Topic: Horrible IV nurse situation AGAIN! I have no good options that I can see.
Rumigirl
Frequent Contributor (1K+ posts)
Member # 15091
posted
[I apologize for the length of this]!
I have been posting about my problems with my port and my IV nurse. I just lost my IVIG and port nurse. The agency didn’t even tell me that my nurse quit for 2 ½ weeks!! I would have done something different, had I known in time.
The agency then told me that they had someone who “is a very experienced port and IVIG nurse.” The number of times I have been told that, and had horrible issues is not to be believed.
I was insisting that a supervisor be there for the first part of the visit to supervise. But the agency said that this was one of the nurses that they would send to supervise and wouldn't do it.
When she came last week, the very first thing she did was unload on me about how upset she was about the election, and say, “____ should be in jail!” And on an on she went about it.
She also had a bracelet on with a political message on it (won’t repeat it to stay away from that hot potato!).
What??!! That is so incredibly unprofessional, it’s beyond belief!! I’ve been in practice in the health care field for many decades and would never dream of doing that.
I was too stunned to say anything, especially because I zippered my mouth when she got into the political stuff, as I did NOT want to go there!
When she was putting in a new needle in my port, which has to be done under a sterile field, first she left the dressing off too long, which is risky.
Then, before she put it on, she had touched many unsterile things with her sterile gloves, and I saw that she was going to proceed without changing them! So I asked her to get another pair of sterile gloves out and use them.
That would have put me at risk for sepsis!! You can die of sepsis within minutes. Sepsis would require emergency surgery to remove my port, and that would probably spread the horrific CRPS nerve pain to yet another area. That would be the end of me.
Then, she took out a clave, from a package, and was clearly not going to wipe it and my line with an alcohol prep pad first. I asked her to do so THREE times. It didn’t enter; she never did it.
Granted, out of the package, it should be sterile, but I take NO chances with my port, and assume nothing. I expect any nurse to do the same, and even more so when asked to do so.
I was trying so hard to make the whole thing work that I didn’t realize how furious I was about all of it until the next day.
What now?? Yes, I can complain and ask for another nurse, but there is no guarantee that I will get anyone any better, as I’ve been through this far too many times.
I’ve been through multiple nursing agencies and many, many nurses over the years, and no agency has been good about this. And most of the nurses have been terrible, as in life-threatening terrible!
The irony with this nurse was 3 things: 1 She has worked for many years with Dr. H, Dr. R, and another Lyme doctor. 2 She accessed my port perfectly, which very few nurses have been able to do.
3 She had a suggestion to help my port that no one else had made, which was to use a larger bore clave, so that there would be less resistance with the flow rate of my port. Why had no one else suggested that??
So now I’m trying to figure out what the heck to do. 1 Complain about it to the agency, but still be willing to try to work it out with her.
2 Complain and ask for a better nurse, but probably get someone worse in terms of accessing my port, as few nurses have been good with that.
3 Change nursing agencies and start over. But that isn’t likely to work out any better, since all of the agencies I’ve been with have been terrible about finding and training good nurses.
I’m leaning towards the first option, simply because I’m not likely to have a better nurse by going through any of the other options, unless I’m willing to go through lots of them along the way.
Another option, which is quite unlikely to work out, is that I am going to ask my doctor if I can do my IVIG infusion by myself. I’d have to learn how to do so first.
But it’s extremely unlikely that he would ok that, as it’s too risky for his license if anything ever went wrong, unlikely as that is.
I will, however, ask for his blessing for me to learn how to put in my own needle, as that would make finding a good nurse easier, as it would remove that obstacle. But that would take a number of weeks, or a month.
Feedback??
(breaking this up for easier reading for many here)
[ 10-23-2016, 05:43 AM: Message edited by: Robin123 ]
Posts: 3771 | From around | Registered: Mar 2008
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me
Frequent Contributor (1K+ posts)
Member # 45475
posted
Oh, Rumigirl. I'm so sorry this is still happening. It's not right.
These are the only ideas I have:
1. Call and address your concerns to the supervisor 2. Address your concerns directly with this nurse. Compliment the things you like that she did, and explain briefly your concerns and how you would like things to be done (I.e., please change gloves again before accessing my port). 3. In the meantime look for another agency?
Also, do you or does someone close to you have the energy to research ratings of home health care nurse facilities?
Could someone be with you if you tried option number two to help you feel more comfortable?
Another thought: Alrhough wearing political bracelets and talking about politics may be offensive to you, would you be willing to change the subject or outright say you're not up to talking about it and keep the/a nurse if they have qualities like that which are bothersome to you but are good at their job?
Again, I'm really sorry you are going through this. You are in my thoughts and prayers. Hugs.
-------------------- Just sharing my experiences, opinions, and what I've read and learned. Not medical advice. Posts: 1431 | From USA | Registered: Mar 2015
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I understand you wanting your port to be accessed a certain way. I have a PICC and I'm very particular about how my dressing is changed, and about how they connect my new extension every week and such.
I have two different nurses that come out. I basically tell them that I know that they know what they're doing and that they're good at it, but that I have unfounded anxiety about certain things and that it would help me to feel better if they did certain things a certain way.
