Content That chenoaspirit Likes

Content That chenoaspirit Likes

chenoaspirit 7,496 Views

Joined Sep 27, '03. Posts: 1,044 (29% Liked) Likes: 709

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  • Jun 12 '10

    I am so sorry, I know this is difficult. Had the same thing happen to me. I had a "low risk stick" too (seems like an oxymoron tho when HIV is involved).

    Mine happened a long time ago (about 17 yrs ago) and I dont recall being offered PEP. Things were probably done differently. Back then, AIDS patients died a horrible death. The became horribly emaciated, couldnt eat and had terrible diarrhea. I was giving my patient a Sub Q injection in his arm. Not sure how it happened, but his arm so so thin that the needle went thru him and thru my glove. I felt the prick. I immediately pulled my gloves off and scrubbed my hands. I went a few hours in denial and put it out of my mind. Later in the day it hit me and I freaked out.

    Waiting the 6 months for the final lab test to come back was agonizing. Not even sure if that amount of time is needed now. I was very careful about not having unprotected sex with my husband, not sharing razors with anyone, etc...

    Thankfully, everything came back negative. I am thinking of you and saying a prayer. Please keep us updated.

  • Jun 12 '10

    I know this is very frightening for you, but the chance of transmittal is relatively low.

    Does your employer have an EAP? SEEK IT OUT. They can help you get some emotional support.

    Try hard to compartmentalize this. In other words, keep in mind that you are doing everything you can, and that this is a waiting game. Take some deep breaths, and then settle yourself. It make take a few days to get to this point.

    Come to this board anytime you start feeling overwhelmed, and pour your heart out if you need to.

    Find some light reading, or humorous websites for distraction. I love www.icanhascheezburger.com for a quick relief anytime.

    Best wishes in this trying situation. Keep us posted.

  • Jun 12 '10

    I had the same thing happen to me three and a half years ago. My husband (then boyfriend) and some coworkers were the only people who knew. I couldn't bear telling my parents. It was terrible the first few months and taking PEP was an experience that has made me much more sympathetic to non-compliant patients.

    You're not overreacting, but you will make it through this. Your ID doc is right, the risk is very low. I have been tested plenty of times since and have since had a baby. Sending prayers & positive thoughts your way.

  • Jun 5 '10

    That is some of the worst documentation I have ever read. It tells me nothing, yet it opens a whole Pandora's box of possibilities. Misspellings aside, it contains nothing of value to anyone who would read it afterward. They are just notes for the sake of notes. I wouldn't want to have to go to court with only this to back me up.

  • Jun 5 '10

    Keep your communication with the MD office short and to the point, give clinical to back up your reasoning, eg: "Mrs Smith has a reddened area around her stoma 3:00-6:00, directly under the wafer site, no breakdown, no drainage, blah blah blah". Request exactly what you want- if you need scripts, tell them, give product names, etc.
    In the case of the silvadene, if you need to call back and tell them why it may not be appropriate (will interfere with adehesion of wafer, etc). If you really aren't sure or the doc will not bend-- then go ahead and try what the doc prescribed, monitor effectiveness and call back if no improvement.
    I try to remember that I am the patient advocate, and if I'm going to call the doctor 16 times until the patient gets what they need, then so be it!

  • Jun 5 '10

    nicki, great catch!
    if i had been on the floor only a year, and caught such an error, i'd be proud as a peacock, too.

    just remember your own words...
    it can happen to anyone.

    and remember my words:
    it will happen to you.
    no escaping it.

