Really Nervous about Everything. Should I reconsider nursing?

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Hi guys,

So I am a nursing student who has done her first Med Pass today. But now I am so worried, my patient needed insulin today. So when I was drawing up the insulin, my stupid self got nervous and slipped and got a NEEDLESTICK!! The thing is I wasn't wearing gloves, and my nurse didn't say anything about it. I was in the nurse's station when I was drawing up the medication. The needle was not used and it was clean. My nurse saw me stick myself, she said "it's a clean needle it's fine". I also informed my instructor and she said since it was a clean needle, I should not worry. However, I can't stop worrying. I wasn't wearing gloves when I was taking up the insulin but the needle was clean. I am so stressed and I feel like maybe I am not cut out to be a nurse. What do you guys think? What are your advice? Should I get my blood tested? Should I reconsider my career?

Specializes in Critical Care.
1 hour ago, ppham said:

Well, recommendation means you don't legally have to. So it's up to you really. It's kinda of like teachers recommending nursing students to not work while in nursing school, but you know not everyone choose to do that (or can't afford to for some). I mean it's just a recommendation.

It's not that it's just a recommendation, it's not a recommendation at all.

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Specializes in retired LTC.
On ‎2‎/‎8‎/‎2020 at 4:48 PM, MunoRN said:

The type of "needlestick" you need to be concerned about is when the needle has already been used on the patient since that's the only way to potentially transfer a bloodborne pathogen from the patient to you.

As for being nervous as a student nurse, that's healthy and shows you're aware of the potential risks in what we do, I'd be more concerned if you were never nervous.

The other type of "needlestick" you need to be concerned about is when it is UNKNOWN if the needle has been used or not.

The one and only time I had to counsel a nurse re a stick is when a med nurse got stuck by an insulin syringe just laying in the med drawer. Of course, all the other nurses denied knowing about it, so that nurse had to go thru the protocol. This was in the early days of the AIDS/HIV scare and that nurse was scared! I felt his angst of not knowing.

OP - it's those unknown needlesticks (and those USED ones) that you can't take any risks. You proceed with reporting it and following whatever the protocol requires.

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46 minutes ago, MunoRN said:

It's not that it's just a recommendation, it's not a recommendation at all.

I clicked on the CDC recommended link that someone linked in their post and under the section that says "Recommended Practices for Preventing Bloodborne Pathogen Transmission during Blood Glucose Monitoring and Insulin Administration in Healthcare Settings," it says to wear gloves...

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14 minutes ago, ppham said:

I clicked on the CDC recommended link that someone linked in their post and under the section that says "Recommended Practices for Preventing Bloodborne Pathogen Transmission during Blood Glucose Monitoring and Insulin Administration in Healthcare Settings," it says to wear gloves...

That is for finger sticks where there is of course blood...

Screenshot_20200209-203417_Samsung capture.jpg
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23 minutes ago, Orion81RN said:

That is for finger sticks where there is of course blood...

Screenshot_20200209-203417_Samsung capture.jpg

Exactly, it says "Wear gloves during blood glucose monitoring and during any other procedure that involves potential exposure to blood or body fluids." Even when the chances are low, it's still a chance, hence it's still a potential exposure to blood.

So you're saying giving insulin to a patient with needles, where you are piercing someone's skin is not a "potential exposure to blood?"

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Specializes in Critical Care.
46 minutes ago, ppham said:

I clicked on the CDC recommended link that someone linked in their post and under the section that says "Recommended Practices for Preventing Bloodborne Pathogen Transmission during Blood Glucose Monitoring and Insulin Administration in Healthcare Settings," it says to wear gloves...

Yes, it recommends gloves for "blood glucose monitoring", not for insulin administration.

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Specializes in Critical Care.
4 minutes ago, ppham said:

Exactly, it says "Wear gloves during blood glucose monitoring and during any other procedure that involves potential exposure to blood or body fluids." Even when the chances are low, it's still a chance, hence it's still a potential exposure to blood.

