JP drain to suction?

[LibraNurse27, BSN, RN]

Hi nurses,

I'm just wondering if anyone has seen a special JP drain that is not closed and is able to be connected to wall suction. I had a pt with this type of drain for the first time today. Looks like regular JP but instead of closed bulb it has a connecter open to air that can connect to wall suction. Throughout the morning the drain was disconnected and reconnected by various doctors wearing clean gloves (or at one point, no gloves!) to check suction, strip the drain, etc. Pt had to go back to OR for emergency surgery. I disconnected the drain from suction and covered the open end with a clean glove to catch any drainage on the way down to OR.

The OR nurse wrote me up because she said I should have somehow clamped the drain or covered it with something sterile since it is connected to the patient's body. She told me I could have given the pt peritionitis and sepsis. I talked to the resident, attending and surgeon who said the drain was not sterile. The surgeon said maybe next time connect the opening to a second bulb drain, but we don't even have those on our floor. She said no big deal though. I am so stressed! any feedback?

[MunoRN, RN]

I'm not sure what you mean since all "JP" drains can be connected to wall suction. In general, the term "JP", short for Jackson-Pratt, is problematic since it is a brand name for a number of suction devices, all of which can be both closed suction systems and can also be connected to open suction.

Regardless of type, when the drain is disconnected from suction then the suction port should be closed in some way, but none of those ways are sterile.

The OR nurse was being a Jackass, don't sweat it.

[brownbook]

About once every 5 years, in my 35 year nursing career, I've come across weird, odd, unusual, "I've never seen that done before", drainage set ups. Your's sounds like one of those. There is no right, perfect, way to work it.

I'd bet the surgeons were improvising this set up.

If a surgeon with 16 plus years of medical school says no big deal that trumps the jackass OR nurse with a 2 - 4 year nursing degree.

Hold your head high. You did nothing wrong. Try to forgive the jackass in OR. Don't waste your karma stressing over her.

[jobellestarr]

I’ve had surgeons hook up some weird things to suction. Kind of MASH like and improvise with what you have. Like the time a surgeon hooked up a chest tube trocar to suction out someone’s liquified pancreas from necrotizing pancreatitis.

[LibraNurse27, BSN, RN]

Wow! that sounds very interesting. Yes I don't think this drain was not manufactured to be connected to suction. I saw online there are some JP drains that have a two way valve and can be connected as a closed system so that even when the drain is unplugged from suction no fluid flows out. It's pretty cool! But that was not what this was, was unpossible to unhook it and keep completely sterile.

Anyway, the patient did not become septic from the glove but they found she has stage four liver cancer so now the glove seems irrelevant. I will care for her tomorrow as a comfort care patient. Thank you all for your kind replies!