So yesterday on a med-surg floor I had a patient that had been admitted at 0200 (shift before) (I was day shift) for a SBO (or according to OR nurse possible SBO). The nurse who gave me report said the patient's NG was on susction and was only suctioning out a small out of green drainage in the tube. I checked the tube and she was right- the patient only had green fluid in the tube. I checked and rechecked the suction equipment- It was on. I gravity drained the tubing into the canister for accuate #. Throughout the day the patient complained of a little back pain, but mostly pain from the tube and throat. She hated it. She said it really irritated her nose/throat/ear. Throughout the day I asked several nurses if it was common for there only to be fluid in the tubing and it barley coming through the cannister. My charge nurse said yes. The patient denied pain/nausea in her abdomen, and I continually kept checking the cannister. The surgeon consulted came in the afternoon and consulted the patient for a exp. lap. That evening- around 4:00 I was still feeing strange about the cannister. I asked another RN walking by (another new grad) to look at the suction. By that point I collected 100ml in the cannister. She said it was normal- but then said wait- the switch on the cannister that said suction was turned to off! But the suction on the wall was operating! I felt HORRIBLE. I turned it on immediatly- and the tubing cleared. A few hours later- about 6:45 almost 400ml had been collected (for the whole day!) The patient was NPO all day- and her stomach was not getting any more distended... thank goodness!
So all in all- the night shift nurse did not hook up the suction properly and I didn't notice that the little white switch wasn't turned to on untill the afternoon- only a few hours before surgery. The nurse that helped me out said it was okay- because it will drain it all out, and that I won't ever do it again. I told the NOC shift nurse- and she laughed and said happens all the time.
I am still feeling horrible over it.... all because I didn't notice the stupid little switch. And all because I should have told the nurses earlier that I wanted them to look at the NG drainage.
I work in an enviorment where most of the nurses are so helpful- but the manager is not. Yesterday I asked her to read two words of two orders because I couldn't read the doctors writing and she said to me: "Are you not your normal assignment today--- is that why you have been bugging me all day?" She will yell at you in front of other nurses and patients- and has called me into her office for doing something I didn't do. She confused my name with another nurse- and never apologized. I'm terrified of her.
So what to do? All I know is I will ALWAYS check the suction switch and equipment even if the NOC nurse set everything up! I asked the RNs if I should write myself up or do anything and she laughed and said don't worry you won't do it again- and you didn't set it up. Should I tell my unsupportive mean manager?? Thankfully the patient was okay- and tolerated the suction after it was officially turned on correctly. She still complained of throat, back, and nose pain. No change. No decrease in distension.
Blah... Guilt! Thanks for letting me Vent! I hate making mistakes... i'll never do it again. Note to ALL nurse: Always check another nurses set-up. Understaffed, exhausted, with not enough CNA's and a work clerk- all nurses make mistakes.
Specializes in future OB/L&D nurse(I hope) or hospice.
I am still a student, but to me it seems you possess one of the most important "skills", and that is intuition. You listened to that inner voice. That is amazing!! God Bless.:)
Honey, I'd been working in acute care for YEARS before I realized that there was an off switch.
Why do I know exactly what you were talking about? B/c it took three experienced nurses to figure out why my pt's NG wasn't draining right. None of us had ever seen the sx switch turned to off like that before...honestly, why is it even there? So no worries...you and I (and all those other nurses) will really look like we know what we're doing when someone else has the same problem and comes to us for help!
You are a very good nurse, that is clear from reading your story. As a nurse of 15 years I see two problems that should be addressed. 1st, the orientation process should be more thorough, including every little detail of the equipment we are expected to know so well. Someone (the preceptor, the educator) should have taught you about that little switch on the NG suction set-up at some point during your orientation. Secondly, managers such as yours shouldn't be allowed to treat new grads the way she is treating you. Any manager who uses intimidation is not a good manager, she is not making you feel at ease, and this in my opinion diminishes your ability to be a good nurse. I'm sure you feel hesitant to ask questions in front of her or to admit you aren't sure about something. I think managers like her (I've had the same experience as you) are bad for the profession. I wish there was something that could be done or that I could give you any helpful advice. Good luck with your career. You really shouldn't worry about the 400 cc that was in your patient's stomach, I don't think it caused any harm for the patient.
Nothing happened but LEARNING and growing! We all learned. Now you know and can teach others! You sound like a very good nurse already! Congratulations!
First of all I'm so happy that you're so good with going with your gut. You knew something was up and you kept at it and at it until you got help. Dont' worry you learned from this and it's all okay. I would just take it as a lesson and move on. Seriously you're fine and if I'm ever in Med Surge I'd want you as my nurse.
kool-aide, RN
594 Posts
Good analogy.