huber needle

SierraBravo · Jan 25, 2015

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.

There are a couple of issues that present with this scenario. First, the OP seems to have known better but still chose to insert the needle back into the port. This throws up a big red flag because it makes me wonder what else this person will do, even when they know better?

Second, like others have said, the OP needs to use some critical thinking here. If the patient is actively dying (i.e. hours to days), there is no need for IVF and the OP should have spoken with the physician to clarify that. Re: the patient losing IV access - only if the patient was on a morphine and/or versed drip would I have moved to ensure the patient reacquired IV access very quickly, and it certainly would NOT have been by reinserting a Huber needle into a port.

ixchel · Jan 25, 2015

There are a couple of issues that present with this scenario. First, the OP seems to have known better but still chose to insert the needle back into the port. This throws up a big red flag because it makes me wonder what else this person will do, even when they know better?

This is what is deeply bothering me about this situation. OP, forgive me for this, but from your posts, I get the vibe that you felt that she was going to die anyway, so it doesn't matter that much. You say you didn't want her to die by lack of fluids, but you were okay with dying from infection. I foresee disciplinary action in your future.

LadyFree28, BSN, LPN, RN · Jan 25, 2015

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.

THIS.

Do you have malpractice insurance, OP???

VANurse2010 · Jan 25, 2015

One word: Clysis.

psu_213, BSN, RN · Jan 25, 2015

You say you didn't want her to die by lack of fluids, but you were okay with dying from infection.

Yes, this is what I found strange about the situation. To the OP, don't try and hide what you did. Admit your mistake, apologize for the lapse in judgement, and make assurances that you won't do this again. Hopefully your supervisor will believe you on the last part.

FlyingScot, RN · Jan 25, 2015

I'm sorry, but I find it hard to believe if the OP was trained to access medi-ports that she didn't KNOW what she was doing was very wrong. If she wasn't trained to access medi-ports then she had absolutely NO business whatsoever doing the procedure EVEN IF a new sterile needle was available. Her actions are indefensible. Either way you look at it this was an egregious lack of basic good judgment on her part, never mind critical thinking skills. This wasn't a mistake. This was a very bad decision complicated by the fact that the supervisor apparently hasn't the knowledge or leadership skills to actually BE a supervisor. A huge mess and a disaster waiting to happen. And I'm further bothered by the OP's seeming lack of remorse. I am also finding it difficult to jump on the "there,there we all make mistakes" bandwagon. This was such an obvious no-no that it makes me wonder what other poor decisions the OP has made or will make in the future. I, too, hope she has good malpractice insurance and she should be worried at the very least about losing her job because she may very well lose her license.

chicookie, BSN, RN · Jan 26, 2015

That really sucks! And I know you are beating yourself about it. Take a deep breath and accept whatever comes.

Gooselady, BSN, RN · Jan 26, 2015

Again, the administration in the facility the OP works in has some responsibility in providing competency training (and gawd help us, supplies).

An unguided, uneducated (in this situation) harried nurse trying to get her work done while keeping her patients free from harm is going to be a disaster. This nurse has responsibility to know when and where she lack the competency to perform a skilled task, yes. Her administration shares this responsibility and in fact, because they have much more authority than the OP, has a lion's share of the responsibility for this happening.

I think suggesting to the OP that she might've did what she did cuz the patient was 'dying anyways' is pretty low. Can you imagine someone suggesting such a thing to you?

Libby1987 · Jan 26, 2015

Again, the administration in the facility the OP works in has some responsibility in providing competency training (and gawd help us, supplies).
An unguided, uneducated (in this situation) harried nurse trying to get her work done while keeping her patients free from harm is going to be a disaster. This nurse has responsibility to know when and where she lack the competency to perform a skilled task, yes. Her administration shares this responsibility and in fact, because they have much more authority than the OP, has a lion's share of the responsibility for this happening.
I think suggesting to the OP that she might've did what she did cuz the patient was 'dying anyways' is pretty low. Can you imagine someone suggesting such a thing to you?

They should definitely have the supplies, we have back up supplies in the home setting. So weird that none were in the facility.

But I don't know that OP needed any additional training to avoid her actions. Would she need additional inservincing beyond nursing school to avoid reinserting an existing peripheral IV? Or an IM needle?

i apologize for sounding like a pile on, but I think OP will have her basic critical thinking skills questioned and needs to be prepared to answer to that.

amoLucia · Jan 27, 2015

[quote=Libby1987;8323182...

But I don't know that OP needed any additional training to avoid her actions. Would she need additional inservincing beyond nursing school to avoid reinserting an existing peripheral IV? Or an IM needle?.Or reinserting a foley that has slipped out?

spma1234 · Jan 27, 2015

Thank you friends for all your replies. but i feel some people's comments are enough is enough okay....im not gonna kill myself thinking of this...no one of you is perfect and im sure you all have made mistakes at some point....and i very well know some of you have not admitted it...but i admitted it honestly to my supervisor.....i have nursing license insurance....and i can find another job if something would happen to this..i have a lawyer to fight if i have my license taken......and honest to god i didnt do it because the patient was dying....i only did it because i didnt want her to die...at that point she was not eating or drinking and nutrition and hydration was priority and it was not that she was immediately getting an infection okay so that wasnt my priority....my goal was to keep her comfortable, she was DNR and going to become a hospice patient......I KNOW IM WRONG PER ALL OF YOU AND PER MYSELF BUT I WILL NEVER DO THIS AGAIN AND I DONT NEED ANOTHER CHANCE TO PROVE IT.....LETS STOP WITH THAT....BYE!!!!

JustBeachyNurse, LPN · Jan 27, 2015

Nutrition and hydration aren't always comfort measures as the body systems slowly shut down in end of life. Hunger and thirst are often waning and the extra fluids can build up. It's not always a priority or an urgency. Something to think about moving forward, especially since most people don't want to think about death especially healthcare professionals who are more concerned with preservation of life than preparation for death.