Last night I accesed a port with a 20 g Huber needle, I had excellent blood return and it flushed great and I connected her IVF's. Well, 5 minutes later it was occluded. I was in another patients room so my CN went in to assess it. The CN noticed that the tubing had blue material in it, it was brought to the patient's attention. Of course "she couldnt see anything". The CN came to get me so I could go take a look at it and remove it. When I entered the room, the patient had already rushed and removed the needle herself and placed it in the sharps container before I could see it. She said that the CN told her to remove it! Now pleeeeaaaaaase, come up with something better than that! Now, I had admin Percocet just 5 minutes prior to all this transpiring. She had crushed that percocet and pushed it in her port! (she used to be a nurse, but her license had been suspended. Im suspecting drug abuse). She HAD to dig a flush out of the trash to do this with. Well, we pulled that needle out of the sharps container along with the previous one. Both had dried material in them. We saved them to show the physician on rounds this morning. But I left before they hit the floor. All night long, I was pushing Dilaudid and Phenergan. Finally I made her NPO. I told her that if she is that sick, then she doesnt need to be eating. (her admission was abd pain and n/v). The physician knows, he had written an order previously in all caps and LARGE print..."NO IV NARCOTICS", but then changed it the next day. I felt like a legal drug pusher last night. Then I had a cancer patient who was in miserable pain, with minimal pain control meds. I hate my job!
Specializes in rehab, antepartum, med-surg, cardiac.
Oh my goodness! She must have a death wish.:selfbonk:
We had a patient years ago that had numerous central lines that had become contaminated with stuff like e-coli and enterococcus. The doctors finally figured out she was contaminating her lines with stool. I think her diagnosis ended up being Munchhausen's.
So she put the percocet in her filthy mouth with tons of germs....... cheeked it ect....... crushed it up and put it in a dirty (from garbage) syringe flush with probably tap water and injected it? Holy crap! So many ways to have a bad outcome there. Not to mention injecting intravenously a med that is supposed to be oral with fillers and binding agents in it that will never dissolve......
Specializes in Day Surgery, Agency, Cath Lab, LTC/Psych.
I cared for a 20-something patient who was discharge from the hospital with an IJ. We had orders to do outpatient IV antibiotics on him but he was very, very inconsistent in answering phone calls to his home, showing up for the treatments, being compliant with the therapy, etc. Well, this was a double lumen port and I was instantly suspicious when he came in the first time after discharge. One of the ports would not flush at all. I worked and worked with it but it was occluded. White matter could be seen in the line. I confronted him about it but he denied everything. He showed up the next day and this time the other lumen was very sluggish to flush. He again denied tampering with the IJ. I passed on these concerns to the doctor and we received orders to dc the central line on his last visit. His next visit was his last and we were worried that he would refuse to have the line dc'd. We didn't tell him that we were going to dc the line until the last minute. He was surprisingly agreeable to having it dc'd. Maybe he realized it wasn't so fun to play with anymore since it clotted off so easily with powered drugs...
No wonder she lost her license, it sounds like she doesn't know what she's doing. That shows how the drug habit makes people lose their sense of reason, which is very sad and pitiful.
What an idiot. I hope the port is permanently damaged and no doc agrees to replace it.
Sounds like they just need to take her immediately to the OR and remove it now. She doesn't choose to care for it properly she does not need to have it. And I agree its liquid meds only for this person.
The sad part is that we left the huber needles for the doc to see, he saw it and just said "well, just continue giving her the meds". He didnt seem to think it was a big deal! Now THAT is the scarey part! The other nurses who take care of this patient now refuse to give her the Percocet and told her why. We also now added to the nursing communication list to check her mouth with a penlight to ensure that she swallows her narcs if she gets any. This is her drug regimen:
Percocet scheduled QID
Percocet 5 q 2 hr PRN
Ativan IV (cant remember the dose or how often)
Dilaudid 1 mg q 3 hr PRN
Toradol q 6 hours PRN
Phenergan 12.5 PO or IV q 4 hr PRN
Zofran 4 mg q 6 hr PRN
But she didnt know about the Ativan or I would have been in her room even more than I was. I was NOT going to tell her about it! She called out for pain meds, I took Toradol to her. As I was pushing it, she asked what it was. When I told her it was Toradol, she said..."Well, I prefer Dilaudid, can I have that?" I told her no and she needed to give the Toradol time to work. She said, "how long until I can have the Dilaudid?" In 30 minutes exactly (after going outside to smoke) ...she called out for her Dilauded AND the Phenergan while laying in bed eating pudding and drinking pop. So I gave her Phenergan PO, rather than the IV form. She didnt like that either. And if I had to give it IV, I would add it to NS in a piggyback so it would go in slower. Oh.. we also had to lock the keypad on the IV pump because she would change the IV rate so it would go in real fast. It was just a plain mess. Im so glad Im off for the next 3 days. Hopefully she will be gone when I go back. It was too stressful trying to chart all that.
