OMG, I cannot believe what I did. What I should do now!

[SoNan, BSN]

I am new Grad from May 2020. I got my job in subacute/SKF.

My patient had a PICC line that needed to be removed. I didn't think about that much. While I was going to give him meds, I prepared to remove his PICC line. All I took with me is a clean glove, gauze and a Bandage. 

So, I told pt to lay down, extend his arm. Then I start peeling off the transparent pad. Once the pad is off, I saw the insertion site. I used my left hand to press the gauze on the insertion site, and with my right hand started to pull out the line. Then I realized, OMG, this is a long line! But I can't stop, so I just pulled it out, and threw it in the trash bag.  I placed gauze then bandage on the site.

Later, when the charge nurse came ask me if I already removed the PICC line, because she was planning to come with me to supervise me. I said I already removed it. Then she asked, if I removed PICC line before. ? I said YES! WOW!! Why I say yes! I only removed peripheral, regular IV line when I was in clinical! Then she asked if I have the measurement. I said no, I forgot, but I still have the line in the trash bin. She showed me the insertion documentation and told me I have to measure the length of the PICC line. It is a different protocol compared to the IV line. And she asked me again if I removed a PICC line before. I said YES, again. She asked,  "Where, school?"  I said YES, I just forgot to measure it.  Thank GOD, the PICC line was still in the trash bin, and the length is the same as the inserted length. 

Now, after getting back home, thinking about what had happened, I feel guilty. I don't know what to do now. Should I tell my charge nurse tomorrow that I lied? I feel so bad! I also googled the PICC line removal protocol. I needed to don a sterile glove to remove it?! I needed occlusive dressing?! Because pt. is at risk for infection, bleeding, and air embolism, and blood clot! 

Sorry about my grammar. I don't know what to do now. I feel so bad.

[caliotter3]

I would tell the charge nurse that in the heat of the moment, you lost your cool and didn’t tell the truth. Also say that you will make sure the next time she tells you to wait for her to supervise, you will. It’s either tell the truth or wait for this to blow over. She probably thinks you fibbed. Better to own up to it now.

[SoNan, BSN]

I just texted my charge nurse. And Im going to talk to DON tomorrow. I just hope the pt will be fine.

[Been there,done that, ASN, RN]

Not sure what  you texted to your charge nurse.   Should have kept your mouth shut and learned from the situation. You already know the patient is fine. If you had to lie three times.. you messed up.

In the future,  know that  you are duty bound to ask for guidance with any first time procedure.   

You threw it in the TRASH? Anything with blood and body fluids on it, goes in the hazard bin.

Best of luck with this mess.

 

[RNperdiem, RN]

. I would have thrown the line in the trash too with all the soiled dressings , dirty gloves, and the other things that go in the trash. Unless it is something sharp. That goes in the sharps box. 

Learn from your mistakes. Next time when you have to do a new procedure, check the policy and procedure for it. 

[JKL33]

You will need to change your MO (the manner in which you operate) immediately. If you have never done something before you have no business doing it without verifying the correct steps. 

[iluvivt, BSN, RN]

Although the risk is extremely low ( OK..almost nonexistant for PICCs) all central lines must be removed in a manner and dressed in such a manner to prevent air embolus.You did not do that either...so I would suggest to you to go look it up now and come back and tell us the proper way to do it.Yes, it should have been measured as well, but you messed up on many levels.You should never perform a procedure if you do not know how to do it and then you lied on top of it.You need to come clean and never allow that to happen again! Patients put their trust in you and if you can't take that seriously then you are in for a long hard ride ahead.There is no shame in not knowing something and you will earn respect by asking when you need help and do not know something.

[AceOfHearts<3]

This clearly demonstrates that you need to review what a PICC line is and proper care for it in addition to the safe removal. You have no business caring for a patient and accessing/using a PICC line until you do so. 

[Tweety, BSN, RN]

3 hours ago, JKL33 said:

You will need to change your MO (the manner in which you operate) immediately. If you have never done something before you have no business doing it without verifying the correct steps. 

^This

People that aren't comfortable asking for help and supervision, asking questions, and admitting they don't know something, and downright lie are setting themselves up for huge mistakes which they will try to cover up.

Good for you for owning up to it.  All you can do now is move forward, learn and grow.   Not sure you need to drag the DON into  it but do whatever gives you peace at this point.

Nurses have to be humble enough to put our egos aside and ask those questions, ask for help, no matter how it makes us look or how simple the answer is.  

[SoNan, BSN]

Thanks for everyone's comment, althought some makes me feel more bad, I know I made mistake.

Basically, I texted my charge nurse that I feel sorry, I don't know what I was thinking when she ask me if I removed PICC line. I told her the truth, and asked her if I need to write any statement or meet with someone to discuss this. 

PICC line removal, correct me if I am wrong:

clean glove, sterile gauze, occlusive dressing, suture removal, alcohol wipe.

1. explain the procedure to pt, and need to avoid some acivities after removal . 

2. tell pt lay supine, extend arm

3. clean the area around the catheter with alcohol wipe

4. remove the dressing and suture

5. ask pt to hold breathe, then slowly pull out the catheter

6. after removed, place sterile gauze, hold for few seconds and then place a occlusive dressing. 

8. after placed occlusive dressing, pt can breathe normally

9. monitor pt for 24 to 48 hr

10. document date, time, pt tolerance of PICC line remove, and the length.

[Wuzzie]

11 minutes ago, SoNan said:

Thanks for everyone's comment, althought some makes me feel more bad, I know I made mistake.

Nobody means to make you feel bad. We just want to make sure you understand how important it is to get help doing procedures that you are unfamiliar with. PICC line removal is fairly straightforward but other CVCs are not and have much more potential for serious complications. That you were willing to do a procedure without the help you needed is what is concerning to us much more than the lie you told when you panicked (although that wasn't a shining moment for you either). Right now you seem to be more focused on how to do the procedure when that isn't the biggest issue. Procedures can be learned but personal ethics come from within. How is your practice going to change going forward?

[SoNan, BSN]

43 minutes ago, Wuzzie said:

Nobody means to make you feel bad. We just want to make sure you understand how important it is to get help doing procedures that you are unfamiliar with. PICC line removal is fairly straightforward but other CVCs are not and have much more potential for serious complications. That you were willing to do a procedure without the help you needed is what is concerning to us much more than the lie you told when you panicked (although that wasn't a shining moment for you either). Right now you seem to be more focused on how to do the procedure when that isn't the biggest issue. Procedures can be learned but personal ethics come from within. How is your practice going to change going forward?

Thank you for your comments.

I feel bad because I did a procedure without enough knowledge about it. and I am worrying that I caused harm to my pt, which may lead the pt into code, hospitalized, or death.

I will never perform any procedure that I have no experience in the future, and I will think twice before I perform anything, and ask for help.