Well, I guess I'm in deep doo-doo now.........A couple of days ago, I was supervising a student nurse while she was removing a Hemovac from a pt. who'd had a total knee replacement, and the tubing broke off near the insertion site. I called the surgeon, who told me to take the dressing down as far as possible and see if I could pull the rest of the tubing out, and to call him if I couldn't.
Mind you, I was in the middle of caring for 5 patients without an aide (3-7P shift), had a fresh post-op, a pt. whom I'd just admitted and had to prep for a colonoscopy, and a 45 YO total-hip pt. with borderline personality disorder who was on the light every two minutes (literally). However, I did as the MD had instructed, but couldn't find ANY tubing......not even a fragment.....at the insertion site, or under the skin. So I redressed the incision, and passed the word on to the night nurse at shift change. I was simply too busy to do anything else---no dinner break, no time to chart, no time to even go to the bathroom. Then I went to another floor for the last few hours of my shift, and never thought about it again until my nurse manager confronted me last night.
To make a long story short, there WAS some retained tubing deep inside the knee, and the pt. had to go back to surgery to have it removed. The surgeon was pissed because I hadn't called him back, and of course my manager was upset because I hadn't written an incident report (I've since corrected that oversight) and the pt. did have to have a second operation.
Of course, I feel like hell because I'm at least partly to blame for this mess, and I'm sure of a write-up at bare minimum; but I'm also angry because of the crappy situation I was in, and the expectation that we nurses must be perfection itself, no matter what we're called upon to deal with. The day shift filled out an "unsafe staffing" form the next day, and the manager told them they were being "unprofessional". Now, staffing is better nowadays than it used to be when I worked there before, but there are times when you can have 15 staff members on the floor and it's not enough, and we certainly didn't have that many on Wednesday.
I'm not the kind of person to make excuses when I foul up, but under the circumstances I'm not sure what else I could have done. I KNOW I should've called the doctor back, even though he said to call only if I couldn't pull the retained tubing out (I'd never seen this happen before, and I presumed the fragment had fallen out and was somewhere in the bed linens). But I'm only human......too bad for my patient.
At this point, I can only hope that a write-up will be the worst thing that happens, and that the patient doesn't decide to sue or that I don't lose my job. What a mess.........never thought I'd find myself in such a position, normally I'm very careful and conscientious, but this was not a normal day.
Thank you for reading this lengthy vent. I feel a teeny bit better now. Think I'll go crawl inside a bottle of Diet Coke and drown my sorrows there.
