A question for the health professionals out there- new Question post #24

[PurpleFrog]

I work in healthcare, suctuoning Trachie's used to be something I jusst couldn't be around. Now I'm fine. This person's infection control procedures are appalling, befoe a similar procedure we would take in a fresh burn bag, wash hands, perform procedure, place items in bag, remove gloves before touching any thing, wash/sanatise hands, place on New gloves remove bag to appropriate area, remove gloves, wash hands, write up notes. Protecting yoysrlf and other patients from cross infection is a vital part of the job.

[JenJay]

You know, I guess I always assumed people who went into healthcare were special and amazing because they weren't bothered by the gross-out stuff. Now I realize you all get squicky, too, and what makes you special and amazing is that you keep doing it anyway. Thank you!!!

[ladiedeathe]

Joraemi- It sounds like you were squicked by your coworker's violation of standard precautions, not by the work itself. Infection protocols require you to remove the soiled gloves prior to touching a common surface (the curtains) and to wash your hands as soon as the gloves are removed- prior to touching a pen or chart station. Given the way she did it, her pen, hands, the chart station, and the curtains are all now "dirty." (I retired from nursing and still teach part-time in a surg tech program).

Yes, this squicks me out. Ethically- I would immediately alert a supervisior to the violation for retraining. Etiquette- hmmm. I would probably do the same thing that I would do if someone in the bathroom with me didn't wash their hands, and was going to contaminate stuff- in the interest of my own safety I'd gently offer some hand sanitizer (or point to the nearest one) and just act as if they were of course looking for it.

[PitBullMom]

I'm not a human nurse, but I am a vet tech and deal with animal fluids everyday. I imagine my tolerance for icky is a bit higher than most, though. That being said, hand washing between patients and after using the lab is a huge part of my day and what you described would definitely bother me.

[joraemi]

Thanks for the input everyone!

I have continued to roll this around in my mind.  I've been trying to picture myself doing the work and how I would do it that would be more "clean" etc.  I think I could do it.  THEN I've been trying to imagine if I would be the nurse that would make the patient feel comfortable and cared for when they arrive for their procedure, etc.  There isn't really time to chit chat and hand hold, so I would need to be getting my work done and putting them at ease all at the same time while I'm sticking them for their IV, etc. I'm not much of a chit chatter anyway, so I'm OK with that part.  It's weird - I never really thought about it, but working in the NICU, I could just do my work, do my tasks, and not *have* to make small talk with the patient, so it's not really a skill I ever developed.

 I can't imagine pointing out this nurse's lack of hand washing to anyone at this point - I don't even work there yet!  lol  I have been trying to figure out if there is a non-offensive way to say to the nurse manager, "You know - part of what squicked me out was the lack of handwashing going on." I just can't think of a way to say that and it not be offensive or inappropriate (ie "not my place" to say it...).

  It just seemed she was always in such a hurry to get stuff done.  Even taking out IV's she'd drip blood on the floors, linen, etc.  Twice she got her glove all bloodied up and instead of changing it just wiped it on the pillow.  She has been there 10 years, so I don't know if some of it is just her own comfort level with other peoples' germs or what. (she *did* clean up the blood splatters on the floor right away with some wipes they keep in the cabinets)  I could never quite figure out what she was in such a hurry about.  I kept waiting for it to get busy and she kept telling me how busy we were. ::shrugs::  Of course, I was just observing and not doing, and didn't have someone tagging along behind me while I worked.  lol

  Here is my PRO and CON list:

PRO: good pay, good location, great hours, 10-14 IVs a day (my favorite skill), well organized, routine work (I like routines!), they are willing to spend as much time orienting me as I need (I have been home with kids for 18 years!! I'm currently working as a substitute school nurse - not a good fit for me but that's a whole other story!!) I could also view this as a stepping stone job that may give me that 1-2 years of "recent nursing experience" that would help me get an even better job - kwim?