Now, I don't believe my anxiety about those things is unfounded, but when I point the finger at me instead of them it makes things better and they're willing to help ease my mind by doing things the way I ask.
For instance, sometimes they want to connect my extension without priming it with saline first. Their reasoning is that they're about to draw blood from it, so they don't need to prime it, but I don't like anything with a large amount of air connected to me at all. I don't want even the remote change of all that air being flushed into my line. So they always prime it for me.
It does sound like your new nurse is experienced and has some good ideas, so maybe if you just give it a few visits and tell her you really worry about things and that you really want to be extra careful with your port, maybe it could work out in the end. I think that's what I would do anyway.
On a side note, I actually read a recall notice on certain alcohol prep pads not too long ago. They were recalled because they were growing a certain bacteria in their packages, even though they were covered with alcohol! So we really just never know. In that case it would've been safer to not use the alcohol prep pads.
Wishing you the best! Sorry you're having to go through this rough patch with your nurses ):
Posts: 748 | From Texas | Registered: Feb 2015
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me
Frequent Contributor (1K+ posts)
Member # 45475
posted
Rumigirl, I think sicksam gave some good advice. That would keep the nurse from being on the defense while hopefully getting your needs met.
-------------------- Just sharing my experiences, opinions, and what I've read and learned. Not medical advice. Posts: 1431 | From USA | Registered: Mar 2015
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Rumigirl
Frequent Contributor (1K+ posts)
Member # 15091
posted
Thank you, me and SickSam.
I am going to try to work it out with her and first call the supervisor. The other alternatives are as bad or worse. It did occur to me after I wrote the post that if I wasn't careful, she could take offense and refuse to work with me. What a ridiculous state of affairs!
On the political thing: I have spoken about political things plenty before with nurses, given that they are here for many hours and we work together over a long period of time. However, to come in for the very first visit and immediately start ranting about your political views in a very angry way is way off base. She was also "on the other side of the fence." But it would have been wrong even if she weren't on the other side.
I didn't speak up about it, because I was so stunned, plus, I didn't NOT want to wade into that morass!
On the nursing issues, the one about touching all kinds of unclean things and then being about to touch my port area without changing gloves, when that MUST be done under a sterile field . . . I don't think that I can say that that is my unfounded fears, even to keep the peace.
And what the heck is with her not hearing me ask 3 times in a row for her to use an alcohol prep pad, and then not do it?? I don't think that it was deliberate, but . . . it is stunningly unresponsive.
So, somehow I have to make my points clearly, but without rancor, to her supervisor and to her. I'm so fed up with dealing with all this endlessly. My life is literally on the line with the nursing issues. It is sheer dumb luck that I haven't had sepsis yet, due to all of the horrifically dangerous things nurses have done before I could stop them. And I know exactly what should and shouldn't be done; I watch them like a hawk, until I know that I can trust them.
I would look for another agency and/or nurse, but I'd probably go through more of the same. The administration that sends these nurses out is half way around the country. They never see the nurses. There are supervisors closer by, but they do a horrible job of choosing, training, and supervising the nurses, no matter how many times I complain. But no other agency that I've trained has been any better. Enough already!!
Posts: 3771 | From around | Registered: Mar 2008
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randibear
Honored Contributor (10K+ posts)
Member # 11290
posted
I complained about a nurse once. I cant tell you how horrible I was treated after that.
I stopped going. they got extremely rude and, well, downright nasty.
I had been going there for years and forgot my checkbook. all of a sudden my credit cards were no good. they wouldn't let me leave without paying and threatened to call the cops. my husband had to come with cash and drive for about 30 minutes.
needless to say I was beyond angry, furious does not describe how I felt. even my husband said he never wanted to strangle anybody that bad before.
learned a lesson tho. I told someone who I thought was my friend about it and boy did I get an earful. she was a nurse.
when I told my sister, she told me its sometimes better to find another dr. I did but lied about why I changed.
find out later that this particular office would really badmouth patients if something happened to other medical personnel and offices.
so for me, it was not good.
-------------------- do not look back when the only course is forward Posts: 12262 | From texas | Registered: Mar 2007
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Tincup
Honored Contributor (10K+ posts)
Member # 5829
posted
You said.. "She also had a bracelet on with a political message on it."
OH MY GOSH! REALLY?
How insane and totally awful is that? How can you live like this- with a nurse who wears a bracelet? If I were you...
I'd first call the Pope in Rome, then maybe our President and report her! Would't hurt to call your Senator too.
Don't let her get away with that!
Are guillotines still available to rent at the local pawn shops in your city? Off with her head, I say! Off with her head!!
posted
You're right, you definitely have founded reasons for concern. It's really crazy that she touched things with sterile gloves.
I hate the tight-rope we have to walk. It's like, we have to say something about their errors, but our life also depends on them helping us, so we have to call them out in the nicest way possible so that they won't turn on us. It's frustrating to be so dependent.
