection rate is, with practices like that.

Similar thread on this issue:

https://allnurses.com/forums/f35/o-r-l-and-d-clashing-in-c-sections-115644.html?highlight=clashing

[SFCardiacRN]

Don't rock the boat as a student. You are there to learn and some of what you will learn will be from bad practice and poor policies. I had to bite my tongue many times as an RN student (15 years prior ORT experience). At this point they are not YOUR patients and staff will make that PAINFULLY clear if you interfere. I feel your pain and feel sorry for the patients on that ward.

[ortess1971]

I decided to mention it if I see something but I won't just blurt it out. I cannot in good conscience not say anything.. If that was me, I sure would want someone to say something especially since we got one of the c-section pts from L&D who had a raging infection. You're right, I will end up pissing someone off, but I can always just mention that I was trying to be a good "patient advocate". Maybe that will save me....

[Marie_LPN, RN, LPN, RN]

The problem is that they don't have a sterile conscience.

No matter who reports it, it needs reported. What if these people were the same ones doing your c-section, with your baby?

[grimmy, RN]

we had similar issues in our l&d or suite, which is several floors away from the or. while there were or nurses there during the day, evenings and nights were covered by an st and the l&d nurses took care of circulating. there was next to no sterile conscience. when the women's center got a new nm, the or nurses who regularly work in l&d instituted in-service sessions to educate the rns who work night shift or call. prior to that, infection rates were awful and the st's who worked there were constantly writing up the l&d rns for refusing to count, allowing the pediatricians in the door without scrubs or a jumpsuit, etc, etc. now, this is not to say that all l&d nurses don't know anything about sterile technique. but sterile conscience is a learned behavior, and if you don't know it and practice it, it doesn't happen.