Perhaps OSHA should get involved here . . .

[Crescent Cat]

As part of my job of working with people with disabilities I function as a supervisor for a group in the vocational program. What we do is go to two hospitals and collect the recycling from the bins. It's a great job, I love my crew and they are hard workers. The EVS people at the hospitals are great too. They work with us and if I ever need anything they're there.

However, some of the things I've found in the recycling bins have lead me to question the competency and basic common sense of some of the hospital staff.

Sometimes we find trash - Styrofoam cups and the likes - no big deal. I have a trash bag on the cart for just such occasion.

Other times I find medical equipment that I don't know what the hell it is. I found this plastic bag with a half circle opening with the print "single patient use only" on it. What the fuck? What is this? Was it used by someone? Should it be in the biohazard bin instead? Is this a fucking ostomy pouch!? I don't know!

Other things I've found in the bins are as follows -

- Bags labeled "Biohazard"
- Sealed IV catheter needles
- Yellow sterile jackets. I don't know the actual name but they're used by phlebotomists when they take your blood.
- And worst of all . . . a hemoccult card. A USED hemoccult card.

You fucking pieces of shit. What the hell is wrong with you? You people are doctors and nurses yet you can't comprehend that these are things that should absolutely never, EVER, go in a recycling bin?

Now being that I've worked in assisted living for over a year let me assure you that I'm not squeamish. I've dealt with blood and human waste personally and I always practice universal precautions every time I do. So my frustration is not in the fact that I find these items nauseating.

I am pissed off because these things are putting my crew at risk. They don't understand universal precautions. If bio hazardous material, medical equipment and human waste is getting into these bins they won't understand how to handle it properly. I've done my best to train them but it can only go so far. This negligence is putting the safety of my crew at risk and I won't stand for it.

I've already spoken to the heads of the EVS departments at both hospitals and they're taking my complaints just as seriously as I am. I'm glad that I have a voice and the incidents have decreased but this shouldn't be an issues to begin with.

I realize being an ER nurse or doctor is not easy and very stressful but please, use some common sense and dispose of your shit properly. If any of my crew ever ends up contracting a disease from something like this, I will personally hunt done the irresponsible bitch that disposed of it and make sure that his/her nursing/medical license is taken away.

[Sapphire Silk]

Please, please, PLEASE report this to Infection Control at this hospital. Take pictures to show them. Environmental Services is good, Infection Control is better. IC nurses are pit bulls

They will move swiftly to deal with this, because as you say, this is completely unacceptable.

Not sure what the bag was; it could be an ostomy bag or an antibiotic IV bag.

Sharps . . . omg.

The yellow thingies are called vaccutainers.

[Seshat]

Seconding (thirding?) both of you that something has to be done about this!

If Panacea recommends Infection Control, then go there. And yeah, I can imagine an IC nurse' reaction to this ... they're the ones who have to deal with the results!

[Crescent Cat]

Please, please, PLEASE report this to Infection Control at this hospital. Take pictures to show them. Environmental Services is good, Infection Control is better. IC nurses are pit bulls

They will move swiftly to deal with this, because as you say, this is completely unacceptable.

Not sure what the bag was; it could be an ostomy bag or an antibiotic IV bag.

Sharps . . . omg.

The yellow thingies are called vaccutainers.

Fortunately the sharps were still in the original wrappers and hadn't been opened yet. If I ever do find a dirty needle in the bins where will be hell to pay. Still I don't know what is going through these peoples' minds when they think it is okay to dispose of stuff like that. I sure as hell don't want to trust anyone that dimwitted with my life.

I didn't know IC was an option. If anymore incidents come up I'll see about putting a complaint in with them as well. EVS said that they're investigating what I found. Hopefully it'll knock some sense into someone.

BTW - I was referring to the yellow coat that phlebotomists wear when they take your blood. I've taken Phlebotomy and I've had to wear one myself, I just can't remember what they're called since its been a few years.

