Nursing instructor in the wrong

squirt2008 · Apr 30, 2010

Why must a filtered needle be used? I am assuming it's to filter any glass out, before injection?

You are correct. use a filter needle when drawing from glass ampoule, then change needles before administering. I think they should add a 5th "right" when admin. meds....now we know about right patient, right dose, right med, right time, right route......we should have right technique.

laynaER · Apr 30, 2010

I think you did the right thing. Safety comes first and sometimes we have to put each other's pride aside if it means protecting a patient. No one wants to be embarassed, but sometimes we have to be willing to accept critique if it means we potentially saved someone's life. We can deal with the embarassment later. Like the other people said, if it occurs again, you should report it to your manager. Good Luck with the situation.

LesMonsterRN, ADN, RN · Apr 30, 2010

It's quite possible that the CI was embarrassed that she was being corrected in front of a student, but what's a little embarrassment in comparison to a patient being harmed? Yeah, ideally she should have been talked to in private but you didn't have that luxury. You were exactly right in stopping the CI and student.

greenfiremajick · Apr 30, 2010

Cracking open an ampule spews microscopic particles of glass. Injecting without a filtered needle has been proven to cause inflammatory reactions, phlebitis, and granuloma formation in animals.

Thanks, cb!

greenfiremajick · Apr 30, 2010

Yep. You may not be able to see the glass fragments that can fall into the med after you break the ampoule, but they can definitely do damage if you inject them into a patient. You draw up the dose through a filter needle then switch it out for a regular needle, blunt cannula (for needleless systems), etc.

So I guess that since the instructor from the OP's 1st post was not using a filtered needle, was because she had never seen a big reaction and she thought that it doesn't matter. Isn't those small things that can sometimes make a HUGE difference? Now I better understand cb's worry over the instructor doing what she was doing.

My 1st impression was that cb should take the instructor aside and really speak with her about many things. I still think that a concerted effort should be made as a last resort and then if the instructor refuses to change her ways, reporting, etc (as mentioned by several others) should be done.

The thing is, in many other professions, if a colleague sees a peer making ignorant choices, choosing unethical practice, etc they will usually consult a supervisor, and speak with that peer. Once those actions have been exhausted, there comes time to report....

P-medic2RN · Apr 30, 2010

If it could cause harm then put a stop to it right then and there. If it's not going to cause harm then handle it later in private.

AF IDMT · Jun 24, 2010

Hey there P-Medic!

Just wondering when you went through IDMT school? I went in 1984, I think. Iknow I was at Shemya in 1985.

BabyLady, BSN, RN · Jun 27, 2010

How do you handle it when you hear/see the nursing instructor telling a student the wrong thing?
I have become the evil RN on her high-horse because I saw an instructor helping a student draw medicine up out of a glass amp with a regular needle. I spoke up (very professionally) by saying something like "Oh, here, let me get you a filtered needle for that!" She was fairly snotty and said that she doesn't ever use a filtered needle so I said, "Yeh but its the correct way, please don't use that on a patient."
Never intended to embarass her. I have heard her say several questionable things in the past related to meds (timing, indications, etc) but never corrected her or contradicted her except to call her out on the need to wear a mask when administering SL prograf (but that was just her and I in private)

I would have done the same thing...if you had went to your manager, the patient would have already been given the med.

The instructor is also setting up students to miss questions on their NCLEX by giving them the impression that the NCLEX won't ask them about filtered needles.

However, on the flip side, I work in a hospital where we don't use filtered needles.

But if I was an instructor and they WERE available, the students need to be taught what is correct and then when they work the floor, your learning gets "tweeked" specific to that facility.

allnurses Guide · Jun 27, 2010

QUOTE=greenfiremajick;4274259]So I guess that since the instructor from the OP's 1st post was not using a filtered needle, was because she had never seen a big reaction and she thought that it doesn't matter. Isn't those small things that can sometimes make a HUGE difference? Now I better understand cb's worry over the instructor doing what she was doing.

I don't know when filter needles became the norm, but another thread here recently on the subject, about half had either never used a filter needle or had never heard of a filter needle. It may be true that she was in one of those groups, and given hundreds of injections from glass ampules without hearing of a single incidence of the serious adverse reactions the filter needles are designed to prevent.

Regardless, that would fall into the category of anecdotal experience-- and it's not appropriate for her to let that trump current best practice no matter how useless she personally feels it is. She probably thinks gloves are overused, too.