Unhygienic techs; the last straw.

[RightSide]

At my center, some time ago, I had complained to the Head Nurse about the failure on the part of some staff to always follow hygienic and sanitary protocols.  I mentioned no names, telling her that I hoped she could just deal with the problem generally.  Unfortunately, that didn't work:

This evening, a tech wearing gloves pushed a garbage can along the floor with her hand, and then proceeded to try to hook my catheter up to the dialysis machine without either washing her hands first or changing her gloves first. 

I protested, and asked her to change her gloves after having touched the garbage can.  She refused, and got angry, saying "Don't tell me how to do my job!"  I retorted that if she doesn't change her gloves after handling a garbage can, she would not get to work on my catheter site.  She shouted, "Then get somebody else!"  Back and forth the shouting went, until I shouted at the top of my lungs:  "YOU!  You are the least hygienic tech of all the techs here!!!"

By this point, a nurse intervened and offered to hook me up to the dialysis machine.  I accepted gladly.

This is the last straw.  Nobody who touches a garbage can is going to come anywhere near my catheter and catheter site, without putting on fresh clean gloves at least.  I don't like to call people out.  But this time, I'm calling her out with the Head Nurse.  This is the last time I'm going to observe this particular tech violating protocol without doing something about it.

I'm not going to risk bacterial endocarditis because of some careless tech.  She's not worth it!   

[Wallyz]

Sweet fancy moses, RS.  That's reprehensible.

Keep up the fight.

[Chris]

"Don't tell me how to do my job!"

Apparently someone has to because you do not know how to do your job properly

Hope something happens this time RightSide.

[tyefly]

  Funny that you wrote about this RS.....   last night I had a new tech  ( my reg was gone) and she was also very crude on how she did things....  I thought for sure she was going to infiltrate me  and they was she taped the needles... was crazy.... just one tape per needle.....thats it.... nothing else.....   she said there is no reason to use anymore tape .....  sometimes she didnt even want to wear gloves......  I had to keep reminding her....   and when the needles were pulled   she ask me how much tape I wanted   one or two tapes......LOL....  Help..... I want me reg tech back....Please.....   just a little more time  since I am so new to D  and I still have a baby fistula.....  I want to learn this stuff my self.... At least  last night was very educational..... I learned what not to do.......

[Rerun]

Rightside you need to go in on your day off and demand a face to face with the director.  That is ridiculous!

               

[Hemodoc]

You have the right to demand that techs adhere to legally mandated standards.  Unfortunately, there have been many who have been kicked out of units for even insisting upon minimum hygiene standards.  You may wish to keep a log of all of your encounters that would be your protection if ever needed to defend your interactions.  Even an MD after my name did not keep techs from ignoring hygiene standards.  Be careful not get into a situation where they call your behavior a violation to unit rules.  That will be difficult to defend and they do have the right to have you leave if it persists.  Shouting could be used against you.

[RichardMEL]

"Don't tell me how to do my job!"

Apparently someone has to because you do not know how to do your job properly

Hope something happens this time RightSide.

A bit OT to this thread but I had problems for a few weeks with my dialysis sessions.. about half way through I'd get these "hot flushes" and become very hot and sweaty and it was disgustingly uncomfortable. I wasn't cramping and my BP didn't go down it was something else. Anyway we tried all kinds of things - changing dry weight, UF profiling, machine temp etc,... Anyway it suddenly came to me that they'd changed my bath to a "K1" to take more potassium out and I figured maybe that was the issue.. well I asked them to change it back and volia a few sessions without incident... so chief nurse came to me the other day and said "You know you make a better dialysis nurse than me!" 

(she could have spat the dummy with me telling her how to do her job.. not that I did I just made a suggestion and since everything else had failed well.. why not? lol)

Sorry we just had that pop in my head when reading this thread.

