Policy breach.

[augustRN13]

I recently took a temporary position in an Interventional Radiology Suite. Within the first 4 days of starting, I had noticed several things that were total breaches in policy. They don't witness the narcotic count and when asked why I was told there aren't enough nurses on staff.

When being instructed on how to use a PCA pump for a Uterine Fibroid Embolization, I asked who I should grab to do the independent-double check. I was told again, that they don't do those because there's not enough nurses.

I left for break while this nurse was trying to figure out how to set up the PCA. When I returned the procedure had begun. Throughout, the patient kept stating how much pain she was in. By the end of it, she was shaking, hypertensive, and crying, rating her pain an 8/10. When we went back to check the PCA we noticed that the line of the PCA pump was never connected to the patient's IV line. The med had just been leaking on the floor! I was so horrified.

When I mentioned submitting an RLS (a learning report for medication or other errors) I was told, "don't kid yourself, if you think you'll never make a mistake like this someday".

I was appalled. Not only did I report the incident and all the other downfalls the unit was experiencing, I asked to be reinstated in my old position. I was so afraid of hurting someone or losing my licence that I didn't want to stay.

I got some backlash from my old manager in regards to this. A conversation I had with him left me feeling like I did the wrong thing. He basically told me I'm burning bridges and need to watch my back because now I look unreliable.

Anyone had a similar situation? I just feel like I should have had more support from my nursing manager.

Feeling pretty bummed, currently.

[8-ball, BSN]

First of all I don't think you are wrong. Witnessing Narcs is part of your license. I might have dealt with it differently but we each handle things differently. I would have submitted a report (each hospital has a different name for the system they use but whatever its called there) which it sounds like you did. I would have gone to the manager and told him/her my concerns. If that doesn't help there are higher level people to report to inside the hospital then I may have reached out to people outside the hospital (JCHAO, Etc). When I worked IR we witnessed waste all the time...we didn't deal with PCAs much so we asked them to remain on the floor and we sedated with Fentanyl/versed.

[armyicurn]

OP,

run!!! Sounds like that place is out of control and basically do not give a ____________! If they are not staffed sufficiently, then they should not be doing cases. @ 8-ball has pretty much covered the rest of what I would say.

Have you thought of going to see patient advocacy? Perhaps PI coordinator?

And that manager you have for a boss is worthless!

[BexnRN]

We sedate during a UAE and have the PCA ready for afterwards. But I've seen floor nurses who didn't know how to hook one up properly. I would have gone to administration. Sounds like that department needs a major shake up. They're gonna kill somebody. They need nursing re-education to start with at the very least. And it sounds like they have no nursing oversight as in the last two IR departments I worked in, until we made a lot of noise. We mentioned it repeatedly during a Joint Commission visit for stroke certification :)

[Wjcostel]

Unbelievable , someone is going to get hurt.