As above, I have had 2 needlestick injuries, both insulin needles, in 2 weeks. Stupid I know, I am about 2 months into orientation as a new nurse. The first one the safety cover was on all the way, I had 2 in my hands after administration, and was talking to about a million family members, and touched the end of it, somehow piercing skin. Negative for hep C and HIV.
The second one, I was hurrying since I had 5 insulins to give in 30 minutes, again working almost 13 hours without a lunch break, and touched the end of it before I could get it to the container. I washed it right away, but did not report it this time, for fear of being fired. Now I am quite nervous since she is a LT dialysis pt, obese, end of life, mostly non-verbal.
Would I likely be fired for reporting the second needlestick, even if it's less than 24 hours? Not sure that my health is worth a job that would fire me for this stupidity, even overworked stupidity.
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.
It's hard to believe that it has been almost a year since these incidents happened, and I have learned to be much more careful with every needle I work with, though I still have much to learn. No more of these incidents, but I did have something happen a few days ago....
I was taking care of my first HIV+ patient, who I found out later also has chronic hep C and, at least at one point, hep b (what are the chances). I was being as careful as I could with her, and was even wearing gloves for something as benign as vital signs. As it happens, she also had over an inch long fingernails (surely fake). When I was performing care, she accidentally gouged her fingernail into my hand, and caused an abrasion, at least removing the epidermis. I wasn't thinking clearly at the time to try and bleed the wound, so I can't say with certainty whether it reached the bloodstream. I washed it very thoroughly. I did not report it since I figured it would just be considered a joke, and wasn't certain it had reached my blood anyways.
Not much chance of HIV transmission, unless she had been pulling an Elizabeth Bathory in a tub of her own blood before I came in the room, so I probably wouldn't have done the HIV PEP. I wished I had reported it so I could follow the Hep C--in this do you think I could get away with reporting it days later? I do feel that God has protected me from this like He did with the earlier incidents, but it's the fear of not knowing as well. Should I have taken the PEP, or would any of you?
On another note, what might some of you feel about not knowing your pt's status for these conditions? If I didn't know about the HIV, I wouldn't have been wearing gloves for her VS, most likely. I sure wish I had known to be more cautious of fingernails, especially when they aren't intentionally trying to scratch you!
psu_213, BSN, RN
3,878 Posts
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.