I hate to brag, but I am damn good at inserting urinary catheters. It’s just something I did well when I worked at the hospital in Nashville.
As such, we had at one point a woman that had attempted suicide which ended up not killing her, obviously, but left her permanently paraplegic. She required an in&out catheter every six hours or so to empty her bladder. The idea was to bladder train her so that she didn’t become dependent on a continuous catheter.
I worked with her for a set of three shifts one week in which she discovered that while the RN struggled to do her catheter – causing her pain – I was able to do it quickly, efficiently, and without pain.
The next weekend when I came back on shift I was not assigned to her, but she found out I was there. That nurse approached me and asked me to do this particular task for her because the patient did not wish either person assigned to her to even attempt it if I was on the premises.
I was stressed, I was busy, but I told the nurse I would attempt to fit it in my plan for the night.
The patient’s schedule had her needing her cath three times on night shift. Once at the very beginning, once around midnight/1 AM, and once at the very end of the shift.
I was able to go for the first one, explaining to her that I could not make promises, but I would attempt to come for her other caths as well.
Because she had been suicidal, she had been assigned a “sitter,” someone employed to sit and keep an eye on the patient. They were not employed to do anything for or touch the patient. Only once in a blue moon might we ask one to assist with steadying or rolling a patient when we needed extra hands – but they must be explicitly asked and must do exactly as they were told if they agreed to assist as they otherwise had no clinical training. On night shift their main job was to stay awake. Quite a boring job, really, though they were allowed to entertain themselves by reading, using laptops or watching TV, as long as it didn’t disturb the patient, obviously.
I gathered my supplies, prepped the patient and set up my sterile field.
Before I knew what was happening, the sitter rose, walked to the opposite side of the bed while putting on non-sterile gloves, and reached in to my sterile field and touched it. Literally picked something up with her completely unsterile hands. TOUCHED IT! AGH!
I was livid.
“What. The Hell. Do. You. Think. You. Are. Doing?” I said in a low menacing voice. My head still bent over the task, but my eyes looking up at her. “Don’t ever do that again.”
She looked frightened and stepped back – hands up, then took off her gloves and hurried back to her seat.
I’m a scary bitch when I want to be, apparently.
I ripped off my sterile gloves and tossed them in the middle of the field before gathering it all up in the sterile wrapping underneath and tossing it directly into the trashcan beside me.
“Apologies, Lisa*, my sterile field was contaminated. I need to go get another packet; I’d hate for you to get an infection,” I said.
“Okay,” she said. “Thank you.”
“I’ll be right back,” I assured her.
I quickly got new supplies and returned to finish the task. Once I was done I informed her nurse what had happened.
“Are you kidding me?! ARE YOU KIDDING ME??!!” I raged. “What the fuck… SERIOUSLY… Has she not been trained?!” I asked incredulously. “INAPPROPRIATE!!”
I clearly had some choice words.
The RN assured me she would talk to her, then later returned to let me know she had done it.
I was unable to make it for her mid-shift cath, but was able to fit in the end of shift one – just barely, but I made it work.
I walked into her room with my supplies at around 6:30 AM. I breezed past the sitter and went directly to the bedside, my back turned to the sitter.
“Good Morning, Lisa!” I said with a smile. “Wasn’t sure I’d make it, but found I could squeeze you in!”
“Oh thank God,” she said with a sigh of relief and a smile.
I went about setting up for my task once again. As my sterile field was set out, my gloves on, and my head lowered once again… I saw a movement… Someone coming around the bed. Eyes moved up again as I saw that fucking sitter coming into my line of sight – putting fucking latex gloves on again.
This time I didn’t say a damn word.
The DON’T YOU FUCKING DARE look on my face said it all.
She realized it was me again and she quickly took her gloves off and went back to her seat again.
Afterwards I went to the charge nurse to complain. About not only the sterile field incidents, but also other things I had witnessed – for instance this woman playing very loud ethnic music on her laptop in the patient’s room. Clearly not my very classic Tennessee country girl patient’s choice.
“Inappropriate!” I bitched again.
“Well, I understand she’s a nursing student, that’s probably why she wanted to help or practice,” the charge nurse said diplomatically. I knew she was one that liked to give people the benefit of the doubt and give second… and third… chances.
“I don’t care!” I said. “You know me,” I continued. “If she had actually asked to watch or asked me to explain what I was doing and why I was doing it, I would happily oblige… But… she didn’t. She didn’t ask. She decided herself to ‘help,’ when it was not needed nor welcome. She decided to do it regardless of the rules for her position – COME ON! You know as well as anyone she shouldn’t be doing anything like that as a sitter! It doesn’t matter what she’s studying outside of work! Besides which she was told TWICE,” I emphasized my point by raising two fingers, “in ONE shift not to do it – by me and then the RN – and then tried to do it again when she thought I was someone else! For fuck’s sake… STERILE FIELD! INFECTION CONTROL! FIRST FUCKING YEAR!!!!” ([of nursing school] – indicating that if she was in nursing school she should know better already.)
The charge nurse sighed, “Yes, you’re right,” she said. “I’ll make the report.”
“THANK YOU!” I said in a tone that said both FINALLY! and THANK GOD! at the same time.
Medical memory number 5…
and… hmmm… guess I showed my bitchy side in this one… but…. COME ON!