I read a study once that found that patients caring for their own PICCs (except for dressing changes) got less infections than when nurses cared for them. When you're the one the line is going into, you want it done right! I wish I could change my own dressing, but with a PICC that would be a pretty difficult task.
Posts: 748 | From Texas | Registered: Feb 2015
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Tincup
Honored Contributor (10K+ posts)
Member # 5829
posted
Now, you know I love you. I know you know that. And you know that I've also been through this too, as have many others. But...
If you were reading your post above and I'd written it, you'd most likely see the situation differently. It seems you are too deep into details in an unhealthy way.
Personally, I don't care if the nurse wore army boots covered in cow dung and smelled like it too. (Yes, that's a real experience.)
If she did the basics in a half way decent fashion I'd thank her and be on my way.
Is it possible that you are more than normally wound up? Anxiety? Herxing?
Maybe get some sleep tonight and things will look better in the morning. And you know I love you.
Tincup
Honored Contributor (10K+ posts)
Member # 5829
posted
BTW- the other posters here did a good job sharing with practical options for you. Thank them for that and see if you can use their suggestions.
sammy
Frequent Contributor (5K+ posts)
Member # 13952
posted
Hey Rumi,
SickSam had some good ideas. Put the blame on yourself, that way they don't get defensive. Once they feel offended, they are impossible to work with! No matter how tiny we think the issue is!
I won't take over your thread with some of my crazy stories! Trust me, I've experienced plenty of incidents and learned like SickSam.
Rumi, overall, from what you described, it sounded like the last nurse did a good job with your port. That she might be your best available option. That if you lose her, you risk a run of nightmare nurses that are simply beyond comprehension... Yikes!!!
Of course there are a few issues, but I guess that seems normal. Even the best nurses can do things differently than we are used to. Sometimes people get so comfortable with their job that they get a little lax...
The politics issue was not professional but I would let it slide. I would only report the nurse if they caused harm to me. Others will surely say something. You don't want to accidentally lose your good new nurse over politics...
About the dressing issue, do the SickSam thing.
I leave mine off long to make sure the Cloraprep dries. As long as you have no fans, AC vents or such blowing on it, it should be fine for several minutes.
I don't remember if you saw my thread recently, I have a new dressing called "IV Clear". It is antibacterial and antifungal! For adhesive it uses silicone. Also it has chloroprep and silver that releases slowly over the typical 7 days wear. It is super gentle and has healed my skin! You may like it...
As for the gloves, I would definitely do the Sick Sam thing. All about you and your anxiety, not about her contaminating them. That way she will more likely do as you wish to make you more comfortable.
I'm OCD, I order 4 pairs of gloves a week. That way I have extra on hand if needed. I open up the dressing change kit, put on the sterile gloves, place the sterile drape. Then I open all my other supplies. I put new sterile gloves on to clean the port area. New to access (flush & blood return), New for dressing.
Since I don't touch the supplies, I just dump them onto my sterile field, I've been told that they remain sterile from the packaging. I don't use alcohol to clean the clave when connecting the sterile flush, clave, & Huber needle setup.
After the dressing is on, when I go to flush again with reg saline and lock with heparin, I do use alcohol to clean the clave before each connection. Hope that's not to confusing!
Rumi, it sounds like your best option would be to keep the nurse for now and see if you can work things out.
Try to get your doctor to allow you to learn to access your port yourself. My doctor only allowed it because he knew me well, that I was super conscientious, and that I already knew how to do it due to my profession.
I would like to do IVIG myself but I know that my doctor would never allow it. I'm blessed to get it at home and not to have to go to the hospital for the infusions. Oh well, I appreciate that these physicians have very high standards.
Rumi, I hope things work out for you. You know I'm always here for you too if you want to talk...
Blessings!
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Rumigirl
Frequent Contributor (1K+ posts)
Member # 15091
posted
Thank you all! Randi, I hear you. People do NOT like it if you criticize someone, regardless of how warranted it may be.
TC, I wouldn't have minded the political bracelet; it was her coming in and angrily ranting about the candidate/election for a long time that I minded. I don't expect her to be "on the same side of the fence!" Just don't rant about it, please! If I hadn't been so stunned, I would have nicely asked to not talk about it.
The thing with the gloves especially was concerning, because my life depends on her not doing something that risks sepsis.
I've just been through a lot of hell with my previous nurse, who had been wonderful and then suddenly went south, because she didn't want to try to make my port work. She was yelling at me that I had to get a new port. That's not the opinion of the surgeon. I pleaded with the nurse to still work with me, but she wouldn't.
As it is, I am just barely hanging in there at all as the CRPS nerve pain has been getting a whole lot worse; it's getting to the the completely unbearable stage again. And the cancer isn't doing very well either. Plus, yada, yada, yada with symptoms and conditions. I'm at the far end of what I can handle, so . . .
sammy and SickSam, thank you. I will have to speak to her as if it's my issue somehow (will have to practice that one!), so as not to offend her. sammy, I know that you've been through it plenty, as, actually, most of us have who have done IV stuff. Ports are scarier, because of the surgery issue, esp with CRPS being spread by the trauma of surgery (or injury, etc.).
Thank you, all.
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