Ahh how ironic I just saw this post.
My pt. came from the cath lab right smack in the middle of shift change at 1900. I knew the pt. was comming from the cath lab with an 6fr. arterial sheath in the right groin. No prob. I pull Arterial sheaths all the time on my floor.
Recieve the pt. check the groin, and I go to draw the blood from the sheath for labs and an ACT. I notice that there is no cap, nothing cap wise or even a flush attached to the sheath, which is odd b/c there is always a cap on the top port and every sheath we have has one, and the side port always has a flush attached or a cap. A flush is usually attached b/c if the stopcock accidentally opens during transport as long as the top port cap is inplace and the flush is in the side port, there would be no open ports for the blood to come rushing out if the stopcock were to open.
So anyway I knew if I were to turn the stopcock that blood would be spirting from the 2 ports b/c both ports are uncapped. I get a cap , draw my labs, do my ACT call the cath lab and ask for the nurse who took care of the pt. in the holding area. The pt. was trying to get up and walk with the femoral sheath sutured in,I had to explain that the pt. had an arterial sheath in place and blah blah blah, drew a picture and what not pt. understood, and I put an imoblizer on the leg per MD's orders to stop the pt. from bending the leg untill I could pull the sheath.
So I call the cath lab and talk to the Nurse. She tells me, she is new, "oh I just threw it out after I did the ACT before we sent the pt to you r floor.." Ok she's new, I know how it is being new I am only 11 months in to my first year.
I explained to her that the cap ALWAYS need to remain in place, not in a mean way b/c I can't be mean if I tried. She was so upset, I said to her, "It happens, don't freak, the cath lab is a crazy busy place, you are new. If the cap is off with both ports exposed and the pt. is moving or squerming the leg with the sheath sutured into place during transport to the floor and transfer into the bed the stopcock can be affected and open and the pt. can bleed from both ports at the end of the line. If the cap is in place at the end of the line, and the pt. were to bleed b/c the stopcock was affected by movement it would only come out of one of the ports if no flush was attached, it would still be a mess but something that I can handle quickly. So don't freak, just remember for next time not to throw the cap away, let's put it this way we should only have access to one port and the other to be capped. And if you do throw the cap away just grab a new one. It happens."
She said, "thank you so much for being so understanding and explaining the situation to me and for being so nice, I did this the other day and another nurse on your floor ripped into me after the pt. got to your floor and didn't explain why, she just was screaming at me for being so stupid and didn;t tell me what I did wrong, but now I know what I did and now I know that the cap needs to stay on"
I said, "welcome to nursing, and if someone ripps into you don;t take it personal, eventough we do, ask them what happened and if they don't want to tell you, then you ask to speak to the charge nurse.." I said "Good Luck and if you ever have any problems with the night shift nurses on my floor giving you crap, ask to talk to the charge nurse or to me, I am one of the night shift nurses on this floor. I deal with the crap all the time and have become pretty good at defusing these situations." She laughed and said "thanks so much and I will ALWAYS remember to keep the cap in place and not throw it out"