Accidental Needle Stick

You know you're in healthcare if your blood pressure and heart rate just increased a little.

I went to work for the first time since Haiti last night. We took care of a woman who had delivered her baby just before we arrived. Then we took care of a woman from Chile (who met her husband when they were both Chilean missionaries) who was having her 6th baby, 4 of whom she'd delivered unmedicated, who was planning on delivering this baby unmedicated as well. Then the charge nurse said she'd like to cancel us. I called Dan at 6:35 to tell him, we talked about me picking up dinner, I gave report, and changed my clothes. Marianne and Annette said, "Now you've done it. Just so you know, around here, you're never actually safe when they say they want to cancel you until you're in your car. Make sure you turn your phone off." I thought they were joking. When Marianne, the woman who is orienting me, never showed up in the locker room, I went to find her. She was admitting a 15-year-old in active labor. She said she was staying because a bunch of pregnant women had just walked in. I was so disappointed. I called Dan back, changed back into scrubs and ate the other half of my sandwich. Then I helped this 15-year-old as the anesthesiologist placed her epidural; I took her history, and got her situated. Right at 11pm, Marianne was holding a pile of blankets and I asked her if she was going to second (meaning be the nurse responsible for a baby who is about to be born). She said yes and I asked her if I could do it (just trying to get as much experience as possible). She again said yes. I watched this amazing woman hold onto her own feet (she used to be a dancer) and push out her baby girl. Oh, her husband delivered that baby. Yes, he's in med school, a third year student. And the OB was Natalie Loewen, who delivered my own two children. After the delivery I made sure that the baby was okay. Her mother had been pushing for 3 hours. She had a little bit of a hard transition: in nursing lingo we call it "shocky." She was just fine: beautiful, 7 lb 15 oz, 20.5 inches long, head full of dark hair. Then I asked Dr. Loewen for an anatomy lesson. She said, "What do you want to know?" I thought, "Well, I always take care of the baby, do the mom's vital signs, complete my delivery record after a mom's delivery." I said, "Could you show me about the laceration and repair?" She explained what made it a second degree lac, repaired it, then we delivered the placenta. The placenta ripped the stitches out of the tissue, so Dr. Loewen asked for another suture. As she re-repaired, I was accidentally stuck with her suture needle. I jerked my hand close to my face, removed my gloves and expressed a tiny drop of blood. I thought, "Oh my gosh, they always tell you about this but you never think it'll happen to you, what do I do? Oh yeah, I'll go wash my hands." I did, the dad asked me if I was okay, I replied, "Well, she's pulling a little and looks a bit shocky." He said, "No, your -" and gestured with his hand. I said yes. After I gave the baby her shots and eye ointment I left the room. I went to the front desk and called the nursing supervisor. At this point it was 11:45. He came right over and completed the necessary paperwork with me. Luckily, this woman has one classic Mormon, monogomous sexual partner, zero risk factor, prenatal labs negative for everything, history. Hep B, HIV negative. Then I waited 20 minutes for the phlebotomist to come draw my blood. I contacted the postpartum clerk and charge nurse to make sure a couple people knew the situation and how to get the patient's specimen with her am labs. At 12:50 I clocked out and drove home. I fell asleep before my head hit the pillow. This morning I called and made sure the patient's sample had been drawn. I'll wait for lab results, which I'm sure are fine, and then have total peace of mind. Quite the process, eh?

I liked this stat from the info packet they gave me: "Since 1999, no US healthcare worker has developed an HIV infection from an on-the-job injury." (I just hope that one's true.)