I'm fairly new to L&D, only 3 days off orientation. My 2nd night, I had my 2nd delivery at 0622. The doc stitched the lac and just left. I was a little peeved that he'd left all the instruments out on the table, even with the basket for them in the corner. As I'm picking them up however, I see the needle he used. It's still in the needdle driver, pointed up, just lying out on the table. We have the needle holder box on all our delivery tables, but he didn't bother putting the needle in it. He didn't even tell me there was a sharp out!!! :angryfire
I mentioned it to the nurse I gave report to after it happened. She said it wasn't really unusual, especially with this doc, and that she's just really careful cleaning up the table. Is there something wrong with me for thinking that's INSANE? Every other delivery I've seen since I've been on the unit, the docs cleaned up after themselves. Last night after a delivery, doc put the needle box in the sharps container. I made a point to thank him for it and he looked at me like I'd grown 3 horns. He said it was "unfathomable to not take care of my sharps" and asked if other docs didn't. I gave him a very generic version of the other delivery. He said the only time he'd leave his stuff was if he was called away for something urgent, but he'd make sure the nurse knew there was a sharp out on the table.
Ok, now that I've gotten that off my chest... How would you handle this? He was already back in the on call room sleeping by the time I got around to the table. Should I just double glove and use hemostats to clean up his tables from now on or is this something worth fussing about? You guys always give the best advice, can't wait to hear it
I see this all the time. I use to work for an FNP and he was good about throwing his needles out. However, a few of the docs I also work with leave their used sutures, disposable scalpers and needles on the tray. You just have to be aware and be careful when you clean up. Although they should do this themselves.
I'm apparently the only one, but I wouldn't have a problem with this at all. I've seen it happen so many times that I always just assume there are sharps out and act accordingly when I'm cleaning up.
No, you aren't the only one.
We only have one doc who cleans up after himself and does a really good job, taking the placenta and dirty instruments out of the room, wiping up blood from the floor, putting his sharps in the sharps box. But he was an orderly prior to becoming a doc and was well trained by NURSES.
All the others basically walk out after the delivery. I always assume there are sharps on the table . . . oh and by the way our sharps container is across the room and wouldn't fit on our table.
We only have one doc who cleans up after himself and does a really good job, taking the placenta and dirty instruments out of the room, wiping up blood from the floor, putting his sharps in the sharps box. But he was an orderly prior to becoming a doc and was well trained by NURSES.
. . . oh and by the way our sharps container is across the room and wouldn't fit on our table.
steph
Actually, most of our residents do that too. They put all the scissors and stuff in the basket (that we leave on the table for just that reason, it's easy and convinient for them to toss stuff in after using it) and all the bloody gauzes and biohazard bags in the big red trashcan. And btw, our delivery kits include a needle holder box. It's small, red, and has styrofoam to stick the needles into. Like I said in my OP, I was a little peeved that he'd left me a huge mess to clean up, but I can deal with that. What absolutely burned my butt was the fact that he'd left a dirty needle on the table without even bothering to tell me it was there. It wasn't stuck into the foam, I could have handled that. It was still in the needle driver, just lying there saying "get stuck on me, get stuck on me!"
Since a couple people have said this wouldn't bother them, I'm kinda curious about the reasons why? I know they work long hours and have to carry the brunt of liability if a baby goes bad, but should that mean that they are excused from taking responsibility for themselves and the equipment they use? And if I'd just started cleaning up the table and gotten stuck (because I'd never imagined a doc would leave sharps in the open, and because he couldn't be bothered to tell me it was out) would that have been my fault for not expecting it to be there since some people think it's OK that he left it?
I think he should be admonished, but not by you. As a new nurse, he is likely to take offense and it may be uncomfortable working with him after. What I would do is go to my supervisor, and let him/her address the doctor. That's proper chain of command in most facilities, and prevents retribution.
When I received my phlebotomy training we were told to ALWAYS think of dirty needles as load guns ready to go off at any min. They were to be disposed of immediately! As we were told, being stuck by one is like playing russian roulett. It is irresponsible for him to leave sharps laying around, and by not telling anyone they were on the table he is showing a complete disregard for the safety of the other staff. UNACCEPTABLE! I would talk to your supervisor b/c you are new and have not gotten to know the docs (he may not listen to you and be angry at you for callng him out on his reckless behavior). Let the charge do it so that you can remain anonomus (sp??). Good luck! Remember you must also advocate for yourself!
What I would do is go to my supervisor, and let him/her address the doctor. That's proper chain of command in most facilities, and prevents retribution.
Good point! Since the other nurse said he generally doesn't pick up his sharps, it's probably common knowledge. Having my NM talk to him sounds much better. Thanks
Since a couple people have said this wouldn't bother them, I'm kinda curious about the reasons why? I know they work long hours and have to carry the brunt of liability if a baby goes bad, but should that mean that they are excused from taking responsibility for themselves and the equipment they use? And if I'd just started cleaning up the table and gotten stuck (because I'd never imagined a doc would leave sharps in the open, and because he couldn't be bothered to tell me it was out) would that have been my fault for not expecting it to be there since some people think it's OK that he left it?
