I work on an acute medical elderly care ward, several weeks ago I came onto a night shift and one of my patients, who had been with us for several weeks, had had a chest drain inserted that day due to a pleural effusion.
At handover there was 400ml in the canister, it was not swinging or bubbling. I checked the drain with the day nurse; the 3 way tap was open, there was fluid in the tubing and we went over the care plan.
By 11pm, the drain had not drained any further fluid and was still not swinging/bubbling. I informed the nurse in charge who advised me to finish the routine work and then deal with issue (patient was saturating on room air, no breathlessness).
I discussed with a nurse on a respiratory ward (we do not normally care for surgical patients or chest drains) they advised it can be normal for the chest drain to stop swinging/draining and that action may be to flush the drain.
I discussed with FY1 on call (junior doctor), they advised that they would not take action overnight and to continue to monitor. Also discussed with the critical response nurse who advised the same.
I continued the obs on the drain (not swinging/bubbling or draining) and the patient stayed saturating on room air/no breathlessness throughout night. Handed over to day team.
When I came back the next night, the day team stated at the board handover that the chest drain had not drained anything overnight as it had been CLAMPED closed. The other nurses at the board were saying how terrible and dangerous that was. When i took the bedside handover, tbe nurse informed me that the matron had come to check the drain during the day shift and the 3 way tap was at a 30 degree tilt from the open position, as though it had been knocked. However, with tap in position, there had been no further fluid drained from the original 400ml and the drain was still not swinging/bubbling. I had not checked the 3 way tap that morning before handing over however I feel it is very unfair for the nurse to have stated that it had been closed and that's why it wasn't draining.
The repeat xray showed that the effusion had been drained and then the drain was removed.
I know the most important thing is that no harm came to the patient, however I feel very anxious at work yhat my colleagues see me as someone dangerous and incompetent that would not pick up on something like that.
Would you feel this way about a colleague in this situation?
The senior nurse approached me to ask what I had done about the drain not draining the previous night, I told him and he advised I should have escalated to the registrar (senior doctor) to review. He stated I had not done anything wrong but I feel he said this because he could see I was worried as I later heard him talking to the ward sister about it being 'clamped' overnight and them both shaking their heads/shocked at how terrible that was.
I work on an acute medical elderly care ward, several weeks ago I came onto a night shift and one of my patients, who had been with us for several weeks, had had a chest drain inserted that day due to a pleural effusion.
At handover there was 400ml in the canister, it was not swinging or bubbling. I checked the drain with the day nurse; the 3 way tap was open, there was fluid in the tubing and we went over the care plan.
By 11pm, the drain had not drained any further fluid and was still not swinging/bubbling. I informed the nurse in charge who advised me to finish the routine work and then deal with issue (patient was saturating on room air, no breathlessness).
I discussed with a nurse on a respiratory ward (we do not normally care for surgical patients or chest drains) they advised it can be normal for the chest drain to stop swinging/draining and that action may be to flush the drain.
I discussed with FY1 on call (junior doctor), they advised that they would not take action overnight and to continue to monitor. Also discussed with the critical response nurse who advised the same.
I continued the obs on the drain (not swinging/bubbling or draining) and the patient stayed saturating on room air/no breathlessness throughout night. Handed over to day team.
When I came back the next night, the day team stated at the board handover that the chest drain had not drained anything overnight as it had been CLAMPED closed. The other nurses at the board were saying how terrible and dangerous that was. When i took the bedside handover, tbe nurse informed me that the matron had come to check the drain during the day shift and the 3 way tap was at a 30 degree tilt from the open position, as though it had been knocked. However, with tap in position, there had been no further fluid drained from the original 400ml and the drain was still not swinging/bubbling. I had not checked the 3 way tap that morning before handing over however I feel it is very unfair for the nurse to have stated that it had been closed and that's why it wasn't draining.
The repeat xray showed that the effusion had been drained and then the drain was removed.
I know the most important thing is that no harm came to the patient, however I feel very anxious at work yhat my colleagues see me as someone dangerous and incompetent that would not pick up on something like that.
Would you feel this way about a colleague in this situation?
The senior nurse approached me to ask what I had done about the drain not draining the previous night, I told him and he advised I should have escalated to the registrar (senior doctor) to review. He stated I had not done anything wrong but I feel he said this because he could see I was worried as I later heard him talking to the ward sister about it being 'clamped' overnight and them both shaking their heads/shocked at how terrible that was.