Heh, here we go again

SeaCat

Hey, my Halo is smoking
Joined
Sep 23, 2003
Posts
15,378
This afternoon we had two patients on my unit who needed to be Catheterised. (Urinary Caths.) In both cases the job was made much more difficult because of the patients medical conditions.

I listened to the screams of pain coming from one room and the grumbles of the R.N.'s in both cases. I didn't say anything until the R.N.'s declared that they had been beat and it would need a surgeon to get the catheters in place. That's when i stepped forward and told my boss she could save face, not have to call in a surgeon to do a simple job any R.N. should be able to do. She looked at me and thought about it for a minute then told me she would break the rule she had instituted and allow me to do the deed.

(Several years ago my hospital had a problem with U.T.I.'s caused by Catheters being inserted in an unsanitary manner. My Boss felt it was being caused by the C.N.A.'s inserting the catheters while not following Sterile Field Protocols. She was proved wrong in this assesment but her ban on C.N.A.'s inserting Catheters was kept in place due to office politics.)

I reviewed the patients charts looking for reasons for the difficulties and found them. I then went through our supplies and picked out what I would need to do the dirty deed.

The first patient was the easiest but the most painful. He was an older male with Prstate Cancer. His Prostate had swollen to the point where it was almost closing off his Urethra. I was able to catheterise him by using a much smaller catheter than is carried in our usual kits.

The second patient was much more difficult because she was an extremely obese female patient. In order for me to catheterise her I needed a different system.

The cath. kits come with a small amount of Betadyne and maybe six Cotton Balls to put this in place. They also have a total of one pair of sterile gloves. I grabbed a sterile basin and a large bottle of Betadyne, a bag of Cotton Balls and several pairs of gloves. I also grabbed my boss and another R.N. as helpers in sterile gloves to help me pull back tissue. It took me half an hour of cleaning and moving skin but finally I was able to get the catheter in place. (Not to mention half a gallon of soapy water and more than a dozen washclothes to pre clean what was an extremely filthy person, peeeeeew.)

My Boss made the comment after that she was going to push it through that I was allowed to put in Catheters. (Oh Joys. :rolleyes:)

One of the younger R.N's happened to overhear this and made the comment that my boss should reconsider this because my taking so long to catheterise the female patient showed I was being way too sexual in my approach to this kind of work.

My reply was classic Cat and got me written up but had it's desired effect. I reached into the linen bag from the room and pulled out a used Washcloth, stuck it under the R.N.'s nose and told her to identify the scents and their ensueing problems. After she recoiled from the soiled washcloth I started listing them.

Stool in the Vaginal Area. (E. Coli.)
Vaginal Yeast Infection. Major infection risk.
Old Urine
Basic Body Grunge. (Staf. A.)

In other words by my attention to detail I had prevented a probable Hospital Aquired Infection, one that I pointed out that she wouldn't have avoided. I then pointed out my standing feeling about sexuality in Nursing. Anyone who was turned on by caring for another person in our situation needed to be booted out of the Nursing Field and their License revoked, that included youngsters like her.

Like I said I got written up for insubordination. My Boss did tell me however that she liked my message, just not the way I delivered it.

Cat
 
How come you don't have your RN? You should be able to test out...
 
The men I know who looove to play with their peeholes... I get jealous thinking about it. Sounding is much different for women.
 
Always about the delivery, isn't it? Never the message. If I heard that complaint after going through all of the shit you dealt with with that patient, I probably would've done worse.
 
There really is no diplomatic way to tell someone they don't know what the fuck they are doing.

After pointing out "stool in vaginal area", I would have asked the complaining RN, what kind of sex she was used to.
 
I'm really glad there are people like you in the medical profession.

Thank you. :rose:
 

Cat,

No good deed ever went unpunished.
( Mencken, of course )

I've become horribly cynical in my old age. It took a long time and bitter experience to learn that few people are absolutely trustworthy. It is only after years of daily observation that I am able to guage whether someone is truly honest. That's one reason I like living where I grew up; I know who can be trusted and who can't. My great teacher and mentor insisted that, "Your reputation is your most important possession." When I was a young pup, my then boss looked at me while shaking his head sorrowfully and remarked knowingly, "Not cynical enough." It's a fact. Competence, honesty and integrity can be real handicaps in this world.


There's little solace other than being able to look in the mirror.


 
Cat, please forgive the question, but, having read several of your fascinating stories, I wonder what's an RN and what are you ? Like; what's the difference?

I do hope that when your "insubordination" was 'written up', the whole story as to WHY and all the circumstances surrounding the event are included. IT would be horrible to have someone get the wrong impression of your undoubted skills by a line that just said "insubordination to an RN."

I admire your patience. I wish I had it. I'd be bloody livid, and look for some way to get back at that stupid RN.
 
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Cat, please forgive the question, but, having read several of your fascinating stories, I wonder what's an RN and what are you ? Like; what's the difference?

I do hope that when your "insubordination" was 'written up', the whole story as to WHY and all the circumstances surrounding the event are included. IT would be horrible to have someone get the wrong impression of your undoubted skills by a line that just said "insubordination to an RN."

I admire your patience. I wish I had it. I'd be bloody livid, and look for some way to get back at that stupid RN.

I'm what is called a C.N.A. or Certified Nurses Aide. The bottom rung of the Nursing class.

This is followed by L.P.N. or Licensed Practical Nurse. This takes about a year of full time schooling to attain.

Next comes R.N. or Registered Nurse. (A minimum of two years of schooling.)

Oh before I go on I should add that I'm also an E.M.T. and have been in the medical field for more than a few years.