    leslie

  • Jun 5 '10

    Quote from NickiLaughs
    I went to work the other day, Cardiac ICU. And most of the nurses at my work do not do a bedside report. I often will go check the room just to see what state my patient is in, what drips they are on, etc. I saw that my pt's BP was 80 systolic, curious I looked at the lines, saw Levophed was hanging, and checked the bag...which read Azithromycin. Realized that there was no vasopressor hanging on this ladies BP. So even though I had not received report yet, I hit the hold button, and ordered a bag of levophed stat, grabbed the RN while she was still giving report and showed it to her.
    This is an excellent nurse, often works charge and resource, has been around for 10 years and it happened to her. Same with the day nurse who is assumed to have hung the medication. And I, the nurse with a year experience, caught it.
    It was reported and everything is going through proper commands.
    Just wanted to share, hopefully it will help someone else from making the mistake. I often check all my bags multiple times during a shift, see how I'm doing on fluids and plan to reorder new bags early so I don't run out. But it can happen to anyone.
    I had to smile when I read your post. It sounded like you were a newer nurse when I started reading it and bingo! There it was..."I, the nurse with the lesser experience, caught an error that got by nurses who are supposed to be so much more experienced, blah..blah..blah". In fact, I remember making similar comments when I was a young nurse in the ICU's. Your comments really had me experiencing some interesting emotions.

    You see, when I was a young nurse...I really thought I was infallible. I was going to rock the ICU cause I was diligent, kept checking things repeatedly throughout my shift, would NEVER dream of leaving a fellow nurse with the mess I left...yadda, yadda, yadda. The list goes on....throw in any adjective that could describe how great I was and I believed it about myself. But you want to know something? All that checking, all that repeatedly reading of orders wasn't due to diligence..it was due to fear. Fear of killing someone, fear of missing something that would make the difference between life and death for one of my patients. I DIDN'T know it all....and thank God I finally realized that.

    You see, when you started out by saying things like "most nurses at my work don't do a bedside report...I often will go check the room and....check my drips" then you found an error had been made. You stated your patient's systolic bp was in the 80's....You jumped to it and ordered that drip stat and got that nurse who was trying to give you report in there so you could be sure to show her her mistake. Then to add things to the mix you had to go and state how many years experience this other nurse had and that she frequently works charge and is a resource for others..you then proceeded to mention that it was not caught by the other dayshift nurse who also had more experience than you as well. You then tried to wrap things up by saying you posted as a warning to others...so this wouldn't happen to another patient.

    You know what I think? You posted all of this to get some Kudos...and some members here have definitely given them to you. I just can't find it in my heart to do the same. I won't give you kudos for your post because to me, it comes across with a superior attitude on your part..."look how much better I am than these experienced nurses ....I would never do this".

    Let's analyze the situation for a moment..if your ICU is like one of the oh, say 18 I've worked in thru the years, people usually help each other out. How do you actually know who hung that antibiotic as a drip and made the med error? Were you there to witness it? No?... then you can't be sure. All you could have put in an incident report is that when you assumed care for your patient, you found an incorrect med hanging. Was something happening during the day that may have contributed to this situation? I can think of hundreds of reasons that GOOD, STRONG and EXPERIENCED nurses make mistakes every day....as well as INEXPERIENCED, YOUNGER nurses as well. You honestly can't state what happened unless that nurse you got report from told you so specifically..which you didn't share with us. You then go on to pat yourself on the back again because while other nurses on your unit don't do bedside report, you go in there to "check things out". And let's talk about what you did when you did discover the error...you stopped the antibiotic then ordered the correct med. But you left your patient to go get that other nurse to show her the mistake...so you left your patient unattended to do this? And while we're on the topic, you seem to indicate that a systolic BP of 80 wasn't good for your patient...was it wise to leave that pt to go tell this nurse? Wouldn't it have been prudent to call a doc and figure out how long this pt had been off the pressor...maybe it didn't need to be restarted???? And let's face it, with some heart failure patients, a SBP of 80 is great...they may need off-loading to keep function as best as possible.

    I will state there is a lot of information here that is missing...I don't know this pt's diagnosis, vent status, heart status, kidney function...etc. I don't have a clear picture of the overall status so I can't really state that your actions were right or wrong...I did float the questions above to share thoughts I had about the situation. There are a lot of unanswered questions here..but your desire to "share" to me, is, well suspect.

