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

[SoNan]

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.

[Wuzzie]

23 minutes ago, SoNan said:

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.

That's what we needed to know. The patient is fine. Stop beating yourself up, go forward and do better. ?

[DavidFR, BSN, MSN, RN]

The fact that you have a conscience over what happened speaks reams.

You're inexperienced and you stuffed up - WE ALL DO IT SOMETIMES.

Whether you come clean or say nothing is your decision, but if you've learned that in future you should approach things differently that's cool.

I hope this blows over for you, especially since the patient is OK. Learn, move forward, be proud that you didn't take an "I don't care what happened" approach.

You'll do better next time.

[Sour Lemon]

That's called a "self preservation instinct", and mine has acted up on occasion, too.

A face-to-face admission at a "good" time is usually better when confessing anything to anyone. A text is blind, and you have no idea what sort of mood that person will be in when they receive it.

I hope they are forgiving towards you. I think you deserve that.

[FolksBtrippin, BSN, RN]

It seems to me like you didn't really know what a PICC line was, and now you do. Did you expect a peripheral and get really surprised when you saw how long it was?

You have learned from this mistake and owned up to it and you aren't blaming anyone else. 

For that, I respect you. 

And you will never mistake a PICC for a peripheral again. 

[2BS Nurse, BSN]

Most importantly... you actually have a conscience and you've learned from your mistake. I applaud you for that! I know too many nurses who just don't care.

[socal1]

everyone is quick to point out that OP did something wrong, yet when OP posted the steps of PICC removal no one replies if its correct or not. LOL get a grip, its pretty much an IV removal and nothing happens. Just make sure they aren't bleeding and you have an order.

[Wuzzie]

6 hours ago, socal1 said:

everyone is quick to point out that OP did something wrong, yet when OP posted the steps of PICC removal no one replies if its correct or not. LOL get a grip, its pretty much an IV removal and nothing happens. Just make sure they aren't bleeding and you have an order.

That happened for 2 reasons. First it's because it did not appear that the OP grasped the most important aspect of the event and we wanted to make sure she understood so that it doesn't happen again. Otherwise, she will continue getting herself into situations such as this. And second, although PICC line removal is fairly standard, every facility has a policy and procedure for it and that is where she needs to look to find out how to do it. I don't think strangers on the internet are the best source for this kind of information. You've given us a fine example of this by over-simplifying and minimizing the risks.

[londonflo]

On 9/30/2020 at 10:43 PM, socal1 said:

yet when OP posted the steps of PICC removal no one replies if its correct or not. L

These steps do vary by facility. In ours, we put an antibiotic ointment on before the gauze. We never had to measure the PICC line. That might be something new. I was always happy to have the students remove the lines, even if it was not their patient. The look on their face when pulling and pulling was always priceless (oh, and their relief when the end was reached.) I had passed around different lines in class but of course it is so different coming out of someone's arm. My mistake once was not asking if the patient was on coumadin. Learned to always ask!

[Jory, MSN, APRN, CNM]

I have never measured a PICC line ever removal when I was a floor nurse.  Never. That is why there is a tip.  

[Megan1977, MSN, EdD, RN]

On 9/25/2020 at 5:57 PM, Sour Lemon said:

That's called a "self preservation instinct", and mine has acted up on occasion, too.

A face-to-face admission at a "good" time is usually better when confessing anything to anyone. A text is blind, and you have no idea what sort of mood that person will be in when they receive it.

I hope they are forgiving towards you. I think you deserve that.

Or where that text will ultimately land up in the future. Much better to have these kinds of conversations in person. 

[amoLucia]

Jory - only measured lines a very few times and I removed gazillions.

Just for the record, I even had a CNA who removed a line once. Not intentionally, but she came to me with the line to alert me a new drsg was needed. Seems she walked in and caught the confused pt who had all but pulled out the line - "except for the last half inch" and everything was dangling on the floor".

londonflo - I don't ever remember checking about Coumadin. Moot point for me now - am retired. But excellent point to check.

[Workitinurfava, BSN, RN]

This whole discussion should be removed as op can be tracked online.

On 9/25/2020 at 2:53 AM, SoNan said:

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

Have a backup plan in case you get axed from the program.