Well, this happened about two weeks ago...but I haven't forgotten it yet.
We had a repeat customer...a 90 year old female, readmitted for Sepcemia...high fever, UTI, ect. ect. ect. The family had made DNR decisions...but had her dragged to the ER because she was sick. She had just went back to the nursing facility...can we say for 1 day!!!! She had a handy dandy PICC line in her right upper arm....can we say infiltrated to the max...hard, hot, swollen...but somebody had infused IV antibiotics into it regardless.
We got an order for Anesthesia to come and check the line (Xray showed it was out of the vessell....gee...lack of blood return..hot, hard, swollen...that could have been a couple of cheaper alternatives to the Xray). The Dr. wanted another one in. The RN Anesthesic person had to go to an ER C-Sec, so we get the ACTUAL Anesthesia MD....hummmmmmmmm...how did the DNR pt rate that.
Doc is pissed, called out on a weekend, for a DNR patient to place a PICC line when she is SEPTIC already! Call me callused, but I still thought the Doc should have used Sterile Technique...and when she couldn't get the vein...how about a new needle?? No exageration. She stuck that poor woman over 20 times with the same contaminated needle, she finally got blood return. Spurt, Spurt, Spurt....NURSE, DO YOU THINK THAT IS AN ARTERY??? Yes, Highly Trained MD, I do Believe that is an Artery! NURSE, I THINK THIS IS A VEIN! Sorry Highly Trained MD, but I think Arteries Spurt and Pump Blood in time to the Heart Beat....PUMP, PUMP, SPURT, SPURT! NURSE....ARE YOU SURE THIS ISN'T A VEIN, the Highly Trained MD asks, as she drags the INNER cannula (blue) part of the STERILE PICC line set up over my UNSTERILE arm (she didn't set up a sterile field before she started. No ALMIGHTY HIGHLY TRAINED MD, that is obviously an ARTERY...and you just contaminated the sterile cannula....let me go and locate another sterile kit.
I had to leave the room, get a breath. I left the nurse aide in the room and Paged the Nursing Supervisor. I gave a brief...accurate description of the problem to the House Supv, who went to locate another kit....(she also was in the ER C-SEC.) When I get back the Nurse Aide states...I'm leaving...and walks out. Now I know I'm no rocket scientist...but if the Nurse Aide is worried...hummmmm...now I am stuck alone with pissed off Highly Trained MD. WHO FINALLY FINDS A VIEN WITH THE multi-used *sterile* needle and starts feeding the *sterile* cannula in.
STOP....THAT IS A CONTAMINATED CANNULA....STOP THAT IS CONTAMINATED. Her reply...I finally got a vein, why didn't you tell me before this is was contaminated...you did not tell me.
What part of me leaving to get a new kit did you not understand...you stupid BI***?? Well she wasn't leaving the vein...or getting a new kit, so she settled for *leaving the contaminated part out* and suturing it down and covering it up. "What difference does it make, she is septic, a DNR, and a drain on our medical system...it doesn't matter."
All of which was reported ....completely....to management.
The doc still works here.
Now I know why she wasn't in the ER C-Sec.
If I'm every gonna be knocked out for surgury, guess who I don't want starting a line on me
END OF STORY?