Sterile Procedure

I don’t want to leave Dana Farber with a bad taste in my mouth, but my worst pet peeve EVER is when I feel a professional is taking advantage of a patient’s lack of knowledge to be lazy and cut corners. Don’t try it people! But also, readers, don’t be entirely scared. This is a rare phenom.
The dressing nurse put me in a nasty funk. There is no way to send me from 0 to 60 in two seconds than to fuck with sterility of my line. I have a hickman, known as a central line, because it goes directly to my heart. An infection means septicemia, a bacterial infection of my entire body. I am immunocompromised. I do not have a fighting immune system. Previously, I was an infection control nightmare, with two line infections and a mediport (an internal IV) that had to be yanked.
Dartmouth had great numbers when it came to patients NOT having line infection. I went and wrecked all their good numbers. There is no way to make me freak out faster than not changing it perfectly. I know what you’re doing.
I know I look twelve. I get asked daily if I’m at Children’s. Cancer is age defying. An admissions clerk once asked my sister (identical) if she was my mother.
This man obviously did not know I was a nurse. He assumed I had no idea what he was doing. It was bad enough that I had to bear my chest to this man who looked like MR. T with his broken teeth and gold earrings.
Definitely looks like a felon to me, I’m not judging, but under normal situations this man would never get close enough to get his grimy hands on my chest.
He also, had the nerve to tell ME somebody had obviously told me something WRONG, and he was doing the procedure properly after I told him he needed to put on a mask before doing anything.
I don’t know where that mouth has been! Keep your germy breath off of me.
I wanted to tell him Not to under estimate me, bitch. I know exactly what you’re doing. It’s amazing what people will do when they think you don’t know.
In all honesty, this situation has only occurred in two other situations in my years of care. Don’t go getting scared of everybody, most people do their jobs properly, and generally want you safe as a patient.
Except for one nasty radiology nurse, who decided I had to much attitude to treat and pretending to look in my chart for a Benadryl order from the surgeon who had just removed my line.
I have never seen a surgeon, just for fun, write an order for Benadryl when doing something as simple as removing a line. THERE WAS NO ORDER IN THAT DAMN CHART. Bitch, Find the damn surgeon.
I’ve decided since then to no longer use the word bitch to start my sentences.
But I was septic. I was itching head to toe. I have never wanted to tear my skin off so badly, and this woman decides to stick me in a corner because it’s Christmas Eve and she wants to go home to her family.
We all do lady! Not all of us have this possibility.
In this case, even though I told the nurse that there was no order for Benadryl in that chart and she needed to find the surgeon. Her ass walked away huffing, talking about “nobody talks to me like that.”
Actually, septic, loud mouth cancer patients do, and when I got back to the unit to discover my heart rate was 180 beats per minute (60-100 is normal) and my temperature was HIGH, meaning above 105 or too high to register, all hell broke loose. Her ass got reported as fast as I got treated.
I did have one other situation with my line, and a nurse who changed my dressing improperly. I reported her before her car left my driveway. Her supervisor was very upset. The nurse responded that “She was sorry if she offended me, but she did nothing wrong.” I told her supervisor if she thought she did nothing wrong she needs to be kept away from immune-compromised patients and be re-educated, right before I told her exactly what she did wrong.
Moral of the story, I know you’re messing with me and I’m not going to let you get away with it, no matter how sick I am. I’m lucky I have the education I have. I’m glad others don’t know the process, as far as a sterile dressing change of a central line, I’ll break it down.
Both the patient and the nurse should wear masks.
The dirty dressing should be removed with regular gloves. The sterile line kit should be opened with the clean gloves.
The dirty gloves should then be thrown out, and the sterile gloves in the kit removed, and placed on the nurses hands.
The procedure is now sterile. The RN can’t touch anything outside the kit.
She’ll scrub your site with alcohol. Let it dry.
Sometimes they’ll place a piece of gauze over the site or leave it visible. Then they’ll put the dressing, a clear film like bandaid (tegederm) over the site.
They’ll then label the dressing, change the caps, and flush the lines.
This needs to be done once a week.
This is how it’s done, properly. You don’t have to memorize it, but every little bit of knowledge helps. Knowledge is power people. Use it.