muscledriver

That is what I was thinking as well, thinking that the inmate may have fiddled with the line seeing that she has had so many over the years and will do whatever she can to delay going back to prison. My concern now is that this doesn't get me fired! As a new RN coming up on completion of my first year working (with a very Type A personality), I am always on alert that any problem might get me canned.

Yes, the line was flushed, this is why it's so odd. I am starting to wonder, since the patient is an inmate, and has been in and out of hospitals for years with numerous central lines, with a long track record of abusive/agitated behavior while in the hospital, if they somehow tampered with the line? I mean why would there be two lines out of service with the same issue? Doesn't make any sense. Thank you for offering solutions, I work on a med-surg unit but we rarely get triple lumens so I was not sure how these types of issues are dealt with.

It's been one of those weekends... Short story...Due to past hx of drug use, pt had a TLC installed to receive abx r/t a chronic LE infection. While wrapping up my shift, I disconnected the IV line from the lumen, clamped the line and as I was going to put a cap on the lumen, the patient pulled away, the alcohol from the cap mixed with some blood at the lumen and it splashed on her gown. So, pt starts screaming I tried to pull out her line...etc. I calmly clamp her line, place the cap, change all her linens, her gown, and did my best to bow out for the night while trying to find my quiet spot. Come back on the unit this morning, to find that the entire line had clotted. It appeared as there was a backflow and it had clotted all the way to the lumen opening (making me very worried about a clot breaking off or infection). Interestingly enough, the night shift had the same issue with a separate line and now the pt's TLC is down to one working line. Apparently there were no MD's in the hospital today that could deal with this in order to fix it. So my question is - how can this be fixed? I would think you should just be able to put TPA in the line to dissolve the clot but one of the nurses told me that the clot may be too large for this method. I also find it very strange that another RN ended their shift with the same issue. I work on a run of the mill MedSurg floor and I do not have a ton of experience with the TLC, so I apologize if this sounds like a simple fix. I feel terrible that this happened, and take it very personally, I just don't understand how it came about when the line was clamped and capped.

Thank you for you replies! I really appreciate the support. Several close friends who are also RN's basically had the same response as you guys, and also said in actuality I probably played a large role in saving a life. I was also told by one co-worker that the patient has a history of doing this, and felt it was just a matter of time that something like this happened. Hopefully when I return to my unit tomorrow and speak to my manager, we can have a rational conversation about it.

Recently just experienced my first patient fall, and feel completely horrible about it. The patient is a TBI (appx 2 years ago, has no family) whom experiences seizures. She is mute and rarely gets out of bed, but when she does, she jolts out of bed and quickly springs up the hall only to return a minute or so later. After assessing the patient during the evening, prior to shift change, she was resting calmly in bed, staring straight up (baseline) and bed alarm was on (documented). About 10 minutes after leaving the room while writing my notes at the nursing stations, I hear this sort of "grumbling" and then a big hit on the floor. I sprang up from my seat and sprinted over to find her face down on the floor in her own blood. Assuming she had a seizure, I rolled her on her side, checked pulses and respirations - still alive. I yelled for RRT, and assistance, none of the other nurses on the floor responded. I yelled again for assistance, this time I got someone to come, I ran for the crash cart, placed oxygen on the woman, and began to suction. Finally, the troops arrived, we stabilized her, got her on a stretcher, and sent off for a ct. The part that kills me aside from initially having nearly no back up (which has happened 2-3x with recent RRT's), is the bed alarm. I cannot recall if it went off, and even if it had, would I have been able to have gotten there in time to prevent this from happening? It is known that her roommate tends to turn her alarm off because she hates the noise it makes, and I know that it was on when I assessed the patient just prior to the incident - so its possible she turned it off when I exited the room. I feel completely awful this person got hurt, and even though the managers all told me I did a good job, reacted correctly, these kinds of things happen and are unpredictable, etc - I don't know what kind of trouble will result due to this and as a new RN, I am quite nervous about it. Can anyone offer some advice regarding this situation? My stomach is in knots! Thank you for reading.

Thank you very much for taking the time to explain it. So in reality there really is no getting a "100%", it is all based on relative scoring to the other test takers? I was really just trying to figure out if the grades I recieved are considered better than average and it seems that they are. But just to clarify, according to my composite (composite is the one I should be paying attention to right?) AD score of 88, (I am going to a community college with an associate program) I did 88% better than the other people who took the test that same day? Does this sound right?

I just took the Pax-RN today and I ended up with a composite score of 127. What does the composite percentile score really mean? On my school's website it says composite score grades fall in the area of 0-160, so I am guessing my score is "decent"? Also, it says under "DI" that it is a 93, "AD" was an 88 and "ALL" was an 89. What do these scores mean to me? Thanks for your help!