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huber needle

Geriatric   (8,630 Views 47 Comments)
by spma1234 spma1234 (New) New

758 Profile Views; 12 Posts

Hi all, i work as a RN in a skilled nursing facility; i made a mistake by re-inserting huber needle into patient's right chest port since she had pulled it of, i only did it since we didnt have any supplies to insert a new needle and i didnt want the patient with end stage cancer dying of dehydration, since there was delay in new huber needles coming from pharmacy; i know i am in trouble for risk of infection/ cross contamination. I should have known better not to do it but since it cleaned the area with chlorhex prep i thought it was okay.Now my ADON asked me a witness statement and stated that she was going to give it to the DON and said that she doesnt know whats going to come out of it. I am scared i am going to be fired. Any suggestions????

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861 Posts; 14,809 Profile Views

My suggestion is be honest, explain that you know you made a mistake and try to ensure your DON that it won't ever happen again. Then live with the consequences of your actions, whether you are counseled, disciplined or terminated.

But I also have another suggestion based on this statement:

i didnt want the patient with end stage cancer dying of dehydration, since there was delay in new huber needles coming from pharmacy

I think you also need to work on your critical thinking skills. Was your patient really at risk of "dying of dehydration" immediately? Was your only course of action really to reinsert the needle? Is the patient NPO? What about starting a new PIV? Etc, etc.

Best wishes to you.

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IVRUS has 32 years experience as a BSN, RN and specializes in Vascular Access.

1,026 Posts; 20,492 Profile Views

A Huber needle is one type of non-coring needle used to access ports. So, you may want to know exactly what type you actually used. Reinsertion of a non-coring needle after it has been pulled out of the septum of the port is a real infection issue. It is akin to trying to thread a PICC line back into someone's arm, after it erroneously comes out a few inches.

#1. You can never make the skin sterile as it is always shedding it's layers, which house bacteria, therefore, you are pushing that bacteria into the vascular system. Plus, what did that needle touch after it was pulled out? Was it lying in the bed, our heaven forbid the floor? Infection control is your number one violation here, and as vanilla bean stated, live and learn from it. You will get past this, but please remember, you can't make a mistake twice.... the second time you do it, it will be a choice. And... I'm sure you will be the one to learn from this experience and NOT repeat it.

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12 Posts; 758 Profile Views

Thank you for your replies, vanilla the patient was not immediately dying of dehydration but she was going to go with no fluids for a long time, I asked my supervisor to insert peripheral and she said oh its ok for her to wait till huber needles arrive, and IVRUS the needle was laying in bed and if it was found on the floor i would have never never reinserted, and like you said germs are everywhere!!!! thanks again

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12 Posts; 758 Profile Views

The patient was not NPO but she was unable to eat or drink and resisting care; she was like 80 yrs old fighting last stage of lung cancer...

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NurseOnAMotorcycle has 10 years experience as a ASN, RN and specializes in Med-Surg, Emergency, CEN.

1 Article; 1,065 Posts; 23,987 Profile Views

I know you are worried about your job but how is the patient?

spma1234, I hope you know that you made a huge, possibly life-ending error, even to the point of ignoring your supervisor when she said to wait for the new needles to arrive. How about sending her to the ER for a clean port access? Port insertions are sterile procedures. Cancer patients and elderly patients generally have less or no defense against bacteria, and ports go straight to the heart for immediate systemic spread of medications and fluids.

Please tell us she had the needle immediately removed and was sent to the hospital for antibiotics or otherwise immediately cared for in some way.

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12 Posts; 758 Profile Views

nurseonmotor thank you for your reply. the patient died 2 days later, she was not eating or drinking and was actively dying and we all were thinking she was going to die, I understand this could be life ending huge error what I made and would never repeat it if given another chance, hope they don't take my nursing license away for this based on what you are saying!!!

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AnnieOaklyRN is a BSN, RN, EMT-P and specializes in ED, Pedi Vasc access, Paramedic serving 6 towns.

1 Follower; 2,577 Posts; 34,433 Profile Views

nurseonmotor thank you for your reply. the patient died 2 days later, she was not eating or drinking and was actively dying and we all were thinking she was going to die, I understand this could be life ending huge error what I made and would never repeat it if given another chance, hope they don't take my nursing license away for this based on what you are saying!!!

Like someone else said use your critical thinking skills! The bed is covered in bacteria. The bottom line is that this patient was going to die, she is stage four CA, not eating and drinking IS a sign that the patient is actively dying. Placing a used needle that has been sitting on the bed was of course the wrong thing to do, but the bigger question is why would you think reinserting a needle so that a already dying patient could get fluids was necessary?

It upsets me that a patient that is known to be terminal is receiving treatment to try and stop them from dying!

HPRN

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3,726 Posts; 23,724 Profile Views

Actively dying but on fluids? Doesn't make sense, dying patients are given atropine (or lasix in the home). She wasn't on Hospice?

IME, dying patients in LTC are either sent to the ER for tx or are on Hospice.

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NurseOnAMotorcycle has 10 years experience as a ASN, RN and specializes in Med-Surg, Emergency, CEN.

1 Article; 1,065 Posts; 23,987 Profile Views

I think what prompted me to post the way I did was I that the feeling I got from previous posts are that people are saying infecting an elderly or terminal patient isn't as bad as infecting anyone else because they are dying anyway.

I doubt that is what anyone is saying, just a misinterpretation of tone as conveyed by written words, but I can hardly say "there, there, it will get better" as I would have usually done when it feels that ending someone's life wasn't as important as receiving a paycheck.

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amoLucia specializes in LTC.

5,204 Posts; 46,064 Profile Views

Not to be a bearer of bad news, but if you have your own malpractice insurance, now would be the time to contact them ASAP re the error.

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Gooselady has 23 years experience as a BSN, RN.

601 Posts; 7,278 Profile Views

I think your DON failed her responsibility to ensure the nursing staff's competency to deal with such things as central lines/mediports.

If you had known what you've learned on this thread, you'd have never done this. You'd have stepped up to make sure there was at least extra rare-type supplies so you DON'T run out. And the nurse who refused to place a peripheral needs to get a grip.

This lady had the central line to deliver palliative medications, not necessarily hydration.

I see a need for your DON to provide some education about palliative care as well. Not your fault you didn't 'know', this is pretty specialized nursing care. You ought to have been taught this -- not left to MacGyver your way through it.

Alas, another one of those crappy learning experiences :) No huge foul done. What others have said about how to respond if or when you are interviewed about this is what I would say too. Avoid finger pointing which would be hard for me to avoid doing, seeing the lack of necessary staff development and for gawd's sake, SUPPLIES. Sheesh! You'll be fine, and if this facility gives you too much trouble over it, resign and go somewhere else where the staff's educational and medical supply needs are administrative priorities . . .

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