huber needle

vanilla bean · Jan 23, 2015

My suggestion is be honest, explain that you know you made a mistake and try to ensure your DON that it won't ever happen again. Then live with the consequences of your actions, whether you are counseled, disciplined or terminated.

But I also have another suggestion based on this statement:

i didnt want the patient with end stage cancer dying of dehydration, since there was delay in new huber needles coming from pharmacy

I think you also need to work on your critical thinking skills. Was your patient really at risk of "dying of dehydration" immediately? Was your only course of action really to reinsert the needle? Is the patient NPO? What about starting a new PIV? Etc, etc.

Best wishes to you.

IVRUS, BSN, RN · Jan 23, 2015

A Huber needle is one type of non-coring needle used to access ports. So, you may want to know exactly what type you actually used. Reinsertion of a non-coring needle after it has been pulled out of the septum of the port is a real infection issue. It is akin to trying to thread a PICC line back into someone's arm, after it erroneously comes out a few inches.

#1. You can never make the skin sterile as it is always shedding it's layers, which house bacteria, therefore, you are pushing that bacteria into the vascular system. Plus, what did that needle touch after it was pulled out? Was it lying in the bed, our heaven forbid the floor? Infection control is your number one violation here, and as vanilla bean stated, live and learn from it. You will get past this, but please remember, you can't make a mistake twice.... the second time you do it, it will be a choice. And... I'm sure you will be the one to learn from this experience and NOT repeat it.

spma1234 · Jan 23, 2015

Thank you for your replies, vanilla the patient was not immediately dying of dehydration but she was going to go with no fluids for a long time, I asked my supervisor to insert peripheral and she said oh its ok for her to wait till huber needles arrive, and IVRUS the needle was laying in bed and if it was found on the floor i would have never never reinserted, and like you said germs are everywhere!!!! thanks again

spma1234 · Jan 23, 2015

The patient was not NPO but she was unable to eat or drink and resisting care; she was like 80 yrs old fighting last stage of lung cancer...

NurseOnAMotorcycle, ASN, RN · Jan 23, 2015

I know you are worried about your job but how is the patient?

spma1234, I hope you know that you made a huge, possibly life-ending error, even to the point of ignoring your supervisor when she said to wait for the new needles to arrive. How about sending her to the ER for a clean port access? Port insertions are sterile procedures. Cancer patients and elderly patients generally have less or no defense against bacteria, and ports go straight to the heart for immediate systemic spread of medications and fluids.

Please tell us she had the needle immediately removed and was sent to the hospital for antibiotics or otherwise immediately cared for in some way.

spma1234 · Jan 23, 2015

nurseonmotor thank you for your reply. the patient died 2 days later, she was not eating or drinking and was actively dying and we all were thinking she was going to die, I understand this could be life ending huge error what I made and would never repeat it if given another chance, hope they don't take my nursing license away for this based on what you are saying!!!

AnnieOaklyRN, BSN, RN, EMT-P · Jan 24, 2015

nurseonmotor thank you for your reply. the patient died 2 days later, she was not eating or drinking and was actively dying and we all were thinking she was going to die, I understand this could be life ending huge error what I made and would never repeat it if given another chance, hope they don't take my nursing license away for this based on what you are saying!!!

Like someone else said use your critical thinking skills! The bed is covered in bacteria. The bottom line is that this patient was going to die, she is stage four CA, not eating and drinking IS a sign that the patient is actively dying. Placing a used needle that has been sitting on the bed was of course the wrong thing to do, but the bigger question is why would you think reinserting a needle so that a already dying patient could get fluids was necessary?

It upsets me that a patient that is known to be terminal is receiving treatment to try and stop them from dying!

HPRN

Libby1987 · Jan 24, 2015

Actively dying but on fluids? Doesn't make sense, dying patients are given atropine (or lasix in the home). She wasn't on Hospice?

IME, dying patients in LTC are either sent to the ER for tx or are on Hospice.

NurseOnAMotorcycle, ASN, RN · Jan 24, 2015

I think what prompted me to post the way I did was I that the feeling I got from previous posts are that people are saying infecting an elderly or terminal patient isn't as bad as infecting anyone else because they are dying anyway.

I doubt that is what anyone is saying, just a misinterpretation of tone as conveyed by written words, but I can hardly say "there, there, it will get better" as I would have usually done when it feels that ending someone's life wasn't as important as receiving a paycheck.

amoLucia · Jan 25, 2015

Not to be a bearer of bad news, but if you have your own malpractice insurance, now would be the time to contact them ASAP re the error.

Gooselady, BSN, RN · Jan 25, 2015

I think your DON failed her responsibility to ensure the nursing staff's competency to deal with such things as central lines/mediports.

If you had known what you've learned on this thread, you'd have never done this. You'd have stepped up to make sure there was at least extra rare-type supplies so you DON'T run out. And the nurse who refused to place a peripheral needs to get a grip.

This lady had the central line to deliver palliative medications, not necessarily hydration.

I see a need for your DON to provide some education about palliative care as well. Not your fault you didn't 'know', this is pretty specialized nursing care. You ought to have been taught this -- not left to MacGyver your way through it.

Alas, another one of those crappy learning experiences :) No huge foul done. What others have said about how to respond if or when you are interviewed about this is what I would say too. Avoid finger pointing which would be hard for me to avoid doing, seeing the lack of necessary staff development and for gawd's sake, SUPPLIES. Sheesh! You'll be fine, and if this facility gives you too much trouble over it, resign and go somewhere else where the staff's educational and medical supply needs are administrative priorities . . .