CON: general ickiness, questionable infection control practices by other staff (well - I can only speak about this one nurse, really), pulling rectal tubes ( I should just get over it!!)

Her practice sounds abhorrent. I was my hands every time I strip off my gloves, and NEVER touch my face at work. The finger licking? Ew. Just ew.

If the oesophegeal dilation was that distressing, it might be worthh speaking to the anesthesiologist about just what a person may experience/remember. It may help with your feelings of distress.

And every day lends itself to a new kind of squicky, from C-Diff code browns to VAC dressings covering multiple weeping necrotic fistulae. I smile, nod, and swallow hard. And shower before coming home. Where my duty shoes stay on the porch. Outside.

 I know he won't remember it.  I guess normally the nurse would have given him a bit more sedation/pain meds just before the dilation, but they were having a hard time keeping his O2 sats up so didn't want to give him any more.  I think it might be one of those things you get used to when you're around it awhile - it was just not what I was expecting at all.  PLUS - my husband just had that procedure last year and it was like - WOW - my poor hubby! And the oral appliance looks creepy.  It just does.  No way around that.  lol 

You know, I guess I always assumed people who went into healthcare were special and amazing because they weren't bothered by the gross-out stuff. Now I realize you all get squicky, too, and what makes you special and amazing is that you keep doing it anyway. Thank you!!!

Isn't that a nice thing to say!!   

 When I was in nursing school I had a patient having a bone marrow biopsy.  I was in the room to be his "support person".  Bones gross me out.  Completely.  SO - I was sitting beside his bed, he was on his side facing me, and I had my head down on the edge of the bead, sweating bullets, pale, shaky, holding his hand and patting it saying, "Just relax!  It'll be OK!" into the bedsheets.  lol  I don't know if I was trying to convince him or me!!


So - sorry - I kind of veered off topic.  If I could just get my mind wrapped around the "ick factor" and how to manage it for myself, I think this could be a really good job, you know?? I'm glad to know that I'm not an over-hand-washer and that we all agree she wasn't utilizing the best practices!!

[Jocelyn]

RE: patient won't remember it:
I distinctly remember trying to make noises while having an entubation, so that the staff would realize that they were hurting me. I could tell they thought I was under, and the only thing I could think of is to keep whining at them to let them know I wasn't. I don't know why it didn't occur to me to wave my arm, or swat at them- maybe I was enough out of it that I couldn't move. But I remember hearing the doctor tell the nurse to give me more meds, and then I was fine.
The same thing happened during eye surgery a few years later. I truly believe that they forgot to give me the sedation, as I was 100% fully awake, and lemme tell you, lying under surgical drapes and trying to stay perfectly still despite being in serious pain from being positioned awkwardly, is truly memorable. I could repeat back conversations between my surgeon and the scrub nurse (the scrub nurse actually argued with the doctor about what kind of suture she wanted to use!). When I went back to have the other eye done, I told the staff about it, and reactions were horrified, as everything I said was accurate, right down to the color of the suture.
Please, nurses, don't assume that the patient won't remember it...because even if you're right, they may be suffering DURING the procedure.

[joraemi]

^^^^^

I noticed the nurses at this facility asking patients if they remembered anything form the procedure and they all answered no.  These docs do give a drug to suppress memory as well as pain medications.  I have heard of those horrible experiences some folks have like you did with anesthesia/lack thereof.  I always wonder if there is something about the way they/you metabloize the medications that render them nearly ineffective.  It must be awful!!

[Jocelyn]

^^^^^

I noticed the nurses at this facility asking patients if they remembered anything form the procedure and they all answered no.  These docs do give a drug to suppress memory as well as pain medications.  I have heard of those horrible experiences some folks have like you did with anesthesia/lack thereof.  I always wonder if there is something about the way they/you metabloize the medications that render them nearly ineffective.  It must be awful!!

