RN8903

I've been a nurse for 9 months now. I try very hard to do things by the book. My coworkers probably think I'm OCD. For example, if I go into an isolation room without my gown, and am afraid I might have touched something, I might wear the isolation gown in all rooms for the rest of the shift. That said, sometimes I don't do things by the book. In these cases, I often become afraid I've given my patient some sort of infection and get really bad guilt. I don't have good coping mechanisms. For example, one time I drew blood and wasn't sure if the vein I stuck was the vein I cleaned. I brought a butterfly home and stuck it into my own vein without scrubbing with alcohol just to make sure the patient/me can turn out OK. I've drawn my own blood for such reasons at least 3 times this year. I know I'm not the only one who occasionally cuts corners (haven't most people not scrubbed the hub after a flush but before attaching the IV bag?). How does everyone else deal cutting corners with a patient's health at stake? I find it hard to just forget it...

I'm a new nurse. I've been off orientation for about three months. My hospital does community health screenings for diabetes and BP/cholesterol. I was volunteering at a screening and forgot to change gloves between my first and second patients. I realized my mistake after I pricked my second patient for the blood glucose test. In a semi-panic, because I didn't want to have to stick them again, I looked at my gloved hand, didn't see any blood, and wiped the first drop of blood away. Then I changed gloves and collected her blood for the test. When I went home, I couldn't shake the idea that I might have given the second patient HIV or hepatitis from the first (keep in mind, I have no idea if the first patient had anything of the sort). A few hours after the incident, I contacted my manager, who asked if I thought there was any contamination. I said probably not. My manager gave me a number of the person in charge of the community health screenings, saying I could use it if I thought I needed to take action. After thinking it over, I decided I was probably freaking out over nothing, and that my fears didn't justify scaring the second patient. I can't get this out of my head. I did some research online and found that the risk of HIV transmission via a needlestick or open cut is 3 in 1000 (0.3%). In a scenario like mine, in which there was (hopefully) no visible blood exposure and the first patient doesn't necessarily have anything, the chance must be less. But I think about it first thing when I wake up, and whenever I'm not working. I think it's stuck in my head because I'll never know for sure. I decided not to escalate this and I still think it might have been the right decision - I can't escalate it now. I've decided to go to therapy for anxiety, because this is only the latest in a string of obsessive worries I've had for about two years. Knowing that it's probably in my head doesn't help, though.