It's not that I think docs are so great that they shouldn't show common courtesy, I just don't think this is a big deal. Where I've worked, the nurse is usually the one responsible for cleaning up equipment after delivery. I don't consider a used sharp any different from any other part of the delivery equipment cleanup. I don't expect the docs to bag the placenta or help mom breastfeed or anything either. I'm not saying it wouldn't be nice, I just don't get mad for them not doing it. I do think it would be your fault if you got stuck when you are cleaning up after a delivery because I think you should always assume a tray with other sharps on it is dangerous. Some of them will even get bloody when they haven't been used thanks to dripping blood. I never use my hands to clean up that kind of a tray. Plus in the end it doesn't really matter if it is the doctor's fault or mine, I just don't want to get stuck.
It's not that I think docs are so great that they shouldn't show common courtesy, I just don't think this is a big deal. Where I've worked, the nurse is usually the one responsible for cleaning up equipment after delivery. I don't consider a used sharp any different from any other part of the delivery equipment cleanup. I don't expect the docs to bag the placenta or help mom breastfeed or anything either. I'm not saying it wouldn't be nice, I just don't get mad for them not doing it. I do think it would be your fault if you got stuck when you are cleaning up after a delivery because I think you should always assume a tray with other sharps on it is dangerous. Some of them will even get bloody when they haven't been used thanks to dripping blood. I never use my hands to clean up that kind of a tray. Plus in the end it doesn't really matter if it is the doctor's fault or mine, I just don't want to get stuck.
I DO think it is a big deal when ANYONE does not dispose of sharps properly including doctors. I will agree that one should use caution when cleaning up equipment/work areas in case of sharps being left behind, not using your hands to clean up a tray after use is one method and a good one. Gloves DO NOT offer protection from sharps.
Last night while at work there was an incident of a transporter receiving a needle stick injury BECAUSE someone left that sharp on the stretcher that was used to transport the patient. The needle stick injury I received years ago happened in a similar fashion. Pure careless thoughlessness in both instances on the part of those that left the sharps. The point is: whether your a nurse, a plebotomist, doctor, etc, IF YOU USE A SHARP, DISPOSE OF IT PROPERLY.
Sharps being left in a bed are another matter IMO. That would make me mad. I just think that's different from sharps being on a tray that you know has sharps on it.
Sharps being left in a bed are another matter IMO. That would make me mad. I just think that's different from sharps being on a tray that you know has sharps on it.
I can deal with the fact that he left all the equipment out. I can even suck it up that he didn't dispose of the needle into the sharps box. The point of my anger is that he couldn't be bothered to take the needleand simply stick it into the needle box so the point isn't an injury waiting to happen. I absolutely don't think it's too much to ask for a doc to take care of his own sharps, at least to make them less likely to cause a needle stick. The box is on the delivery table, right next to where he picked up (and incidentally, laid down) the needle driver. It literally would have taken 2 seconds of his time, or he could have saved a second and said "there's a sharp on the table"
I'm beginning to think he's just been conditioned to believe (by nurses who don't think it's a big deal telling the nurses who do that it's really not) it's OK to leave your used sharps on the table. If we get stuck it becomes our fault because we should have known it was there???????? Well, by that argument, a transporter should know that patients get shots in their beds. S/he should have been more careful, so it's their fault for not anticipating a needle in the bed.:trout:
I don't see how anyone could think we should EXPECT sharps to be left in the bed. Doing that is an issue of patient safety and most hospitals use safety needles nowadays anyways (those plastic ones or the ones that automatically retract). That's a little different than a delivery tray which always has sharps (used or unused) on it.
If you think it's a big deal, that's fine. So do a lot of other posters here obviously. I don't see why you'd be upset that some of us don't or would imply that we're the reason docs do this. You asked what people thought. I'm just being honest with you.
Like I said, I never used my hands to clean up those trays anyways, so why would I care if there was a used sharp there? I know it isn't a threat to my safety. I just wouldn't risk MY safety even if I was 100% convinced I was right in the argument with the doc. Your manager can talk to him. He may even promise to never do it again, but would you really believe him? Will you ever clean up one of his trays again without assuming there is a used sharp ready to poke you? I doubt it. Plus, even the best docs can leave a sharp out by accident once, so I figure erring on the side of caution all the time is a good idea.
HeartsOpenWide, RN
1 Article; 2,889 Posts
I see this all the time. I use to work for an FNP and he was good about throwing his needles out. However, a few of the docs I also work with leave their used sutures, disposable scalpers and needles on the tray. You just have to be aware and be careful when you clean up. Although they should do this themselves.