RN's removing surgical drains

RN's and LPN's have been removing Jackson Pratt, Duvol, Penrose, Hemovac, Constavac and T-tube drains for years.

Same here Connie Jean-we have been removing all kinds of drains since I've been working here-1972-no problems with it so far!

I guess we are way behind in the times--we are not allowed to remove any type of surgical drains--we technically cannot even remove staples!!!!

I have removed penrose drains, and 1 JP, but if I were requested to do it again I might want to review a procedure book, it has been about 7 years.

I go to a procedure book when I question a procedure or an order to do a procedure, that is how i found out I am not allowed to do things I used to think were basic nursing care (just NOT in the long term care setting)

I am being sent to certification class so I can maintain IVs again, seems odd because I have been starting them and drawing labs for 9+ years, but I cannot even flush a Heplock right now, in my facility.

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*** May we all have the serenity to accept what we cannot change, and the determination to change what we cannot accept. ***

conniejean:

We remove hemovacs, j-ps, davols, piccs, midlines, subclavians, g-tubes, j-tubes, hemovacs, epidurals, staples, retention sutures. Premedication is a nice thing to do when removing a surgical site drain. No policies are necessary - just remember to clean the site, deflate the balloon if there is one, cut the suture, pull the tube, and dress it afterwards securely. Oh, and tell the pt what you're doing before you do it but not too much before - you don't want to give them time to get scared or anxious. Then I found distraction works well - get their attention on something else - then pull the tube when they're not expecting it - then you can say "All done - go ahead and breathe!" brenda-boo

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In the UK, RN's have been removing surgical drains for many years. We are taught to do this during the training, and are observed during the procedure, until we are proficient.

I am a nursing student at a community college we are taught in fundamentals class to remove surgical drains. It is a required check off (pass out) for our lab

We have been pulling regular surgical JP drains all along. What is new is that we have some surgeons are placing JP drains or even "mini" chest tubes in the pleural space following open heart surgery. Critical care nurses must be certified before pulling any drain from the pleural space. Points to remember: JP drains have a flat portion about 6 " inside the patient. There WILL be resistance when you get to this section, just keep pulling firm and steady. If the JP is in the pleural space, clip/ discard the suture, then cover the insertion site with vasoline gauze, 4x4's. Have the patient hold their breath in while pulling, telling him to breath once the tube is out. I prefer to use clear plastic tape over the gauze as some drainage is possible once the tube is out. If the dsg saturates, either reinforce the dsg or change it but do NOT change the vasoline gauze to prevent a potential pneumothorax.
Lori Hadas, RN, MSN (candidate), CCRN
Cardiovascular Clinical Specialist