Any advice about fingerstick?

[8Lovenursing8]

Over the weekend, I was giving a patient a insulin injection using an insulin pen. She was upset and fussing at me nonstop (just how she is)

I have been with this job little over a month.

Anyway, when I got finished I sat the insulin pen on top of a hard surface and used the scoop method to ease it into the cap using one hand. I didn't touch the cap. I assumed the cap was on and when I went to the sharps (no sharps container in room) I felt a sting and looked and my finger was bleeding. The needle had bent sideways through the cap.

I was shocked but went and washed my hands and tried to bleed it as much as a can and then dried them and used alcohol sanitizer.

Now throughout nursing school, I learned to not recap..I felt I didn't.

But my nurse manager is really getting to me, like knocking me when I'm down.

She has put me on the spot and emailed me cc everyone telling me over and over how I shouldn't have recapped a needle and I accept responsibility. But was it safe for me to carry a uncap needle in the hallway?

I got tested for HCV, HBV and HIV.

I'm scared and too ashamed to tell anyone, this weighs on my head everyday and when I go to work. I feel very incompetent. Any advice?

[KrysyRN, BSN]

No, it definitely wasn't safe to carry an uncapped needle in the hallway. I haven't looked, but there must be an OSHA regulation regarding placement of sharps containers in healthcare facilities [specifically addressing the need for one in each patient's room] to minimize needle stick injuries.

I worked in a hospital a while back that only had one sharps container in the semi-private rooms, and the container was placed next to one of the beds. That meant it was a very careful walk to the sharps container after giving an injection to a patient in the opposite bed. I asked my manager if she would consider putting a sharps container next to every bed in the semi-privates, and lo and behold, she did, and did so rather quickly. Who knows how many needle stick injuries were prevented from doing this.

Consider asking your manager about doing this. You should not have had to carry that needle outside of the patient's room to get to a sharps container. I don't think the responsibility for your injury is all yours.

[TruvyNurse]

I agree with the above poster. You should never carry an uncapped needle around out in the hallway but you had no where to dispose of it. If I know a room doesnt have a sharps box ahead of time, sometimes I'll carry one of those little portable sharps containers with me. Best of luck!

[blondy2061h, MSN, RN]

Your facility should be providing sharps containers in every room AND safety sheilding needles.

[8Lovenursing8]

Thanks everyone,

I think one of the issues are I go to different places staffing wise and never really know what tools I have. I saw the Dr and my baseline tests are negative. The patient is refusing to have her blood work drawn. The Dr scoleded me for capping the needle he said I should've walked out to the hall with it uncapped and disposed of it.

[cleback]

Sorry but that doc is stupid for scolding you. Recapping is no more unsafe than carrying a dirty exposed needle in a hallway. You should have had access to a sharps box in the room or at least have had a safety needle. I don't know why we continue to blame the healthcare worker for poor systems.

[8Lovenursing8]

Sorry but that doc is stupid for scolding you. Recapping is no more unsafe than carrying a dirty exposed needle in a hallway. You should have had access to a sharps box in the room or at least have had a safety needle. I don't know why we continue to blame the healthcare worker for poor systems.

Thank you!

I just feel so awful. I own my mistakes but I was in tears today. Thanks you guys for the support!!

[kp2016]

Any time I think I may be forced to carry a sharp I utilize a disposable kidney dish.

[Horseshoe, BSN, RN]

Anyway, when I got finished I sat the insulin pen on top of a hard surface and used the scoop method to ease it into the cap using one hand. I didn't touch the cap. I assumed the cap was on and when I went to the sharps (no sharps container in room) I felt a sting and looked and my finger was bleeding. The needle had bent sideways through the cap.

I was shocked but went and washed my hands and tried to bleed it as much as a can and then dried them and used alcohol sanitizer.

Now throughout nursing school, I learned to not recap..I felt I didn't.

What do you mean you "felt you didn't" recap? You did recap the needle, using the scoop method, which is considered a safer way to recap a needle. Yet obviously, "safer" doesn't mean completely without risk, as your experience clearly shows.

I don't say this with any judgment at all, as I did the EXACT same thing once when my patient's room was filled with family members. That needle went straight through the cap but I didn't realize it until I was stuck.

I thought it was some kind of OSHA requirement that every patient room have a sharps container. Could it be that your manager is trying to deflect blame from the facility for not adhering to OSHA regulations by putting all of the responsibility on you?

Odds are that you will be fine. I was too, but I understand your concern.

[Miss.LeoRN]

I thought all needles had a safety switch or guard on it you're supposed to activate once it's used? I am only asking because I've never come across a needle or used one that didn't have this feature, and that would require recapping after having used it on a patient. The only time I've scoop-recapped it when after I've set up the injection and brought the needle to the bedside, as to not walk into the room and approach the patient with an exposed needle. I have heard from my coworkers to keep an eye on doing that because sometimes the needles bend out through the cap, but I've never dealt with a needle that didn't have a safety feature post use to risk being stuck.