Uncomfortable with new equipment

[Kristie71]

Hello all!

I have posted here only a few times, and I'm in need of advice again! I love my job at a daycare facility for special-needs children, but a situation has come up this week that is really stressing me out.

We enrolled a new client this week. This little guy has a PICC line on a continuous KVO rate with intermittent "bolus" infusions of his antibiotic. This all runs on auto-pilot via his "Prism" pump. Now, we don't deal a whole lot with IV's, but I am totally comfortable with maintaining a PICC line, dressing changes, etc. And this is the stressful part...this kiddo was admitted, his mom was told everything was handled, and his home health nursing visits were cancelled. This home health nurse was supposed to come out and inservice the child's mother and me on this pump. I have NEVER operated a pump like this before, and now I'm supposed to do the bag and tubing changes as per the routine home care orders. My DON did this admission, made promises, and cancelled procedures without ever asking my comfort level with this. Oh, and I need to mention that I am the only RN in the facility while this child is there.

I am so angry with management at this point. Like I said, we don't deal with IV's very much, and I worry about my liablility if I start messing with this piece of equipment that I have never been properly trained on. (Our policy is that the family and/or home health provide all equipment, we do not own anything ourselves.)

Am I just being a whiner? Does anyone else think that my DON was out of line just a little bit? Home health is coming tomorrow to instruct me, so I hope this all gets ironed out then. Can anyone give me advice on how best to deal with a manager who I can't trust from now on?

Thanks,

Kristie

[Zee_RN, BSN, RN]

Nope, you are NOT a whiner. Were you to screw up (which I doubt), they would hold YOU responsible for taking an assignment that you were unsure of. Insist on education.

[semstr]

No you are not a whiner, I would have my pants full too!

Can't you tell your Don to take care of this child herself?

[nur20]

YOU ARE 100%, ABSOLUTELY CORRECT. PROTECT THIS PATIENT!!!! PROTECT YOUR LICENSE!!!! I HAVE FREQUENTLY BEEN CALLED UPON TO WORK WITH VENTILATORS AND THIS IS A WEAK POINT FOR ME AND I DON'T FEEL COMFORTABLE. I NEED MORE TRAINING IN THIS AREA. I HAVE ALSO BEEN CALLED UPON TO DO PROCEDURES ABOVE AND BEYOND THE SCOPE OF MY LICENSE, AND EVEN IF I KNOW HOW, I WILL NOT DO IT.IT IS NOT WORTH THE LOSS OF MY LICENSE OR HARM A PATIENT

[Slowone]

Get the phone number of the medical supply company that supplied the equiptment or even the number of the manufacture.(it will be right on the pump of course) Give it to your supervisor and suggest that she call them to ask about an on site inservice for your facility as well as the family.

Sometimes the companies will send out video instruction as well.

I can't beleive that your DON hadn't already done this, very irresponsible!!!

The family might want to have the number as well..it sounds like your DON isn't very pro-active and they might be better off handling it themselves!

Scary!

[CATHYW]

Good reply, NUR20! NOTHING is worth harming a patient, or endangering your license! As far as the DON goes, maybe you could suggest implementing a policy or changing your existing one to where a patient (on special equipment) will only be able to come for their first day of care after an orientation visit to the facility, or you to the home, to coincide with a visit from the home health nurse. What would you do if this marvel of technology malfunctioned? Would you be expected to troubleshoot a piece of equipment you had never used? Not cool. Keep us posted on how this plays out. Good luck!