    You know what? If you truly wanted to offer a warning to others regarding the fact we ALL make mistakes...you could have changed the entire tone of your post by doing it in third person. Not making it about what you had done but stating that this situation had happened in your unit and then shared what your unit had done to see that this never happened again. Hmm..that is missing from your post...the process improvement side. Did you sit down with your manager/supervisor, suggest this could be a case presentation for a nursing M&M? Did you propose a change in shift report, one to make it take place a the bedside to ensure these kinds of errors are caught? Did you propose a double check for drips initiated in emergent situations or when bags are changed??? What did YOU do other than post here? That truly reflects a situation where kudos would be given in my book....when a nurse realizes a process needs to change and instead of BLAMING a fellow nurse, helps come up with a solution to fix the situation.

    You did what is expected of EVERY ICU nurse when they come on shift..it's the first lesson you learn in any orientation..you assessed your patient. But when you had the opportunity to throw a touchdown by finding a problem and trying to fix the process, you fumbled the ball and minimized coworkers and fellow nurses by trying to make yourself shine. And really, that's a shame...because, one day...YOU will be the one making a mistake....and hopefully, a coworker will help you out and not tear you down. Don't say you'll never make such a mistake..I guarantee you will. We ALL do. It's how we deal with the situation when we make that mistake that counts. Keep being diligent...keep being thorough...but try to build your coworkers up, not tear them down. We have residents and other docs around that do that well enough......we don't need to add anyone else to that group.

    (I apologize for the length of this post to any who make it all the way through...this post just resonated with me, as you can see.)

  • Jun 5 '10

    My experience with recruiters is that they don't assist with anything. They are less than useless. Blow smoke at her. Tell her you have diverse interests and her facility is so yummy that any unit you worked in would be sunshine. Do not tell her you'd work any job just to get out of your old one. It's the truth, but they can't handle the truth. Play the game. I've had good luck going straight to the unit I'm interested in, resume in hand, and giving it to the manager. That way you can get a feel for both the boss and the staff. Don't give up. Job searching is annoying and at times demeaning but it's what you gotta do.

  • Jun 1 '10

    Hi Nurses, I had bi-lateral mastectomies with many lymph nodes removed from each side.
    Soon thereafter I developed Lymphedema in both arms and across my chest. The danger
    of infection, in my arms and chest, is high.

    Blood draws were from my port-a-cath until BC treatments were completed. From now
    on all blood draws, as well as blood pressure cuffs and IV's are done from my feet. (I do
    not have diabetes.)

    I find foot blood draws far less painful than arm ones. During this 5 yr journey and due
    to other health issues I have dealt with many MDs and Phlebotomists in 2 states. Each
    MD understands, the Phlebotomists are about half yes and half no. I've learned to make
    sure that I have the order, with me, when I go to a lab and to call, the lab, to verify that
    they know what is necessary before I show up and that someone is there that can do it.

    None of this is fun. I did everything right. Mammograms each year starting at age 40.
    One morning at age 60 I wake up with a breast that was totally deformed. I got a
    mammogram that day it came back clear. I went to my family MD who called a
    surgeon as soon as she saw the breast. He said it is cancer, took a needle biopsy,
    it came back clear.

    He was screaming at the Pathologist knowing that my breast was full of cancer. He
    opened the breast, took out some meat, and found that I had a rare BC that is rarely
    detected by any current methods and it had been growing for probably 15-20 years.
    As well as likely to go to the other breast. It was staged at IIIc. The story goes on
    and on but you get the picture.

    So, mastectomies, lymph nodes/glands, then lymphedema.....are we having fun yet???

    I am not in the medical field but my Daughter is an RN. I thank each of you for all you do.