[dalesys]

BTW - I was referring to the yellow coat that phlebotomists wear when they take your blood.

Ought to add black stripes and call them B-Coats.


B-Cause we're gonna sting ya!

[Sapphire Silk]

Fortunately the sharps were still in the original wrappers and hadn't been opened yet. If I ever do find a dirty needle in the bins where will be hell to pay. Still I don't know what is going through these peoples' minds when they think it is okay to dispose of stuff like that. I sure as hell don't want to trust anyone that dimwitted with my life.

I didn't know IC was an option. If anymore incidents come up I'll see about putting a complaint in with them as well. EVS said that they're investigating what I found. Hopefully it'll knock some sense into someone.

BTW - I was referring to the yellow coat that phlebotomists wear when they take your blood. I've taken Phlebotomy and I've had to wear one myself, I just can't remember what they're called since its been a few years.

OH! Sounds like a clean gown similar to the kind worn in isolation rooms. They're often made of a paper like fabric because they're meant for single use, then throw a way. Nursing wears them in isolation rooms. Other departments use them to protect clothing for things like phelbotomy. If they're thick enough, sometimes they're worn backwards as a jacket .

[Shalom]

They're often made of a paper like fabric because they're meant for single use, then throw a way.

Makes you wonder if someone looked at the label and said "Oh look! Paper! That must go in the recycling bin, right?"

If they haven't got biowaste on them, heck, they may even actually be recyclable for all I know.

The rest of that stuff, hell no.

[Difdi]

If any of my crew ever ends up contracting a disease from something like this, I will personally hunt done the irresponsible bitch that disposed of it and make sure that his/her nursing/medical license is taken away.

Or better yet, make sure they get stuck with the same needle your crew member did...or at least, tell them that before you jab them with a sterile needle.

[Sapphire Silk]

Makes you wonder if someone looked at the label and said "Oh look! Paper! That must go in the recycling bin, right?"

If they haven't got biowaste on them, heck, they may even actually be recyclable for all I know.

The rest of that stuff, hell no.

If used by a phlebotomist in a regular room . . . maybe.

If used in an isolation room, definitely not. It has to be incinerated. There's even a special way to take off such a gown so you don't get infectious bacteria on your clothing.

[Crescent Cat]

Panacea - I have a question for you.

While doing the shift today I found a vial of 0.45% Sodium Chloride Injection (pretty much just saline if I recall correctly). It was a plastic vial with a rubber stopper. I wasn't concerned as much with this being a risk in the bin but I'm wondering if it shouldn't have just been thrown away or disposed of another way. It was still about 3/4 filled so I'm assuming it had expired (didn't think to look at the expiration date at the time). I didn't see anything suggesting it was recyclable so I threw it in the trash.

So basically, should the staff have thrown it away instead? Should I have disposed of it another way? EVS was closed today and the few hospital staff I did ask didn't know either. I'm planning on asking EVS tomorrow but I was wondering if you knew in the meantime.

[fireheart]

Makes you wonder if someone looked at the label and said "Oh look! Paper! That must go in the recycling bin, right?"

paper-like =/= paper. It'd be like saying "well cardboard's paper, let's just chuck it"

There's even a special way to take off such a gown so you don't get infectious bacteria on your clothing.

Out of curiosity, how does that work exactly?

Because for some reason, I'm thinking there's a no-hands dance in there.

[Sapphire Silk]

Panacea - I have a question for you.

While doing the shift today I found a vial of 0.45% Sodium Chloride Injection (pretty much just saline if I recall correctly). It was a plastic vial with a rubber stopper. I wasn't concerned as much with this being a risk in the bin but I'm wondering if it shouldn't have just been thrown away or disposed of another way. It was still about 3/4 filled so I'm assuming it had expired (didn't think to look at the expiration date at the time). I didn't see anything suggesting it was recyclable so I threw it in the trash.

