Everything went crazy

[Anony123465]

So at change of shift transport comes to pick up my patient , well I was never made aware transportation was set up I was still waiting for my patient to get placement at a snf. And as I am giving report on 1 of my 4, transportation is waiting . No paperwork is ready. So now I have to give report and do all the discharge paperwork for a snf which I've never done before .I start doing all the paperwork and after a hectic mission complete it.

Then the new nurse helps remove the iv and tele box . I was told specifically the iv was a iv but when it was removed it was a central line way to long to be a iv. No big deal .possibly ?

Now as I am at home all I can think was he supposed to go with iv antibiotics ? Did he need that central line . Rookie mistake I dont remember is he should've gone home with any?

Is this a big mistake cause the snf would send him back if he needed iv access right ?

I'm sure I will double check next time any advice I feel down for forgetting to check something simple

[Nurse SMS, MSN, RN]

Removal of a central line is a somewhat risky procedure, so there is definitely a difference in the process of removal, as it needs to be done in a way that prevents an air embolism. Get with your educator or charge nurse to review the process. Don't worry - had that happened, you would have known about it pretty much immediately. There is also an in-between line called a midline, which isn't an IV but isn't a central line. The length of the catheter should help you know which it was. Hopefully you charted the removal. For what its worth, you should have known by assessing your patient and reviewing the chart what kind of line your patient had. Details like this matter - don't start your shift without being aware of your LDAs. You really should have been told all about the line when you got report and you should have verified it both on your patient and in the chart. Attention to details and time management will come - keep working on it.

It is unclear to me how this happened. Did your patient have discharge orders? If so, you probably should have had some idea what those orders were. This is the kind of skill that comes with time and experience - the kind of experience you just had. Its okay. Next time, review those orders when they come in and make notes for yourself if needed, so that when/if the poo hits the ceiling device, you aren't completely off balance. Someone else dropped the ball in not informing you transport was ordered - primarily your charge nurse I would think, or the social worker/case manager depending on your facility. That being said, everyone gets caught in the muck sometimes. This is the kind of situation that can be mitigated by being prepared. You weren't, but if you are new to nursing, that's not surprising. Take a deep breath. Its okay. Next time, take the time to review those orders before releasing the patient to transporters.

If he had orders for IV antibiotics and came without a line, they will either change it to PO or they will send him back to the hospital. I want to say that most SNFs will not take a patient with a line, but I am not 100% sure this is accurate. My memory is telling me a patient in need of a line goes to LTACH, not SNF.

This was a learning experience. You will grow from it. Chin up.