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
That's a little different than a delivery tray which always has sharps (used or unused) on it.
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.
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.
Actually, our trays don't come with sharps. Hemostats, scissors, clamps and needle drivers, yes... needles, nope. Not on there. Docs pull their own sutures from the drawer.
I wasn't trying to say that this doc makes a habit of leaving his needles on the table because of you. Sorry if it came across that way. I was ready to write an incident report about it, and was made to feel (by the oncoming nurse) that I was crazy for not being OK with him leaving a needle, I didn't even know was there, exposed. What I meant to say was something along the lines of "Nurses have continued to clean up after him without making a fuss about the danger he's placing us in with every delivery. That makes the ones who want to fuss feel like we're wrong in some way. Furthermore, it perpetuates (to him) the myth that he doesn't need to take responsibility for his needles"
You're absolutely right. I will never put my hand on one of his tables again. I'll use a pair of scissors to pick up the handles of the instruments until I have a clear view and know there's nothing hazardous to my health left.
I really am trying to understand the logic of those who don't think it's a big deal. I'll admit, it's for the selfish reason of recruiting other nurses at work to present a united front when docs jeapordize our safety. But, if I don't know the reasons why people aren't bothered by it, I don't know what arguments to make.
I've been working in the hospital for almost 6 years. I've never been as close to being stuck as I was that morning. If I appear to be lashing at out at the posters who don't think it's a big deal, I apologize. I'm not trying to. I'm still very angry that my entire world could have changed in a second because of his action (or inaction, however you'd like to look at it) so maybe I'm projecting a bit of that... I was told that he routinely leaves needles out, and can't help but think it's because nurses on the unit have become complacent about the issue. Hopefully I'll be able to stir things up enough it's no longer an everyday occurance. I am definately going to be more careful from now on. I'm going to ask all my docs if they've taken care of their sharps before they leave the room though
Specializes in Specializes in L/D, newborn, GYN, LTC, Dialysis.
I always ask if they dispensed with their sharps (if for some reason I did not see them do it)----- and keep a count of them myself so I know what is on the table, and what is not. Most of our docs are very considerate and dispose of their own; a couple do not, but I know what is there and dispose of them myself very carefully. Never ever ASSUME anything when it comes to sharps; this rule will save you heartache and injury down the line.
I am truly so sorry for your scare. I dont' blame your being upset. I am sure you learned a lot from this situation!
Actually, our trays don't come with sharps. Hemostats, scissors, clamps and needle drivers, yes... needles, nope. Not on there. Docs pull their own sutures from the drawer.
I wasn't trying to say that this doc makes a habit of leaving his needles on the table because of you. Sorry if it came across that way. I was ready to write an incident report about it, and was made to feel (by the oncoming nurse) that I was crazy for not being OK with him leaving a needle, I didn't even know was there, exposed. What I meant to say was something along the lines of "Nurses have continued to clean up after him without making a fuss about the danger he's placing us in with every delivery. That makes the ones who want to fuss feel like we're wrong in some way. Furthermore, it perpetuates (to him) the myth that he doesn't need to take responsibility for his needles"
You're absolutely right. I will never put my hand on one of his tables again. I'll use a pair of scissors to pick up the handles of the instruments until I have a clear view and know there's nothing hazardous to my health left.
I really am trying to understand the logic of those who don't think it's a big deal. I'll admit, it's for the selfish reason of recruiting other nurses at work to present a united front when docs jeapordize our safety. But, if I don't know the reasons why people aren't bothered by it, I don't know what arguments to make.
I've been working in the hospital for almost 6 years. I've never been as close to being stuck as I was that morning. If I appear to be lashing at out at the posters who don't think it's a big deal, I apologize. I'm not trying to. I'm still very angry that my entire world could have changed in a second because of his action (or inaction, however you'd like to look at it) so maybe I'm projecting a bit of that... I was told that he routinely leaves needles out, and can't help but think it's because nurses on the unit have become complacent about the issue. Hopefully I'll be able to stir things up enough it's no longer an everyday occurance. I am definately going to be more careful from now on. I'm going to ask all my docs if they've taken care of their sharps before they leave the room though
Thanks for the clarification. Even "just" scissors are enough to make me not clean up a tray with my hands. I understand why a close call like that would upset you. A needlestick injury is every nurse's nightmare scenario and I hope you never have to deal with another scare or worse.
The reason a doc leaving a sharp on a tray doesn't particularly bother me is that I know it doesn't endanger my safety because I don't clean up those trays with my hands EVER. I think cleaning up those trays should always be done with an instrument, since any doc can have a lapse. I don't freak about a doc's behavior in this case because I know that I have the power to keep myself safe regardless of what they do. Maybe I am just not a trusting enough person, but I wouldn't even clean up those trays with my hands even if it was with a doc who "never" leaves sharps out. My paranoia has worked for me so far (I've been a nurse for not that much longer than you've been working in hospitals:)).
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
OK if it was me I would prepare what I was going to say first, making sure I knew what the hospital's policies were for disposal of sharps, then speak to the Doc about it. I would politely but very firmly tell him (or her) that it is not acceptable that they do that, and tell them that next time I would not be cleaning it up for them because I don't want to risk a needle stick. You have to expect that they will pretend they cleaned up properly/ get defensive/ blame you. I would then say "that's fine (I have a way of saying fine that makes them realise that it's not fine at all) but if it happens again I will have to fill in an incident form (or whatever you have at your hospital) as a near miss." They will probably get reasonably angry but if you know the policies and reiterate to them that this is hospital policy and if they don't like it they can take it up with the manager / CEO / Chief etc they will probably be OK in the end. This is just me though!!