So basically, should the staff have thrown it away instead? Should I have disposed of it another way? EVS was closed today and the few hospital staff I did ask didn't know either. I'm planning on asking EVS tomorrow but I was wondering if you knew in the meantime.

Staff should have thrown it in the regular trash, not the recyclables, especially if it was a multiple use vial (30 ml or more).

Some vials are single use only; contain one dose of medication. They're usually only a milliliter or two. They're meant to be used and thrown away. Sometimes the nurse won't use the whole dose. For example, a vial of Phenergan (nausea med) 25mg comes in a 1 ml vial or glass ampule . . . but the doc might order 12.5mg or 6.25 mg. So the nurse will pull 0.5ml or 0.25 ml. The rest can't be used on another patient because it is single use only, so it should be thrown away. Even if the vial is plastic not glass, I prefer to throw them in the sharps box for incineration so you don't have "meds in the wild." Visitors or patients can and will fish meds out of the regular trash (I get on my students about this all the time). I also don't like to throw glass into the regular trash for fear a shard might cut a housekeeper.

Technically, a plastic or glass vial should be recyclable. I'm not entirely sure if the plastic ones are made of the right kind of plastic though. And I'm also not sure about the rubber or the aluminum seal on the cap.

But more seriously, there have been issues of biohazard transmission of dangerous diseases through poor practices with these vials. Specifically I'm thinking of a case in Nevada where staff in an endoscopy clinic were re-using needles that had been in patients IVs to draw meds from multi use vials that were shared among patients.

There's nothing wrong with multi use vials; keeps costs down. But you have to use a new needle everytime you access such a vial to prevent contamination. There were a number of cases of Hep C associated with the Nevada clinics: the GI doc had to shut down, and lost his license IIRC (so did some nursing staff IIRC).

So the short answer is: they should not be in your recycle bins. Pass along word to EVS and Infection control. The latter can do the education with nurses to make sure the practice stops.

Out of curiosity, how does that work exactly?

Because for some reason, I'm thinking there's a no-hands dance in there.

Referring to the procedure for how to take off a gown . . .

First you have to understand how to put one on. The clean gown goes on first, and is always tied in the front. Then the gloves go on to go over the cuffs of the gown. This is done before you enter the room.

When you leave the room, you break the tie and tear the front of the gown so it rips away from the back of your neck to come off over the shoulders. Pull the front of the gown until the sleeves are down to the gloves, and pull the gown off inside out with the gloves coming off last WITH the rest of the gown. The gown is balled up inside out and thrown in the trash. Exit the room and wash your hands with the alcohol gel on the cart at the door (unless the patient has C.Diff, then use the sink and wash with soap and water).

It's a pain, and everyone hates doing it. But it prevents the spread of infectious disease.

[Der Cute]

suggestion to OP:
Use a camera phone. This will give substance to anything you file.
Dec 21 2011, Beige Hospital in Nowhere.
10am emptying recycle bin on east wing
Found these items (take pic with stuff IN the bin, don't remove it)
Please advise on best procedure to remove/throw/whatever with it.

Send those in to your boss.

[Sapphire Silk]

suggestion to OP:
Use a camera phone. This will give substance to anything you file.
Dec 21 2011, Beige Hospital in Nowhere.
10am emptying recycle bin on east wing
Found these items (take pic with stuff IN the bin, don't remove it)
Please advise on best procedure to remove/throw/whatever with it.

Send those in to your boss.

Make sure you know the hospital policies on cell phones in the facility by workers. There are HIPPA issues, and many hospitals are banning their workers from having them on site. One of my local hospitals bans any cell phone with a camera being on site by an employee, both regular and contracted employees.

[ArcticChicken]

paper-like =/= paper. It'd be like saying "well cardboard's paper, let's just chuck it"

I'm assuming this is a US/Australia thing, 'cause - at least where I am - cardboard does go in with the paper. Actually, we've switched to single stream, so all the recyclables go in the bin together.