So you're saying giving insulin to a patient with needles, where you are piercing someone's skin is not a "potential exposure to blood?"

No it's not a potential exposure to blood, if you feel that it is then you should revisit your technique since with proper technique there is no meaningful likelihood of getting blood on your hands.

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8 minutes ago, MunoRN said:

No it's not a potential exposure to blood, if you feel that it is then you should revisit your technique since with proper technique there is no meaningful likelihood of getting blood on your hands.

I don't find anything wrong with my technique, but if there's a chance for exposure even if it's low, the risk is still there. I've seen blood coming out from patients when insulin were given from myself and other experienced RNs throughout the nursing career. It rarely happens, but it does happen. You never know, to be on the safe side, I would wear gloves and still recommend other nurses to wear gloves. It's just a recommendation and in the end, it is up to you to decide, right?

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22 minutes ago, ppham said:

I don't find anything wrong with my technique, but if there's a chance for exposure even if it's low, the risk is still there. I've seen blood coming out from patients when insulin were given from myself and other experienced RNs throughout the nursing career. It rarely happens, but it does happen. You never know, to be on the safe side, I would wear gloves and still recommend other nurses to wear gloves. It's just a recommendation and in the end, it is up to you to decide, right?

?‍♀️ I'm going to start walking around with a helmet since its possible I might trip and hit my head. Not one time did I ever draw blood after giving 100+ injections within a few hours at the allergy clinic. I didn't say there is anything wrong with your technique, other than wasted supplies and money. I don't have that luxury in home care as supplies are severely lacking.

Heck, that's it. I'm wearing gloves all the time. I might scratch someone and draw blood. Not very likely. I do have short nails. But it CAN happen.

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8 minutes ago, Orion81RN said:

?‍♀️ I'm going to start walking around with a helmet since its possible I might trip and hit my head. Not one time did I ever draw blood after giving 100+ injections within a few hours at the allergy clinic. I didn't say there is anything wrong with your technique, other than wasted supplies and money. I don't have that luxury in home care as supplies are severely lacking.

Heck, that's it. I'm wearing gloves all the time. I might scratch someone and draw blood. Not very likely. I do have short nails. But it CAN happen.

The technique response wasn't for you at all :). You are correct about the helmet example, but that's for the helmet example. I will say this, I don't think we are wrong, we just practice nursing differently. Heck, maybe your facility doesn't require it but mine does ?. And your experiences varied from mine, and so the person next to me. You didn't see blood from doing those 100 injections, but that's your experience, not mine :). It only takes 1 exposure and your life could be ruined. In this case, both me and u and Muno, no one is wrong at all, just different approaches on this matter is all. We still have a long career life ahead of us, so let's just all be safe ?

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Just now, ppham said:

The technique response wasn't for you at all :). You are correct about the helmet example, but that's for the helmet example. I will say this, I don't think we are wrong, we just practice nursing differently. Heck, maybe your facility doesn't require it but mine does ?. It only takes 1 exposure and your life could be ruined. In this case, both me and u and Muno, no one is wrong at all, just different approaches on this matter is all. We still have a long career life ahead of us, so let's just all be safe ?

The helmet example came to my mind very quickly bc...I actually do want to wear a helmet while driving. ? I think everyone should. My friend teased me one time, saying everyone would know my family was out on the town bc we'd be the bunch wearing helmets.

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5 hours ago, Orion81RN said:

I'm getting confused about the gloves comments. Probably because I worked at 2 allergy clinics where I'd give injections to 50 patients back to back. Never wore gloves. According to the CDC, OSHA, the WHO wearing gloves for injections is not necessary unless you anticipate blood. I do wear them to give heparin.

The key phrase is "unless you anticipate blood". The problem is we cannot really anticipate what will happen so the guidelines are left open for you to use your own clinical judgement. When administering injections - from intradermal ppd to deep IM shots. Everytime you puncture the skin there is that potential for blood exposure so it is a safe practice to wear gloves to protect yourself.

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