@#%*!! (long.....sorry)

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Specializes in LTC, assisted living, med-surg, psych.

Well, I guess I'm in deep doo-doo now.........A couple of days ago, I was supervising a student nurse while she was removing a Hemovac from a pt. who'd had a total knee replacement, and the tubing broke off near the insertion site. I called the surgeon, who told me to take the dressing down as far as possible and see if I could pull the rest of the tubing out, and to call him if I couldn't.

Mind you, I was in the middle of caring for 5 patients without an aide (3-7P shift), had a fresh post-op, a pt. whom I'd just admitted and had to prep for a colonoscopy, and a 45 YO total-hip pt. with borderline personality disorder who was on the light every two minutes (literally). However, I did as the MD had instructed, but couldn't find ANY tubing......not even a fragment.....at the insertion site, or under the skin. So I redressed the incision, and passed the word on to the night nurse at shift change. I was simply too busy to do anything else---no dinner break, no time to chart, no time to even go to the bathroom. Then I went to another floor for the last few hours of my shift, and never thought about it again until my nurse manager confronted me last night.

To make a long story short, there WAS some retained tubing deep inside the knee, and the pt. had to go back to surgery to have it removed. The surgeon was pissed because I hadn't called him back, and of course my manager was upset because I hadn't written an incident report (I've since corrected that oversight) and the pt. did have to have a second operation.

Of course, I feel like hell because I'm at least partly to blame for this mess, and I'm sure of a write-up at bare minimum; but I'm also angry because of the crappy situation I was in, and the expectation that we nurses must be perfection itself, no matter what we're called upon to deal with. The day shift filled out an "unsafe staffing" form the next day, and the manager told them they were being "unprofessional". Now, staffing is better nowadays than it used to be when I worked there before, but there are times when you can have 15 staff members on the floor and it's not enough, and we certainly didn't have that many on Wednesday.

I'm not the kind of person to make excuses when I foul up, but under the circumstances I'm not sure what else I could have done. I KNOW I should've called the doctor back, even though he said to call only if I couldn't pull the retained tubing out (I'd never seen this happen before, and I presumed the fragment had fallen out and was somewhere in the bed linens). But I'm only human......too bad for my patient.

At this point, I can only hope that a write-up will be the worst thing that happens, and that the patient doesn't decide to sue or that I don't lose my job. What a mess.........never thought I'd find myself in such a position, normally I'm very careful and conscientious, but this was not a normal day.

Thank you for reading this lengthy vent. I feel a teeny bit better now. Think I'll go crawl inside a bottle of Diet Coke and drown my sorrows there.

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((((((((mjlrn)))))))

i am sorry you had such a crappy shift. maybe, looking on the bright side of this, your employer will look at the unsafe & potentially dangerous level of staffing & DO something about it! I will be thinkin about ya

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Hugs, mjlrn97. I hope everything works out well for you.

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I'm so sorry mjlrn..we've all had shifts from hell and wished we woulda,shoulda,coulda..you did the best you could hun..we're all human..hope everything works out for you (((hugzzz)))

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Specializes in Everything except surgery.

(((((((((((((((((((mj))))))))))))))))) Here is a BIG HUG from me to you! You didn't cause this pt to go back into surgery, as the pt would've have went back, whether you called the surgeon back or not, if it was deep inside the knee. And you realize he shouldn've been called back, and maybe you would've called him back, if you hadn't been sent elsewhere.

But you reported to the oncoming nurse, and that nurse probably was just as stretched out.

You have that diet coke, and have one for me two:kiss Things like this catch us off guard, and in an overwhelming situation, and trying to pull things together in such a short time, without enough help, unfortuantely these are things we all worry about.

I'm just sorry it had to happen to you.:kiss

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Specializes in LTC, assisted living, med-surg, psych.

Me, too, Brownie! Thanks, you guys, for commiserating.:kiss

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Specializes in Specializes in L/D, newborn, GYN, LTC, Dialysis.

Oh yea I can relate. I am so sorry yours was such a bad shift. Lessons learned the hard way are tough to take. Best wishes!

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Specializes in Med-Surg.

You did great! We live and learn. Try not to lay a whole lot of blame and realize that perhaps it was your responsibility to call back the MD and make the report. Otherwise you did great with the lousy hand you were dealt.

I get upset when people always try to lay blame and eat each other alive. Fact of the matter is, even with one-to-one staffing the tubing still would have been retained, the patient still would have had to go to surgery, and most likely not any earlier than they went.

Don't let anyone make you dwell in the past, in the mistake, own up to your part and move on with your head held high.

I've been burned by the "but I told the next shift" kind of thing before too.

Best wishes.

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Specializes in Med-Surg, Wound Care.

"student nurse while she was removing a Hemovac from a pt"

Ok call me old school, but I've never removed a hemovac!!! In every hospital I've worked this is a physicians responsibility. Is it standard practice for nurses to remove hemovacs???????

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Specializes in Everything except surgery.

In many facilites it is, even CTs!

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Specializes in Everything except surgery.
Originally posted by mjlrn97

Me, too, Brownie! Thanks, you guys, for commiserating.:kiss

Anytime ((((((((mj))))))))..anytime! I'm praying now for you to have some peace of mind! Go see a silly movie, or get out and enjoy the beautiful sunshine we're haviing today! You're a special person and don't you ever forget that for a sec:)!

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Specializes in Hemodialysis, Home Health.
Originally posted by 3rdShiftGuy

Fact of the matter is, even with one-to-one staffing the tubing still would have been retained, the patient still would have had to go to surgery, and most likely not any earlier than they went.

Don't let anyone make you dwell in the past, in the mistake, own up to your part and move on with your head held high.

Best wishes.

My sentiments exactly. So sorry for such a crappy day. Warm hugs, and please continue to vent and share even the BAD stuff here, 'cuz this is how I LEARN.... ok? ;) So something GOOD has come of it afterall.

I do hope they won't tear you a new one. ((( HUG)))

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