[Dana Renee]

OMG! Where do you dialyze at that they talk to the patients like that? That is very unprofessional and in my opinion she should definatly be fired. I am on pd now but I did hemo for quite a while and I have dialyzed at 4 different centers and though I must admit there were some careless techs and nurses at some of the centers, none of them ever talked to a patient in that manner. I mean they would get aggravated and roll thier eyes or huff and puff but never talk loud or disrespectful to a patient. Its not your fault that she didnt know how to properly do her job and if she had maybe you wouldnt have had to tell her. At all of the centers I have dialyzed at if you dont like a particular tech for any reason you are allowed to request not to ever have that tech, that is your right. This is your life, you are in control of it.

[Zach]

Aseptic technique was the standard in all health care settings until the late 1980s when "universal precautions" seemed to supplant it.  In fact, aseptic techniques were for the benefit of the patient, whereas universal precautions were for the benefit primarily of the healthcare providers.

It was on a trip to Florida when a patient care technician did the same as you describe RS, that convinced me to learn to self-cannulate.

[Goofy]

RichardMel,

Thank goodness you found out what the problem was.  For a minute there I thought the hot flashes were from "man-o-pause"!!!!!

[lizabee]

That is ridiculous!  I hope that speaking with the head nurse will solve it...good luck!

[RightSide]

Rightside you need to go in on your day off and demand a face to face with the director.  That is ridiculous!

Yes, this morning I tried to phone the Head Nurse to set up another meeting.  (I would prefer to talk with her once more before going to the manager.)  She wasn't in, but I left a message on her voice mail, and I also sent her email.

I feel so bad I could cry.  In fact, several times today I got teary-eyed but I didn't quite start actual crying.  After four operations over nine months, I still don't have a fistula that works, and I'm still stuck with a hemo catheter.  And with a careless and indifferent dialysis center staff, it's beginning to dawn on me that I'm not going to make it.  Not the way things are going.   

Damn, damn, damn, damn....

[Hemodoc]

Dear Rightside, with proper care, people can live for years even with catheters.  They are certainly not ideal, but make your statement and request for proper hygiene standards.  That is your right. You may consider insisting on RN hook up only.  That is the standard in many units anyway.  Keep doing all the right things for yourself.

The other option you may consider instead of a fistula is a good graft.  They are not as good as a good fistula, but they are better than most catheters and will decrease your infection and complication risks.  Hopefully that is an option you can discuss with your surgeon.

Keep your head up and insist upon proper technique.  We all support your efforts.

Take care,

Peter

[okarol]

  Rightside
I agree with Hemodoc, a catheter can work fine for a long time, but I know it must be frustrating not having a fistula work.
You should demand good care - you're a paying customer and besides that, you're a person that should be treated with dignity. Isn't it tough enough being on dialysis without having to fight for adequate care?
I hope you get a response from the RN.
 

[CybeR]

At my center, some time ago, I had complained to the Head Nurse about the failure on the part of some staff to always follow hygienic and sanitary protocols.  I mentioned no names, telling her that I hoped she could just deal with the problem generally.  Unfortunately, that didn't work:

This evening, a tech wearing gloves pushed a garbage can along the floor with her hand, and then proceeded to try to hook my catheter up to the dialysis machine without either washing her hands first or changing her gloves first. 

I protested, and asked her to change her gloves after having touched the garbage can.  She refused, and got angry, saying "Don't tell me how to do my job!"  I retorted that if she doesn't change her gloves after handling a garbage can, she would not get to work on my catheter site.  She shouted, "Then get somebody else!"  Back and forth the shouting went, until I shouted at the top of my lungs:  "YOU!  You are the least hygienic tech of all the techs here!!!"

By this point, a nurse intervened and offered to hook me up to the dialysis machine.  I accepted gladly.

This is the last straw.  Nobody who touches a garbage can is going to come anywhere near my catheter and catheter site, without putting on fresh clean gloves at least.  I don't like to call people out.  But this time, I'm calling her out with the Head Nurse.  This is the last time I'm going to observe this particular tech violating protocol without doing something about it.

I'm not going to risk bacterial endocarditis because of some careless tech.  She's not worth it!   

Wow! That is extremely scary!

[Lillupie]

OMG you are too funny. man-o-pause
Lisa

RichardMel,

Thank goodness you found out what the problem was.  For a minute there I thought the hot flashes were from "man-o-pause"!!!!!