  • May 30 '10

    I just recently had surgery. Everything was great. Exactly as I would have expected it to be. They all knew I was a nurse but did not expect me to know everything about what was going on. They treated me respectfully. I understood everything that was said to me before surgery, so on and so forth.
    Except for one after my surgery. I did not notice this but my husband sure did. I was outpatient so I am not sure what each area is called. I rememeber waking up in PACU and then being transferred somewhere else but it was not the floor. Recovery maybe? (may have dreamed it too, who knows
    At some point I asked for water. I had some nausea but I just wanted a sip to get rid of my dry mouth. That was what my mind was focusing on. Due to obvious reasons I was not totally with it. I had just woken up. Well my husband asked the nurse if I could have a sip of water and her response was rude to him. "Certainly not and she is a nurse and should know better". Luckily he reinforced the fact that I just woke up and not exactly in a nurse frame of mind. Other verbal exchanges took place that I just do not remember from this same nurse. (My hubby has not said what else happened. He just wants me to get better)
    I was clueless at the time. I may be a nurse on a surgical floor but how much did she think would carry over while in a drug induced haze. Eventually I felt better and my mind became clearer but still I was groggy. I just had major surgery. Nothing was obvious to me.
    I usually give my pt's lots of reinforcement just in case something did not sink in after arriving to the floor from PACU.
    Now I know there is alot of room for misunderstanding. I now can use this experience to help my pt's.
    I have seen many nurses make comments about their pt like, "they should know better." At times I have asked the nurse if they have been educated. Most times the response is "they already know, it's obvious"
    This surgery will help me be a better nurse for my patients.

    When I go back to work I will keep in mind what happened and try and be patient with my patients.

  • May 30 '10

    Quote from Da_Milk_of_Amnesia
    baha yes i did, I love how people automatically assume I'm a female and I'm not..ahhh the stereotypes of the nursing profression...wait i bet you think i might be possibly gay or not smart enough to get into medical school to? bahahah lol


    I read your entire post & I figured out you were male. I also figured out you weren't gay because you stated you were out with your girlfriend. But, I also picked up that you are probably pretty young (ie: immature). Living at home with parents, treating them very disrespectfully with your language and tone & not having the guts to professionally tell this caller to knock it off. It all seems pretty simple to me.

  • May 30 '10

    i worked doing home care and forgot to block my number one morning when scheduling my stops... well of course my phone rings at 9:30 on a saturday night calling to say that patient's dressing is oozing a lot of fluid and could i stop by and check it and change it. I politely told the caller that i was no longer on duty and if they were concened they should call ems and go to the hospital. I also told them not to call my home number again and that any urgent calls should be made to the agency. She was a little indignant when i told her that but i just calmly repeated the message and assured her i'd call the agency and report the issue.
    Bite the bullet and take the call and set them straight - if they persist then take action.

  • May 30 '10

    Just out of curiosity, why have you not just answered the phone and clearly explained your professional boundries and tell this guy that all further health related questions need to be directed to his doctor & to please not call your number again?

    Then if he continues to call then I would alert the hospital and probably the police as well.

    At this point it seems to me like you're freaking out for nothing and being a little unreasonable with your family.

  • May 26 '10

    i don't agree that she is necessarily evil...more like, miserable.
    and we know how that goes...

    you need to call her on it.

    leslie

  • May 26 '10

    It is not acceptable for a nurse or any person in medical field to tell the patient that her coworker did not do a good job. It is a hospital policy, that we should never tell the patient that the other nurse is lazy, she doesn't work hard, she did not do much for you etc. What I hate the most is when they tell you face to face that you are an amazing worker with great personality and once they leave your sight they complain. I wonder how some people become nurses when they have no warmth in their heart. Just ignore those miserable people and keep doing you job. You are right, when a patient complains about a nurse that was previously taking care of that patient, you ask what happened?What bothers you? Is there anything I can do? But you do not support the patient's opinion for that particular nurse. When I first started working (first day at work) a person complained to my director instead of coming to me and telling me that I was doing something wrong. Some people just don't like to help or they have nothing better to do but complain.


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