Second needlestick in 2 weeks

You need to slow down. You're on a bad trajectory. Don't let others' problems make you feel compelled to practice in an unsafe manner. You have to take whatever time it takes to be conscientious/careful.

What JKL said. I don't know if you would be fired, but it would give your manager pause- you learned nothing from your first needle stick injury and exposure. And now you didn't do the right thing and report it.

Why are you working such long hours so soon into your career? Take you time while you're new: "slow is fast." Do the right thing. Build good habits now, or else you may find you will continue bad ones for the rest of your career.

Don't your facilities needles have safety locks you can engage once you've given a medication via needle to prevent incidences like this?

Also, your health is much more important than a job

Yes, they do have safety locks, which did not help me in the first case. I hadn't gotten to use the safety lock yet on the second one.

These are just the hours I have, not usually overtime every week, but of course long days with little break. I am also in the float pool, which means I have to be familiar with multiple floors and layouts, and can have a lot of patients in one day. I am also taking two BSN classes, getting paperwork ready for a practicum course, in a nurse residency program, and my wife and I have a baby on the way in about a month. I'll be switching to overnights in about a week too.

I did see the pt had all her Heb B vaccines, as do I of course. Nothing of course about HIV, since I didn't report it, or labs for liver enzymes were available.

You already know you need to slow down. You should be counseled by your preceptor.

That will include following protocol as for any needle stick. Occupational health will do what they do to protect you.

No job is worth worrying if you contracted something from a patient.

No matter how many people are around or what else is going on, needle safety comes first. Always. Tell the family members, "Excuse me, I need to dispose this needle." ALWAYS engage the safety mechanism as the absolute first thing you do after finishing using the needle. Weren't you taught needle safety in school? I dunno about you, but HIV and Hepatitis risk were enough to make me pay attention.

And PS if you contract anything and didn't report the needle stick, you get all the bills. Workers' comp won't cover a dime. So report it.

When your needles have a safety lock, it should be basically out of habit to remove the needle from the patient and slide the safety on. Same hand that holds the needle. Practice with a few needles to get the feel of it. I would try not to let the needle be more than a few inches from the patient before having the tip secured. Then I get almost obsessive about putting sharps in the sharps container. Then clean up.

Take a lunch break. Sit down. Eat lunch. It is necessary, and a part of your job to yourself.

The only thing they would do with the new BFE is test this patient. By now you should already know if you are immune to Hep B and C, should be up to date on your Tdap, and know if you are HIV negative. You should be having routine visits for the first exposure for one year so you will know if anything changes.

Try to breathe and slow down. You'll be okay.

Edit to say that of course the right thing is to report it. You're only human.

111th said:

By now you should already know if you are immune to Hep B and C

I have never had a HepC titer and there is no vaccine, so what are you talking about?

Aunt Slappy said:

I have never had a HepC titer and there is no vaccine, so what are you talking about?

I apologize, I typed that incorrectly. I used to work for a clinic who routinely took care of post-exposure patients. It is routine to draw titers for Hep B and C. You can show immunity to Hep B of course, and Hep C should come back as "nonreactive." These lab draws need to be repeated throughout the year (1 month, 3 month, 6 month, 9 month and 1 year if I remember correctly).

I worked for a large hospital system that required all employees to have a Hep C titer drawn for employment. Only hospital out of 5 that did though. Still not positive what they would do if it came back reactive...nothing? Educate importance of standard precautions?

111th said:

I worked for a large hospital system that required all employees to have a Hep C titer drawn for employment. Only hospital out of 5 that did though. Still not positive what they would do if it came back reactive...nothing? Educate importance of standard precautions?

I worked for a hospital that tested for Hep C upon hire so they had a baseline if a needle stick occurred.

A couple things come to mind (most of which has been said in one form or another):

1. Slow down. I know when things are busy it is only natural to try and go fast, but this is how errors happen. Those errors can post a safety risk both to you and the patient.

2. Report all needle sticks right away. I can't speak for your employer, but I can't imagine them firing you for sticking yourself too many times. Heck, they may even see that there is a problem with their insulin needles, the safety lock, and/or the number of and position of sharps bins.

3. Throw a used needle in the nearest sharps bin right away. Tell families, "excuse me for one moment while I dispose of this needle. I don't want anyone to get accidentally stuck by it." I think even the most unreasonable of families will grant you 20 seconds to correctly dispose of a sharp. Don't take needles in the hall, don't even stop to answer a question between you and the sharps bin--get it to that bin and toss it.