Cat
 
Ahhhhhh, thanks. (I think I'll be adding that one to the list of things I would prefer not to try.)

Cat

If anyone comes near me with one of those things, they will be needing nursing care.
 
I'm really glad there are people like you in the medical profession.

Thank you. :rose:

There are plenty of people like her in the medical profession. I spent most of last year in a hospital bed with a catheter and a (temporary) colostomy bag. Taking care of someone in my condition was a nasty job, yet they did it with an always friendly and encouraging smile. Yeah, like you, I'm glad there are people like that.
 
I'm what is called a C.N.A. or Certified Nurses Aide. The bottom rung of the Nursing class.

This is followed by L.P.N. or Licensed Practical Nurse. This takes about a year of full time schooling to attain.

Next comes R.N. or Registered Nurse. (A minimum of two years of schooling.)

Oh before I go on I should add that I'm also an E.M.T. and have been in the medical field for more than a few years.

Cat

And can you/do you want to progress to the dizzy heights ? (or; has anyone told the snooty RNs that they ain't God?)

I had a catheter fitted. It was done to two ladies (I had to apologise for a lack of something to work with), but they got there in the end. The pretty Blonde nurse who came to remove it was a real charmer. That stung!
 
There are plenty of people like her in the medical profession. I spent most of last year in a hospital bed with a catheter and a (temporary) colostomy bag. Taking care of someone in my condition was a nasty job, yet they did it with an always friendly and encouraging smile. Yeah, like you, I'm glad there are people like that.

I'm so glad to hear this positive story, and apparent positive outcome for you!:rose:

Seacat, though, I think, is a he. ;)
 
Saint SeaCat

I'm what is called a C.N.A. or Certified Nurses Aide. The bottom rung of the Nursing class.

This is followed by L.P.N. or Licensed Practical Nurse. This takes about a year of full time schooling to attain.

Next comes R.N. or Registered Nurse. (A minimum of two years of schooling.)

Oh before I go on I should add that I'm also an E.M.T. and have been in the medical field for more than a few years.

Cat

... and that is not a cynical reference. Those of you at the lower rungs of the Nursing profession are simply amazing to me.
I was married for 28 years to an RN whom I met in Korea where she was head of triage in a major hospital and retired a few years ago as a Nurse Practitioner at Kaiser Permanente in CA where she helped pioneer the program that helped get CNAs some respect; at least at Kaiser.

Her comments about CNAs and LPNs were laudatory. In her soft southern accent she would say to those who complained about CNAs "Now (sir/maam) you just be quiet about (her/him) or you just might not get any supper tonight". This was always followed by silence.

She had an imperious attitude but not about or toward CNAs and LPNs.

Sometimes I miss her.

Loring
 
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There are plenty of people like her in the medical profession. I spent most of last year in a hospital bed with a catheter and a (temporary) colostomy bag. Taking care of someone in my condition was a nasty job, yet they did it with an always friendly and encouraging smile. Yeah, like you, I'm glad there are people like that.

:eek::devil:

Cat
 
And can you/do you want to progress to the dizzy heights ? (or; has anyone told the snooty RNs that they ain't God?)

I had a catheter fitted. It was done to two ladies (I had to apologise for a lack of something to work with), but they got there in the end. The pretty Blonde nurse who came to remove it was a real charmer. That stung!

I'll be going for my R.N. when I have enough money to get my wife and I through school. (She plans on getting her R.N. as well.) Unfortunately we make too much to qualify for grants and loans are a killer.

Catheters aren't that hard to emplace if you know what you are doing. They don't have to be painful either in the emplacement or the removal. The problem with them is the sanitary practices needed to avoid such things as U.T.I.'s. Unfortunately too many people skip this or skimp on it for any number of reasons.

Cat
 
... and that is not a cynical reference. Those of you at the lower rungs of the Nursing profession are simply amazing to me.
I was married for 28 years to an RN whom I met in Korea where she was head of triage in a major hospital and retired a few years ago as a Nurse Practitioner at Kaiser Permanente in CA where she helped pioneer the program that helped get CNAs some respect; at least at Kaiser.

Her comments about CNAs and LPNs were laudatory. In her soft southern accent she would say to those who complained about CNAs "Now (sir/maam) you just be quiet about (her/him) or you just might not get any supper tonight". This was always followed by silence.

She had an imperious attitude but not about or toward CNAs and LPNs.

Sometimes I miss her.

Loring

I like her attitude but it is sadly lacking in most places I have worked. Nursing is rife with politics, something that is not needed in medicine.

The biggest headache though isn't the reactions of the patients to C.N.A.'s but the R.N.'s reaction to the C.N.A.'s. Unfortunately the only way to fix this is unpopular because it isn't politicaly correct. To whit holding people, in this case C.N.A.'s responsible for their actions. When the C.N.A.'s are held responsible for doing their jobs and are willing to accept that responsibility then they will start receiving the respect they are do.

Cat
 
Thought.

"I listened to the screams of pain coming from one room and the grumbles of the R.N.'s in both cases. I didn't say anything until the R.N.'s declared that they had been beat and it would need a surgeon to get the catheters in place. That's when i stepped forward and told my boss she could save face, not have to call in a surgeon to do a simple job any R.N. should be able to do."

I wonder what the unit reputation would have been if you'd not volunteered to do the job and a surgeon had come down and seen the mess the RNs were in. You'd be well clear of the flack, but the RNs might have been a little deflated.

I can almost imagine a senior surgeon's comments about "bloody inefficient RNs"
 
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