first shift of preceptorship: told that my IV priming is wrong

1 The hospitals in this city use the Alaris pump and this kind of Alaris infusion set:

http://www.imed95.com/catalogo/ampli...ain.php?cod=36

Prior to my preceptorship, I've always twist that end cap a little bit so that the IV solution can dribble out while priming.

However, during my first shift of my preceptorship, my preceptor didn't agree with my method. She said just to let the IV solution flow to just before the end of the line, put in a threaded cannula (http://static.medshop.com.au/images/...ula_303369.jpg) and then let the solution dribble out. She mentioned that my method would cause the end to be non-sterile?????

Can someone shed some light on this as my previous clinical instructors have seen me prime IV lines and they never had a hissy fit about the way I do it.
You know it reallly is not worth getting worked up about. The inside of the end cap is sterile and so is the fluid.You need to accept that you have a preceptor who has her way of doing things and that neither of you are wrong.Just say okay, thank you and drop it. If you argue with her she will put you in your place right quick. So not worth it.

Agree with the previous poster ... if you are going to judge your preceptor based on the precious little clinical experience you gained in school, you will have a very hard road ahead of you.

Actually I didnt' argue with her. I just said something like "oh..no..didn't know that would be non-sterile"Well, if she happened to be my side when I prime another IV line, should I do it MY way and let her criticize me again?

Potential is there for fluid, regardless how it "appears to be" flowing, to be nonsterile if it's touching an outside environment. If you were mixing and creating an IV bag or drug under a hood, those are the types of rules they follow. Microscopically, you could theoretically find swirling within the drops of solution from the outside exposed to bacteria cap and the unexposed sterile fluid inside, so allowing it to flow with minimal disturbance (optimally not allowing it to drip at all) seems to be the best practice. If you sit back and look at it as if under a microscope and recognize what happened to our petri dishes when we removed the cover for 15 seconds, recovered and incubated, your preceptor has a point. Even the most sterile environments get seeded with a single bacteria, mold or virus. One cannot be too careful when there's a life at stake and there's absolutely nothing to lose by adding that extra care taking step. Just my two cents, but I'd learn why (exactly why) and definitely follow the hand of experience (and always, evidence based practice). Fluid transfers impurities, wherever the fluid is touching at a single moment is considered to have transfer and the outside of a sterile cap is exposed and potentially colonized by air drift or a brush of a hand, finger or dust (I'm not there to see, but I assume this is your preceptor's point and to that I agree). If it were my body, I'd want someone THAT careful hooking up my IV. Placing dirty fingers on a priming cap will definitely result in wet, transferrable contact from where your fingers were to the inside of the tube if viewed under microscope all that water swirrling (water never takes a direct route under magnification).

Quote from seksActually I didnt' argue with her. I just said something like "oh..no..didn't know that would be non-sterile"Well, if she happened to be my side when I prime another IV line, should I do it MY way and let her criticize me again?

Quote from seksWell, if she happened to be my side when I prime another IV line, should I do it MY way and let her criticize me again?

So are you all saying my past clinical instructors are incompetent and don't know what they were thinking?So who is right or wrong or too anal or giving unecessary steps in this situation? My current preceptor or my past clinical instructors/buddy nurses?That is my MAIN question.It really is frustrating when you get different opinions on a technique and I don't know who to believe or abide by. Guess that is part of the so-called "reality shock"

Quote from seksSo are you all saying my past clinical instructors are incompetent and don't know what they were thinking?So who is right or wrong or too anal or giving unecessary steps in this situation? My current preceptor or my past clinical instructors/buddy nurses?That is my MAIN question.It really is frustrating when you get different opinions on a technique and I don't know who to believe or abide by. Guess that is part of the so-called "reality shock"

Quote from seksSo are you all saying my past clinical instructors are incompetent and don't know what they were thinking?So who is right or wrong or too anal or giving unecessary steps in this situation? My current preceptor or my past clinical instructors/buddy nurses?That is my MAIN question.It really is frustrating when you get different opinions on a technique and I don't know who to believe or abide by. Guess that is part of the so-called "reality shock"

Unless your preceptor is telling you to do something in a way that you KNOW is unsafe/incorrect, just do it her way. No one is calling your clinical instructors incompetent, no one is calling your preceptor incompetent. There is more than one way to do many things correctly (there are a few things where the only is one correct way). Unless this is one of the latter situations, just do it they way she wants and move on.

Quote from seksSo are you all saying my past clinical instructors are incompetent and don't know what they were thinking?So who is right or wrong or too anal or giving unecessary steps in this situation? My current preceptor or my past clinical instructors/buddy nurses?That is my MAIN question.It really is frustrating when you get different opinions on a technique and I don't know who to believe or abide by. Guess that is part of the so-called "reality shock"

We use the same tubing. There is no need to remove the end cap as it is "flow through". There is a chance, however small, of contamination if the end cap is removed or loosened - especially if, like me, that end hits things like the sink or garbage when I'm priming the line (particularly in a rapid response situation)