Ok nurses and practitioners, this one is for you. Quit prescribing antibiotics for cloudy, funky-smelling pee. Weird pee is sometimes OK.
Nurses understand this: Every 85-year-old in the world has funky smelling cloudy urine. There are age related changes to the body to explain this. It doesn’t mean someone has a urinary tract infection.
Oh, and STOP, just stop, assuming a change in mental status is a symptom of a UTI. It’s not! Quit asking for a culture for these symptoms. Ask instead for the practitioner to come in for a medically necessary visit to find out why your patient has that change in mental status. How’s that for a good idea.
And practitioners, cease OK’ing those cultures. If you really, really think the patient has a UTI, get a urinalysis with reflex. That way the lab won’t get a culture unless there’s enough white blood cells in the urine. That way you won’t even be tempted to treat asymptomatic bacteriuria.
And for goodness sake, just restrain yourselves when a family member begs you for that antibiotic for that imaginary UTI. Give them a virtual hug and let them know we’ll monitor Mom or Dad every shift, and IF they show signs and symptoms (by the Loeb criteria) that only then we will go ahead with that antibiotic.
So quit treating imaginary infections before the whole world has C-Diff or some other antibiotic resistant infection. And, yeah, all I am saying is give pees a chance!
Just keeping it real,
“The Real Nurse Jackie” is written by Jacqueline Vance, RNC, CDONA/LTC, Senior Director of Clinical Innovation and Education for Mission Health Communities LLC and an APEX Award of Excellence winner for Blog Writing. Vance is a real life long-term care nurse. A nationally respected nurse educator and past national LTC Nurse Administrator of the Year, she also is an accomplished stand-up comedienne. The opinions supplied here are her own and do not necessarily reflect those of her employer or her professional affiliates.