Iv infiltration on Pediatric patient

  1. Fellow nurses: I had an Iv infiltrate on a pediatric patient and didnt discover it. The nurse whom I gave report to found it on her morning rounds. I got written up and a three day suspension . I feel terrible . I have been a nurse for over twenty years and this is the first time anything like this has ever happened to me. What do I do now? How can I regain my reputation? I will be surprized if I am able to keep my job! Any advise out there ?
    •  
  2. 12 Comments

  3. by   fergus51
    Unfortunately this kind of thing can happen to even the best nurse. I don't think there is anything for you to do now other than be extra vigilant with IVs in the future. I can't imagine you be fired for this if it was your first incident. Are you a nurse in Ontario, Canada?
  4. by   MamaTheNurse
    oooh - I feel your pain - I did the same thing once - almost lost my job because my boss was out of town and the manager covering for her wanted me gone, like yesterday. lucky thing that some of the other nurses and the house supervisors stood up for me........ I don't think your reputation is totally trashed - you are not the first nurse to mess up - let your 20 years speak for themselves - you took your punishment, now just make this incident the one that makes you more hypervigilant than ever with peds with IV's ......I hope all goes well for you....
  5. by   saskrn
    Pediatric or not, infiltration is just a common risk, and can happen quickly and easily. I am surprised that you got written up for this. Unless the area was doubled or tripled in size?

    I hope you charted your IV checks, etc, to CYA.
  6. by   Bettybooppp...
    Ontario, The same thing happened to a fellow nurse I was working with over one year ago now. Unfortunately no one at the hospital stood up for her except for me. She was fired the next day. About a year later we both received letters in the mail from the board of nursing. (This is in Oklahoma.) She was given an extremely hard sentence. 3 months suspension, 2 years under another RN in a hospital setting, (which after this happened she was devastated and has been working in a dialysis center.) A $1500.00 fine, and required to attend 6 classes on varying nursing courses at an (approved by the board school) which is approx. 90 miles from her home. She was an LPN at this hospital for several years, she received her RN about 6mos before this incident happened. Because I was working with her that night and hung a bag of D5 1/4 ns at 2230 and helped her retape the site at approx 0300, the board wants to fine me $1000.00 and have me attend 4 classes at the same location. My fellow worker hired an attorney and got the sentence reduced to $1000.00 fine and one year under another RN. She is still required to attend the classes, which by the way, have to be completed in a 90day period, and she still received 3mos suspension which starts Feb 1st. Fortunately, the company she is with now is supportive and allowing her to continue to work as a CNA. I am impressed with her determination to continue to do what she loves(nursing.) I, on the other hand, (not receiving any punishment from the hospital) upon receiving this news from the board, went directly to the higher ups in the hospital and after stating my case the second time (very plainly) have received free legal counsel through the hospital. I am still preparing my case with my lawyers D/T the fact I am not willing to accept such an off the wall scenerio. Sorry to go on for so long and the last thing I wanted to do is cause you worry. I hope all goes well for you. I think the fact that your facility is willing to stand behind you counts for alot. Mistakes happen. Anyone who is williing to pay all that money and incredibly stressful amount of time to complete school, make less yearly then a fast food manager, because they have a love for people deserves compassion and support in a time like this. God speed. Bettybooppp...
  7. by   vamedic4
    Quote from Ontario
    Fellow nurses: I had an Iv infiltrate on a pediatric patient and didnt discover it. The nurse whom I gave report to found it on her morning rounds. I got written up and a three day suspension . I feel terrible . I have been a nurse for over twenty years and this is the first time anything like this has ever happened to me. What do I do now? How can I regain my reputation? I will be surprized if I am able to keep my job! Any advise out there ?
    Could anything be any more petty or pathetic? Seriously, a three day suspension??? This is overkill, to say the least.

