Needlestick yesterday, should I report it?

[I like cats]

Long story short I poke myself on the inner part of insulin pen needle, these are safety needles so after injecting the patient the safety guard should have gone up and my thumb shouldn't have been poked

i assume the safety didn't go up after injection because I did not insert/push down hard enough with the pen on the patients belly when injecting it which is also why the dose likely leaked out of her skin when I removed the pen even though I held it for 10 secs after

i regave her the dose as you should, but when switching needles on the pen, I poked my thumb with the first used inner part of the needle that inserts into the pen

The poke on my thumb was superficial and no bleeding, patient is not known HIV or HEP Positive but no idea if she has ever actually been tested.

i didn't report it yesterday while at clinical because I didn't think much of it and was super busy, as a student this is something that could also ruin the next 4 weeks of my clinical rotation just because it happened (it's a very small hospital and I will be gossiped about non stop)

but after going home last night it was on my mind, I'm a single mother with a young child to care for and I realize what happened yesterday was potentially a dirty needle stick--a low risk one tho yes

should I go to dr today, I don't want to report it at the site, which means the patient won't get tested and I prolly won't get PEP, but at least then my labwork can be ordered and started?

[Wannabenurseneko]

I'm not a nurse, but I am taking a phlebotomy class and our teacher said that you should always report if you get stick with a needle specially if you got stuck after using it on a patient

[direw0lf, BSN]

I was still blinking my eyes over how she repeated the dose of insulin.."the dose likely leaked out of the skin" Likely? And you repeated the full dose? Without telling a nurse or your instructor?

ETA

Just read the rest of the comments.

That is some questionable policy imo when a student says she's not sure if insulin went in but most "likely" leaked out.

[I like cats]

I Saw the insulin leak out, and no there is no way to verify how much the patient got and how much she didn't, but again I did as per policy by regiving the insulin and after consulting the charge nurse as well.

The 'likely' is that the insulin likely leaked out of the patient's skin because I must not have pressed hard enough with the pen to inject the needle deep enough into the patient. Also why I figure the safety on the needle did not automTically go up when I removed the needle from the patient, and thus how I got poked afterwards

Didn't realize how some people feel the need to pick apart every single sentence...

Yes it seems weird to regive the dose when no one can be certain exactly how much the patient got the first time, but that's the policy here, followed by more frequent gluc monitoring. I'm assuming that most people commenting are from the US.

Whereas I am not

[Castiela]

I'm not American. You showed poor judgment not reporting a needlestick. We can't assume you didn't follow the same judgment with administering the second dose of insulin which is why you are getting comments about it.

You made a mistake, and as a student, sometimes students (or full fledged nurses) aren't aware that they made a mistake which is pointed out. This forum is an educational support. We are making sure you are aware so you can grow as a nurse. I'm glad you followed up with the charge nurse and followed the hospital policy. I think at this point, we are just shaking out heads at the policy because it seems odd.

Best of luck with your future studies and I'm glad everything worked out when you did report

[BadAszFannyPak]

I feel your pain. I would hate the ration of feces I would get from my instructors if that happened. However, your health and safety and your kid's is so much more important. I really do feel where you are coming from but next time, report it. It may suck and lead to bad stuff but hiding things in this business is always a bad idea. I'm sure you're fine though. Even if your pt was infected with some real nastyness, needle stick transmission rates are really low. Mucous membrane transmission rates however...

[BadAszFannyPak]

Yeah. It feels like my instructors and preceptors troll this site.

[wannabeny]

Quote

The poke on my thumb was superficial and no bleeding, patient is not known HIV or HEP Positive but no idea if she has ever actually been tested.

I didn't report it yesterday while at clinical because I didn't think much of it

You sound exceptionally blasé about a needlestick. You , showed blatant disregard for your own safety and more concern over assumed gossip and people's perception.

Please learn from this. Not only for your own sake but your patients. We in the racing world have this saying about some horses...that they have "zero self preservation instinct". In other words, they'd rather near kill themselves and us than think things through that scare them.

If you worry more about others perception rather than doing the right thing, what will you do the next time you make a mistake on yourself or your patient..?

[Ambersmom, BSN, RN]

Castiela said:

I'm kind of concerned that you double dosed a patient with insulin... You don't know how much insulin she had absorbed from your first dose. I would have waited an hour, checked her sugar, then, depending on of the patient was on a sliding scale or not, administered according to that or waited until her next dose

Agree with you on that.

Also concerned for OP's nursing conscience, seems to be more concerned with gossip than patient safety. Who cares if you get a needle stick?

[WereBadger]

wannabeny said:

If you worry more about others perception rather than doing the right thing, what will you do the next time you make a mistake on yourself or your patient..?

A thousand times this.

[CelticGoddess, BSN, RN]

I like cats said:

I Saw the insulin leak out, and no there is no way to verify how much the patient got and how much she didn't, but again I did as per policy by regiving the insulin and after consulting the charge nurse as well.

The 'likely' is that the insulin likely leaked out of the patient's skin because I must not have pressed hard enough with the pen to inject the needle deep enough into the patient. Also why I figure the safety on the needle did not automTically go up when I removed the needle from the patient, and thus how I got poked afterwards

I'm an insulin dependent diabetic and will have a small amount of insulin leak out sometimes. It happens. It's impossible to determine exactly how much, and it's dangerous to re-dose a diabetic. I don't care how often you check their fsbs. I've been given a small dose (6 units) and had my blood sugars drop to a dangerous low in less than 15minutes.

I personally don't think this is a good policy.

[Froggybelly]

It's concerning that you are more worried about people gossiping than protecting your health by making the ethically sound, mature choice to speak with your instructor. I have seen countless residents and physicians stick themselves. They just roll their eyes and go handle it at employee health. It's a paperwork headache when it happens, but the important thing is to deal with it, even if it turns out to be nothing.

[Here.I.Stand, BSN, RN]

I like cats said:

Please keep in mind that you and I may live in different countries and thus do things differently,[/Quote]

The pathophysiology of DM is the same the world over. Let's assume for a moment that a drop of insulin leaked out, and the pt did in fact receive a partial dose. Nobody has ever died from a BG in the 200s-400s. People DO die from hypoglycemia -- which will be the result of giving an entire 2nd dose.

This is important information whether you asked for advice or not. As a student receiving practice advice from seasoned RNs, the mature/professional thing to do is consider that advice. Not snarkily disputing perceived snark.

To answer your question: Yes. All needlesticks must be reported.