How to protect self from needles?

GitanoRN, BSN, MSN, RN · Apr 26, 2013

Awesome!!!... Aloha~

Bioethicist · Apr 26, 2013

I have questions and concerns regarding needlesticks as well.

I had my first accidental needlestick last week. As I was dropping the needle and cap into the sharps container post safely administered heparin injection, I felt a stick and realized I had stuck myself. I was in total shock and felt so embarrassed. I followed universal protocol 1. told my charge RN 2. went to ED for testing 3. all tests were negative on me and patient (Thank God).

As soon as I told my charge RN she rolled her eyes and said "Did you recap the needle??! Did you? You did, well that's a medication error! You never recap needles that's the first thing you learn in school!! Yup, that's a med error!" She seemed super annoyed that she had to fill out all the paperwork and call the supervisor.

I said, "I don't know..I don't know. I felt a stick as I was dropping it." It was a 1am heparin injection, and I was tired and hadn't had a moment to take a break. She kept drilling me and finally I said. "I don't know, maybe I did recap it! I don't know, I'm in shock at the moment."

Does anyone know if a needlestick is can be considered a med error or only an accidental injury. Now my nurse manager wants to meet with both of us next week, and I'm very concerned I'm going to get written up. Thoughts, advice? Thanks. I've been a RN for exactly one year this week.

allnurses Guide · Apr 26, 2013

Considering needles have safety lock-caps after you inject, I'm not sure why you would recap it?

Did the needle not have a safety?

If it did, that's kinda on you... but maybe if you were really really tired and overwhelmed, you just weren't thinking...

But when you're dealing with a used needle, you need to be so so careful, no matter how overwhelmed or tired.

I'm glad your pt turned out clean and good luck next week.

DeBerham · Apr 26, 2013

Medication errors occur when when of these things occurs during drug administration:

Wrong pt

Wrong route

Wrong time

Wrong drug

Wrong dose

Now I'm unclear as to if you'd recapped the needle or not. If you were you may be written up for that, and you should regardless of if you were injured or not. Still, that's not a medication error by any stretch of the imagination. Protocols are in place for a reason and there is no reason to ever recap a used needle. As I interpret it though you were throwing away the needle and the cap when you accidentally got stuck. If that's the case your shift supervisor is an idiot and suggesting that people get written up for an accidental on the job injury is asinine. These things happen, and you cannot realistically remove all risk from this job. Her type of attitude only serves to not have staff report these types of injuries, and if a lawsuit comes down from an employee who gets sick because they feared that they would be fired if they reported this type of injury your facility will be paying through the nose in court. I PROMISE you, odds are that anyone who has been a nurse for any length of time HAS been stuck. I stuck myself once several years ago... it sucks, got checked and moved on. If you get written up for it, file the incident away as a thing to be careful about. I would also seriously consider moving to another floor/hospital as this type of attitude is dangerous.

K+MgSO4, BSN · Apr 27, 2013

Considering needles have safety lock-caps after you inject, I'm not sure why you would recap it?
Did the needle not have a safety?
If it did, that's kinda on you... but maybe if you were really really tired and overwhelmed, you just weren't thinking...
But when you're dealing with a used needle, you need to be so so careful, no matter how overwhelmed or tired.
I'm glad your pt turned out clean and good luck next week.

not all hospitals use safety locks on their needles. I know mine doesn't .................. huge state referral centre and centre of excellence............yet..............

Seas · Apr 27, 2013

I am not doing anything specific. I just follow what I learned in school and just be careful.

Recapping a used needle is a big no no. And I learned this in first semester of nursing school. Things like that.

CrazyCoconut · Apr 27, 2013

As someone who occasionally forgets to re-cap needles, I might consider that armor. Is it on sale?

iluvivt, BSN, RN · Apr 27, 2013

Was it a safety needle? You always need to make sure you know how the mechanism functions especially if it an active process and not a passive one. If you do not complete the action fully you can partially cover the needle and upon disposal it can reopen . So examine the mechanism often you will hear of feel a click and can even see it has been covered, Also I have seen many nurses get stuck when disposing a needle into a sharps container that is very full (too full) and they get stuck with a needle already in the sharps. So never dispose PAST the fill point. Call for a change of the container. I can't stand overstuffed sharps containers and see this a lot!

This is not a medication error nor should you be punished for this. it just needs to be used to find out what happened and how to correct it. I agree with the poster that stated the manager is dangerous in her view of the situation.

AJPV · Apr 27, 2013

It sounds like your supervisor has never heard of just culture and has no grasp of the damaging effect of a punitive nursing culture. If nurses are constantly in fear of disciplinary action when they report incidents, then incidents will go unreported. Unsafe patterns will continue uncorrected, and worse incidents will occur as a result. The fallout will affect the safety of nurses and also patients.

Biffbradford · Apr 28, 2013

How about: pay attention to what you're doing? 15 years and never once stuck myself with a needle. Sure, accidents happen ... I have hit my thumb with a hammer, but only once and never again!

K+MgSO4, BSN · Apr 28, 2013

How about: pay attention to what you're doing? 15 years and never once stuck myself with a needle. Sure accidents happen ... I have hit my thumb with a hammer, but only once and never again![/quote']
Trust me I pay attention and yet got stuck with a HCV+ pt needle. I was taking bloods and she thought I was out and she moved. Right through my finger. 6 months of stress all because the pt assumed I had withdrawn completely from her vein and moved.