I assume it's me, as dentists have to give me extra painkillers, too. I've just gotten used to warning anesthesiologists about it. What's interesting about it is that I don't have a panicky feeling, so much as an awareness that I'm completely alert, and I shouldn't be. I've had carpal tunnel surgery done, and conversed with the OR staff while it was being done. When I had my cataracts done, I reacted and they had to knock me out- but then, the surgeon (same one as the previous eye surgeries) made that decision. I thought about it for a week, and when I went back to have the second eye done, I told the surgical center staff that I thought it simply was that I'd gotten overheated. (because it didn't make sense to me that I'd PANIC, when I hadn't panicked in that awful first surgery). They basically rigged a CPAP machine to blow under the drapes and I was perfectly comfy without being knocked out. Fortunately, I don't think I'll have to have any more eye surgeries...but if I do, I know what to tell the anesthesia staff.

[lady_disdain]

Unless you are going for a position that allows you to change the way things are done in that facility, I would stay away for two reasons. First, you say you have been away from the workplace for a while. There might be a lot of new safety and cleanliness practices in place that that facility just ignores, since they ignore so many basic ones. Second, facilities have reputations. If you work there for a while, it may be a hit on your resume ("hummm, this person was at place A. She might not follow procedures. Let's just interview Joe, Mary and Diane instead").

If you are tactful, you can even bring this up as a concern with the person interviewing you. "When I was shadowing your team, I noticed a lot of sanitary violations - dripping blood, lack of hand washing, contamination (just give one or two examples - not necessarily the entire list) Is this being addressed?" The reaction will tell you a lot - maybe they were unaware (bad management, in any case), maybe they are already trying to fix it, etc.

[joraemi]

Unless you are going for a position that allows you to change the way things are done in that facility, I would stay away for two reasons. First, you say you have been away from the workplace for a while. There might be a lot of new safety and cleanliness practices in place that that facility just ignores, since they ignore so many basic ones. Second, facilities have reputations. If you work there for a while, it may be a hit on your resume ("hummm, this person was at place A. She might not follow procedures. Let's just interview Joe, Mary and Diane instead").

If you are tactful, you can even bring this up as a concern with the person interviewing you. "When I was shadowing your team, I noticed a lot of sanitary violations - dripping blood, lack of hand washing, contamination (just give one or two examples - not necessarily the entire list) Is this being addressed?" The reaction will tell you a lot - maybe they were unaware (bad management, in any case), maybe they are already trying to fix it, etc.

SECONDARY QUESTION:

What do you all think of this idea? ^^^^^

 I was thinking of sending the nurse manager an email later this afternoon requesting another shadowing day and thought perhaps I could include something to the effect of: "I think part of my hesitance is that as a NICU nurse we were all about germ avoidance.  I noticed there was not nearly as much handwashing going on among the staff as I am accustomed to."  That way it kind of brings the issue forward, but at the same time puts it back to me - sort of...does that make sense?  Good idea?  Bad idea?

Thanks!

[lady_disdain]

Personally, I would do it. If the person interviewing holds it against you that you brought up important safety considerations than you don

[Jocelyn]

I suggested you bring it up, because I think there are far worse things than not getting a job you apply for.
One of which is getting a job where your co-workers routinely ignore the basics of good patient care.
If they get huffy about you even bringing it up...bullet dodged.

[PurpleFrog]

I suggested you bring it up, because I think there are far worse things than not getting a job you apply for.
One of which is getting a job where your co-workers routinely ignore the basics of good patient care.
If they get huffy about you even bringing it up...bullet dodged.

Seconded.

[WillyNilly]

Put it this way - what have you got to loose?  If they don't care about their procedures and have no intention of improving them, well then, you don't really want to work there right?  But if they have answers or plans to improve (heck maybe you are being hired to replace the lazy worker!) they will appreciate that you noticed.

[PurpleFrog]

I suggested you bring it up, because I think there are far worse things than not getting a job you apply for.
One of which is getting a job where your co-workers routinely ignore the basics of good patient care.
If they get huffy about you even bringing it up...bullet dodged.

Seconded.