[RichardMEL]

Don't worry the nurses all suggested I was going through Male Menopause with my "hot flushes" and it created much mirth.. I guess Goofy and my lot are on the same wavelength!! lol

[tee]

It is very sad, that while you have to go through Dialysis, which is not fun, that you have to deal with rude and ingnorant people.  At my husband's center, he has had problems with some of the techs as well, and he argues with them as well.  A few years back, he had an infection, which nearly killed him, so you have every right to ask her to change gloves, and that is part of universal precaution.  I would definately report to mgmt, she owes you an apology, for speaking to you so rudely, and you should demand one.  Good Luck

;

[Chris]

Can't wait for an update

Hopefully it's a good one.

[*kana*]

I am a cardiac tech and I can tell you that you are right in being aggressive.  I often see infections on dialysis caths and it is not a pretty thing.  If you get that infection on a valve then you need to have open heart surgery.  It only takes 2 secs to replace gloves and prevent you from getting a very horrible infection that will impact your life.   Never understood stupid people.  She was in the wrong and knew it and got angry with you.  Kind of like someone cutting you off in your car and flipping you off when you honk your horn at them!  Why can't all people be kind and considerate!

[Chris]

  Kind of like someone cutting you off in your car and flipping you off when you honk your horn at them! 

Was that you the other day? Sorry, my bad 

I do agree though, I never understood that. Usually gloves are abound and easy to get too within a few steps.

[Stacy Without An E]

Stories like this make me extremely angry and I'm proud of you for holding your course and speaking up.  This is reprehensible.

I have a friend at a clinic in the East Bay of San Francisco, one of the chains.  She has a catheter and she had to watch like a hawk because they would drop her line on the floor, pick it up and try to hook her up.  Sometimes the techs would fall asleep at their stations and ignore alarms.

It got so bad she had to work her way up to the Board of Directors and speak to them directly.  Numerous people were fired after that.

Some Dialysis clinics are run exclusively by that giant, smiling dollar, patient be damned.

[nick]

Hi  This is Harv  Nicks friend.
Nick was in the worst dialysis center I had ever seen  and I have seen many after doing technical work on a regular basis in over 30 dialyis centers in the Southern California area.  He was at  NCM here in Manila.  I had proposed an upgrade on their tv systems as the 2 sets downstairs and 2 upstairs blared constantly and one could not hear the alarms.   But one day I stayed with him during his treatment and here was patient families going back and forth to the sterilizer getting tools and then leaving them around.   Then a pct drops a roll of tape on the floor and then with her gloves picks it up and puts it on the counter.    Then another pct is sitting
at the counter with her dirty tennis shoes up on the counter about 1 foot away from injectables.   Well i blew up and I would imagine one could hear me all the way to Los Angeles across the Pacific ocean.   I yanked him out of that place faster than you could blink an eye and sent a note to the US vice president that the last thing he needs to worry about is  TV sets and i am withdrawing my proposal.  By the way there was a small notice stuck on a wall that they had lost their accredidation
with  PhilHealth  and of course Nick was denied his benefit which is a pitiful 15%
Now i know why he wound in the ER twice during that time.   After changing facilities he has been fine and I monitor these places with  a magnifying glass and tell the staff  that I am watching.
Harv

[okarol]

I would be tempted to use my cell phone to video some of these things in the dialysis center - post it on youtube - maybe then they would take it seriously!

[RightSide]

I spoke with the Head Nurse today.

I told her I didn't want an apology.  You know, my attitude is:  I'd rather be alive and have enemies, than be dead and have mourners.

In fact, I'm willing to meet this tech halfway; I understand how overworked and rushed they are due to understaffing.  I also pointed out that most other techs are conscientious (and I usually remember to thank them for their diligence).

All I do want is for these one or two less fastidious techs to be more careful in the future.  That's all.  She said she'll work on it.

She said that she's trying to discuss with management how to create a better climate which encourages the reporting and swift handling of medical errors like these.

Let's see if this problem can be resolved smoothly.  I'll keep you posted.