I work in OR and have found that if I politely but firmly tell doctors that I need them to do something differently, they are usually quite happy about it. Such as "I don't mind if you take the scalpel off my mayo tray but could you please take it in the sharps dish because I don't want to get stabbed".
Good on you for getting angry and not just accepting it. I was always taught in Nursing school that just because it has been done that way for a long time doesn't mean it's right. We have to be proactive in protecting our own health and safety!
I think this, too, unfortunately is more commonplace than you would think. I followed the night supervisor on 7-3 shift and over the course of 1 year, found 4 sharps either on the bed of a pt or on the bedside table. I was mortified. I never filed a report, because I know the DON would have discarded it, and never pursued it, but I did make her aware of it.
As new nurses, we have such high expectations, I don't know why, but it I have found nursing to be nothing like I was taught in school. That is sad!
This definitely sounds like an issue that needs to be addressed, and I'm glad to hear that you were able to see the needle before you may have been stuck!
If I was in your situation as you described it, I would probably try and make the best of it by turning it into a learning experience and always assume that there is a chance that there may be a sharp left and to take such precautions - and especially when cleaning up after this doctor. I would also start to ask this doctor if there are any sharps left out before he left in hopes that he would 'get the hint', and maybe even approach this doctor and explain to him as you did to us that you did not expect that you would find an exposed sharp like that when cleaning the area after he left and the possibility of you being stuck had you not seen it, etc. But only if you feel comfortable talking with this doctor-depends on your relationship with this doc.
I would definitelly recommend following the chain of command and protocol for your institution for reporting incidents starting with either the charge nurse or nurse manager and going from there and filling out an incident report about the situation. Although you were lucky enough to see the needle before possibly getting stuck, along with others that have worked with this doctor already know to expect this from him, the next person may not be so lucky! Bottom line is that this is not safe practice and needs to be addressed.
Good luck to you with whatever you may choose to do with this situation, this was just my "2 cents"....I'm sure you will do what is right. Keep us posted and let us know how you made out!
This definitely sounds like an issue that needs to be addressed, and I'm glad to hear that you were able to see the needle before you may have been stuck!
If I was in your situation as you described it, I would probably try and make the best of it by turning it into a learning experience and always assume that there is a chance that there may be a sharp left and to take such precautions - and especially when cleaning up after this doctor. I would also start to ask this doctor if there are any sharps left out before he left in hopes that he would 'get the hint', and maybe even approach this doctor and explain to him as you did to us that you did not expect that you would find an exposed sharp like that when cleaning the area after he left and the possibility of you being stuck had you not seen it, etc. But only if you feel comfortable talking with this doctor-depends on your relationship with this doc.
I would definitelly recommend following the chain of command and protocol for your institution for reporting incidents starting with either the charge nurse or nurse manager and going from there and filling out an incident report about the situation. Although you were lucky enough to see the needle before possibly getting stuck, along with others that have worked with this doctor already know to expect this from him, the next person may not be so lucky! Bottom line is that this is not safe practice and needs to be addressed.
Good luck to you with whatever you may choose to do with this situation, this was just my "2 cents"....I'm sure you will do what is right. Keep us posted and let us know how you made out!
LUVNOB
It has opened my eyes a bit, so I'm not just gonna start cleaning up the tables for the few docs that don't take care of their instruments without first asking them if they've taken care of any sharps. Still gonna be careful though. I've got the number for risk management. I think I'm going to give them a call before I go to bed tomorrow morning. I tried filling out an occurance report on it, but ours are electronic and it can't be submitted without a patient or visitor name. It's common knowledge among the more experienced staff that he routinely does that, but new nurses aren't warned about it. We have LDR rooms, and the FOB, friends and grandmas are routinely in the room at delivery. One of them could just as easily have put a hand down on it too!
I don't know why, but it I have found nursing to be nothing like I was taught in school. That is sad!
Sher
yes i agree - when i started out a million yrs ago lol - what was said was "welcome to the real world now" - sad but true things arent all hunky dory as they portray in school. hang in there - its the little changes we make ( like getting your doc to put away his sharps ) that make big differences.
nursejohio, ASN, RN
284 Posts
Actually, our trays don't come with sharps. Hemostats, scissors, clamps and needle drivers, yes... needles, nope. Not on there. Docs pull their own sutures from the drawer.
I wasn't trying to say that this doc makes a habit of leaving his needles on the table because of you. Sorry if it came across that way. I was ready to write an incident report about it, and was made to feel (by the oncoming nurse) that I was crazy for not being OK with him leaving a needle, I didn't even know was there, exposed. What I meant to say was something along the lines of "Nurses have continued to clean up after him without making a fuss about the danger he's placing us in with every delivery. That makes the ones who want to fuss feel like we're wrong in some way. Furthermore, it perpetuates (to him) the myth that he doesn't need to take responsibility for his needles"
You're absolutely right. I will never put my hand on one of his tables again. I'll use a pair of scissors to pick up the handles of the instruments until I have a clear view and know there's nothing hazardous to my health left.
I really am trying to understand the logic of those who don't think it's a big deal. I'll admit, it's for the selfish reason of recruiting other nurses at work to present a united front when docs jeapordize our safety. But, if I don't know the reasons why people aren't bothered by it, I don't know what arguments to make.
I've been working in the hospital for almost 6 years. I've never been as close to being stuck as I was that morning. If I appear to be lashing at out at the posters who don't think it's a big deal, I apologize. I'm not trying to. I'm still very angry that my entire world could have changed in a second because of his action (or inaction, however you'd like to look at it) so maybe I'm projecting a bit of that... I was told that he routinely leaves needles out, and can't help but think it's because nurses on the unit have become complacent about the issue. Hopefully I'll be able to stir things up enough it's no longer an everyday occurance. I am definately going to be more careful from now on. I'm going to ask all my docs if they've taken care of their sharps before they leave the room though