I have 3 years experience on an Onc floor, but I'm new to ICU. Last shift, a newly intubated s/p cabg (2 days) pt was intubated and an OG tube was placed @ 1500 and the MD said it sounded like "it is in the right place". At 1730, I was expected to give meds via the tube. I heard no air bubble in the R abd, a faint bubble midline. When I drew back on the tube, I only got frothy, clear fluid. In all the NG or OG tubes I've used, I ALWAYS got some kind of greenish gastric fluid back and ALWAYS got a clear sound of an air bubble in the R ABD. I questioned this to my preceptor (she has one year in ICU) and she too questioned the placement. She suggested I order an xray to confirm placement which I did. I did not give the meds. Another, more experienced nurse came to listen and said she "thought the bubble sound was OK". This nurse has never been helpful to me, indeed, she has exuded hostility for the 6 weeks I've oriented on the unit. She reported to the Charge Nurse that I "refuse to take direction" and the Charge Nurse reported that to the Nurse Manager. I was called on the carpet to explain my behavior. The nurse manager said it was "common" in the ICU to get back clear, frothy fluid from a pt who had not eaten in 2 days and that "if the tube had been in the lungs, the pt would have been desatting".
