Feeling ambivalent about decision

[MJane29]

To provide a little background, I am currently a junior (2 semesters remaining) and am currently on the pediatrics unit for clinical. I had a somewhat difficult day yesterday, as my 7-year old patient was quite complex. The day culminated in a moment where my clinical instructor asked me to retrieve a soiled diaper that I had erroneously thrown away earlier from a biohazard bin in order to weigh it. I did make two attempts at retrieving the soiled diaper, as I certainly did not want to tell her no. Unfortunately, the diaper was so deep in the bin that I would have had to submerge my entire arm (up to top of my rotator cuff) to retrieve it. I suppose this just felt completely unsanitary and more importantly unsafe to me in that moment. I decided that I simply didn't feel comfortable retrieving it. My plan was to communicate my concerns with her before she had to ask me about it. However, I was so busy and overwhelmed by the tasks of caring for my patient that she followed up with me about it before i had the chance to approach her. I told her that I was unable to retrieve it, as I felt uncomfortable with the idea of submerging my arm up to the top of my rotator cuff. It is very possible that I misread her, but she looked a bit perturbed. It may be worth noting that the patient's orders did not include an order to weigh diapers and when I checked the chart, I found that only one diaper weight entry had been recorded since admission. However, I made sure not to repeat my mistake and saved the subsequent diaper for weighing. Maybe I am just neurotic, but my question is, was it wrong of me to tell my instructor that I was uncomfortable retrieving the soiled diaper from the biohazard bin? Did I make the wrong choice? Should I have retrieved the soiled diaper? Has anyone else had a similar experience? :-/

[BittyBabyGrower, MSN, RN]

We have to dig out diapers many times when parents ditch them. And that must be a huge bin to be that deep, ours are like yard waste size.

Was there a reason that would lead her to want to weigh the diaper? You do not have to have an order to do this, especially if there is a reason to be concerned about I/O's. On our peds floor it is in the routine care protocol that anyone on IV fluid is strict I/O. Also, if kids aren't eating/drinking enough, vomiting, or are Failure to Thrive. Make sure you know your floors protocol, if it is in there you don't have a formal

order as that is a given on that floor.

[MJane29]

Good points...thank you! I honestly think the reason she wanted me to weigh the diaper was primarily due to the fact that the patient had been admitted for a fever and intermittent vomiting. Perhaps less relevant, but I also believe that my instructor is very vigilant and tends to go above and beyond in everything that she does, which is a wonderful quality. The patient did spit up a little bit (quarter size worth of spit up) while I was on the unit, but had not vomited in 24 hours. Yes, you are correct, the bins are quite large and very deep. :)

[BittyBabyGrower, MSN, RN]

Better over vigilant than under! Always check your protocols, don't be a follower on what others have done, good way to get stung up!