Problem with wound vac

[missfl07]

Hi, I am worried sick about a wound vac issue that might get me fired! I am in my job for about a year and I had my assignment that includes a wound vac patient after an I &D. The PACU forgot to bring the power cord with the wound vac and the night shift nurse and charge nurse could not find a power cord, so the wound vac ran-out of power and shuts down at 3 AM. Day shift charge nurse was notified to find a charger but she did not either instruct me neither she look for it. I notified my wound care team about the problem also my nurse leader did see the vac is off and did not gave me instruction to find one. Being Friday and being incredibly busy with my six patients I forget about it and at 4 pm MD called and get extremely angry and speak with my Manager. My manager gets on the case and filed a incident report making me responsible for everything. Wound care team refused to put the wound vac in and MD called them directly and ask them to put the vac on again. So, the wound care team put the vac on at 5 pm without any problem and pt's wound looked ok to me from outside without any harm or excessive bleeding or drainage. But the problem is the vac was off from 3 am to 5 pm and the entire blame now for the delay of care, is now put on me by the management. As a new nurse I was not so sure about how important the wound vac is and also there was not any order either to manage or observe the wound vac by the MD, like what is the pressure setting should be, etc. I told my manager but she said, the wound vac itself is a order and it doesn't matter and I will be responsible for not properly maintaining the wound vac. I did not get any couching about the wound vac and as a new RN don't have any previous experience. So, please help me with your expert opinion and experiences if you think I would be fired for this incident or not?

[Daisy4RN]

There is no way to know what your management will do but it seems unlikely they would fire you over this. That said there are things you probably could/should have done in this situation (and maybe you did but just didn't mention).

When the pt arrived without the power cord did you call PACU to see if they had it, that would have been the easy fix (if they had it). I also would have documented how the pt arrived (no power cord) and everything you did to attempt to obtain one including who you spoke to (Charge, central svc for either a cord or a new vac, wound team etc). Technically you do need an MD order to run the WVAC including pressure etc. I would have called the MD for clarification of the order (and taken a VO) and also notif him/her that at present there is no power cord (and documented that and their response). MD probably would have just OK assuming you are still trying to find one. Depending on how much time went by I might have notif the MD again prior to leaving and document they were made aware the vac would be off when the battery runs out (they might have wanted to come and put a different drsg on the wound). I would have given report on where the situation was at (at shift change), then the next nurse is responsible to f/u. It looks like you are the day nurse, gave report to NOC nurse, and came back the next day? If you did everything you could to fix the situation and documented that I don't see how it is your fault, you cant make a power cord appear out of thin air and the NOC nurse was the one present when it actually went off. When you came back on shift did you get report it was off, or find that in AM assessment, again what did you do and make sure to document (I am a little unclear re: the timing/sequence of events). I have never heard of a manager filing out an incident report that s/he had nothing to do with so I am not really sure what to make of that, also how do you know she blamed you for everything, did you see it or did she say that? If you didn't document everything you should have I would put in a "late note" and do that as soon as you can. Also, not sure why if you have a wound care team they would not help in this situation.

Either way, these things do happen and I would fine it unlikely you would be fired for just this one thing.

Hope it works out well!!