And I would be so mad if I ended up in court over complications due to her ignorance and noncompliance. Surely to God a judge would take into consideration that she was a nurse with educated knowledge of acceptable drug routes and administration and knowingly put herself in danger. I administered it PO, I did not crush it and put it in her port. It wasnt my fault she did it. I was just trying to do my job. Her mother in law was already threatening the staff with lawsuits. Now Im really worried. Could I get in trouble over that?
The sad part is that we left the huber needles for the doc to see, he saw it and just said "well, just continue giving her the meds". He didnt seem to think it was a big deal! Now THAT is the scarey part! The other nurses who take care of this patient now refuse to give her the Percocet and told her why. We also now added to the nursing communication list to check her mouth with a penlight to ensure that she swallows her narcs if she gets any. This is her drug regimen:
Percocet scheduled QID
Percocet 5 q 2 hr PRN
Ativan IV (cant remember the dose or how often)
Dilaudid 1 mg q 3 hr PRN
Toradol q 6 hours PRN
Phenergan 12.5 PO or IV q 4 hr PRN
Zofran 4 mg q 6 hr PRN
But she didnt know about the Ativan or I would have been in her room even more than I was. I was NOT going to tell her about it! She called out for pain meds, I took Toradol to her. As I was pushing it, she asked what it was. When I told her it was Toradol, she said..."Well, I prefer Dilaudid, can I have that?" I told her no and she needed to give the Toradol time to work. She said, "how long until I can have the Dilaudid?" In 30 minutes exactly (after going outside to smoke) ...she called out for her Dilauded AND the Phenergan while laying in bed eating pudding and drinking pop. So I gave her Phenergan PO, rather than the IV form. She didnt like that either. And if I had to give it IV, I would add it to NS in a piggyback so it would go in slower. Oh.. we also had to lock the keypad on the IV pump because she would change the IV rate so it would go in real fast. It was just a plain mess. Im so glad Im off for the next 3 days. Hopefully she will be gone when I go back. It was too stressful trying to chart all that.
And I would be so mad if I ended up in court over complications due to her ignorance and noncompliance. Surely to God a judge would take into consideration that she was a nurse with educated knowledge of acceptable drug routes and administration and knowingly put herself in danger. I administered it PO, I did not crush it and put it in her port. It wasnt my fault she did it. I was just trying to do my job. Her mother in law was already threatening the staff with lawsuits. Now Im really worried. Could I get in trouble over that?
Anyone can sue anyone for anything. That said, it would be quite the desperate attorney who'd take on a case for an idiot like this. Just keep documenting. Especially her eating while asking for nausea meds, going out to smoke, adjusting the IV pump, etc. She sounds like a real piece of work.
BTW...
Percocet scheduled QID
Percocet 5 q 2 hr PRN
Um. That is WAY the hell over the daily dose of acetaminophen allowed. I'm surprised pharmacy even entered these orders. Does she even have any liver left? And the toradol? What is her renal function?
I'd love to be her doc for just five minutes... the phenergan needs to be d/c'd altogether. And after her little stunt with the port, the percs need to be changed to oxycodone elixir. And I'd inform her if there was any suspicion of her manipulating her IV pump in any manner, all IV access would be discontinued and no further IV meds would be given. Period.
Does your hospital have a pain service or even a pain management doc on staff? This person needs an iron-clad contract that specifies exactly what she is allowed to have and the consequences of breaking the contract.
weesyanne
81 Posts
Oh my goodness! She must have a death wish.:selfbonk:
We had a patient years ago that had numerous central lines that had become contaminated with stuff like e-coli and enterococcus. The doctors finally figured out she was contaminating her lines with stool. I think her diagnosis ended up being Munchhausen's.