One month into my new job. Somehow I’m on “week 6” in my training. They’re trying to get me up to speed as fast as possible.
I’m keeping track of the number of sticks I’ve done:
Grafts – 4
Fistulas – 8
Catheters – 12
Today was technically a bad day. I cannulated a guy with a smaller fistula, sort of my first “non-easy” attempt. The stick itself went fine. The arterial line was perfect. The venous line a bit trickier to get a flash. I had to fish around a little and push deeper than I expected. Finally that pulsing red ribbon appeared. About 45 minutes into his treatment his pressures kept sy rocketing. The nurse and tech came over to assess. They flipped the needle and pulled out a little. When we restarted treatment he infiltrated. Darn. I helped recirculate the blood while they put in another, higher stick. The rest of his treatment went ok. So I didn’t infiltrate him personally, but I feel responsible for the venous line going awry. Later I took off a different patient. As I was removing his venous line the tape nicked the safety wings and brought the needle out as I pulled off the tape. A fountain of blood squirted at me, I was not prepared to cover the hole yet. I grabbed a fistful of gauze and tried not to stick myself with the errant needle. Blood all over the floor, the table, my supplies, and my shoes. Ok, so it was probably only 10 cc, 20 at most. But this was the first time I had blood on the loose! I was able to stay cool, calmly asking my preceptor to bring me a LOT more gauze. The patient continued to snore the whole time, completely asleep.
I’m glad for these little mishaps because they show me where I’m making mistakes. Things have been going so smoothly. I’m happy when I spill blood, when a line is busted, or when a patient gets hypotensive. How else am I going to learn to handle these things on my own?