    Yes, we're out to ensure patient safety and patent IV access...but as an expert at IV assessment I can assure you that it's still difficult at times to truly tell if one is in or not on some patients. I am terribly sorry for your predicament. I could understand if it were something like D50 that infiltrated...but even then, as another poster put it - IV infiltrations can happen quickly and without you realizing it. Kid moves his hand the wrong way or some IV tubing gets pulled and WHAM!! No more patent IV. And if his fluids are only running at 16cc/hr, it'll be awhile before you notice it's infiltrated anyway.
    Now? You just keep doing what you've been doing - no one here needs to remind you to check your IVs frequently I'm certain. If you have questions, call another nurse to help you with your assessment. 4 eyes are better than two in many cases.

    3 day suspension. What a bunch of BS.

    Best of luck to you.

    vamedic4
  8. by   AprilRNhere
    Good luck to you.

    As far as in the future....my preceptor (CCU charge nurse) gave me advice with peds and IV"s. She told me to always set them with only enough fluid for 1-2 hours at a time. That way it will beep when done..and I'll always remember to go back in and check no matter how busy.

    I hope all goes well when you get back to work.
  9. by   Bettybooppp...
    New to allnurses just checking to make sure this makes it to the forum before responding.
  10. by   vamedic4
    Something we just implemented on our unit (to hopefully prevent the situation you so unfortunately had to endure) is for the offgoing and oncoming nurses to assess IV sites together at the bedside. This goes a little further in ensuring patent IV access on little ones. The theory is that 4 eyes are better than two, it just depends on each one's experience with IV assessment.

    Something to consider.

    Best of luck.

    vamedic4
  11. by   chubbsrn
    our policy is qhr iv checks. Don't feel bad like others said IV infiltrates happen and if this is your first serious case in 20yrs of nursing, need I say more...think of it as a learning expeirence and now be more cautious. Suspension??? i think thats crazy. If the right steps were taken to decrease any s/s of the infiltration I don't feel that such harsh steps should be taken....don't know if you could tell me but what hospital is this???
  12. by   Nurse K8
    Sorry to hear this Ontario.

    As a new nurse, this is the kind of thing that terrifies me. Is that sort of "punishment" common for infiltrating IVs? Does it happen often? I saw one infiltrated IV in nursing school and the nurses acted like it wasn't a huge deal. They just DCed the IV and restarted it in the other arm. Was this more of an issue becuase it was a peds patient?

    Kate
  13. by   Bettybooppp...
    Thank you for continuing to E-Mail me. It has been a while since my first thread. I would like to give some encouragement by letting everyone know that It is not as impossible to fight for your rights with the board of nursing as everybody seems to think (everyone I spoke with anyway.) I am refering to the situation I had first disscussed about the RN I was working with that had a ped pt with an infiltrated IV, about how she lost her job and the board of nursing was tryng to implement me as being responsible also, (although it was not my pt, and the hosp where I work, the LPN'S and RN'S each have thier own pt.) To make a long story short, the hosp where I work did stand behind me and their lawyers were wonderful. They understood that I had nothing to do with what happened that night and were willing to take the case to court if need be, to clear my name. In the end the board dropped the whole thing and I can now continue on with what I love, Nursing.:angel2:

    "My personal opinion. Go with what you believe in your heart, stand up for your rights and although things may become overwelming and very scary at times. Have faith in God and know he is on the side of truth."
    Last edit by sirI on Aug 5, '08 : Reason: merged post
  14. by   Bettybooppp...
    Kate, IV infiltrates happen all the time. What makes ped infiltrates so different is that they can happen quickly and since infants have alot smaller body and cannot tell you if the site is hurting they need to be checked hourly and the parents need to be informed on what to look for so they can notify the nurse in between that hour time. once the intial infiltrate takes place they say the tissue in the body becomes more flexible and the infant may not show signs of pain. once it has gone past that point necrosis can set in and even compartment syndrome. Although it sounds very scary if you are faithful to do your job and check the site hourly It is nothing more then any responsibility as a nurse.

close