Nur363 clinicals day 3

Revised out of HIPAA considerations...
Today I took care of a ... wound. This was my first real dressing change, as my previous wound care--last semester--was on a quite old incision requiring only a change of abd pad. Today's wound had had trouble in the past and the surgeon had taken the patient back to the OR to have a "triple lumen drain" placed.... I read about this in the chart the day before, and I was expecting some little thing like a JP tube. Woa, did I have a surprise.

When I went in to see the patient, the catheter had come out and was on the floor. Rather than a small tubing, it was a long, flat silicon tube with holes all along both sides, like a soaker garden hose. I had never seen anything like it, and neither had my nursing instructors. I can't find any pictures of this type of wound drain on the internet, but it was marked "Axiom," so I assume it was one of these. There was a plastic flange sutured to the abdomen, and I'm not really sure where the drainage tubing went from there. The surgeon was not happy that the tubing came out, but he elected not to replace it.

The wound change went okay, but the day in general was pretty crappy. Nursing school is difficult for me partly because by nature and by previous training, my memory works in abstractions and generalities. So... at our hospital, Lovenox comes in special pre-drawn syringes, but I had to give heparin, which I found in a vial. Now, when I found it, I was thinking that I was going to find it in a special pre-drawn syringe, because in my memory I generalized Lovenox/heparin/special syringe. When I found the vial, I thought, "well, it must be that the syringe is not pre-drawn, but one of these syringes with a pre-applied needle [an insulin syringe, which we don't use in our hospital because we have the insulin SQ pens, but they're still stocked for some reason...]." So, I drew up 1ml of heparin in a 1ml insulin syringe that is marked in units (duh!). This made me feel like a real idiot. It didn't help that I double-checked the syringe with a nurse who gave me the wrong information before I went to the instructor. Oh well, at least I had the right dose of heparin.

No comments:

Post a Comment