As a little girl, I often heard my mother say … “You’ll be wiser when you’re older”. At that time, I thought older adults were totally cool folks. They were wise, acted, talked and behaved like they knew it all!! I couldn’t wait to become like them. As an RN, I had the same thoughts about the “older, experienced” nurses. I’ve worked with many of them. They were RNs before I was, so they have been there, done that, and know everything!!! I followed their every move, absorbed everything I can from them, and learned their techniques and ways of doing things. I admired and respected them (and still do..) and in my mind, they were practically perfect!!
Fast forward to a few weeks ago when I met an RN working in an infusion clinic owned by a physician. She had been a nurse for 38 years, was an IV Team nurse for many years then retired but got bored, so now works 3 days a week giving infusions. I’m always excited to meet long time nurses because I love to hear their “nurse” stories and more excited meeting this particular one since she was an IV nurse. Older and wiser, that’s how I think of these nurses.
Then things took a nosedive when I observed this “older experienced” nurse used a syringe to reconstitute a medication for a patient, then set it aside for use on the next patient. Yes, she was using one syringe to reconstitute all the medications she will be infusing that day. Maybe it was just an oversight, so I gently asked if she meant to throw the syringe she had set aside. She replied in an irritated voice, “No, I will need that for the rest of the patients today”. I reminded her that she is “re-using” a disposable item meant for single use. She replied, “is something wrong with that?”
This scenario of “re-use” was repeated many times by this nurse during that day – with an IV catheter that was removed from its protective covering and laid on work surface; IV tubing dropped on the floor; alcohol swab used then re-used over and over till dry; cleansing an IV site with betadine and wiped off with non-sterile gauze prior to venipuncture; and many more!
We had a long and contentious conversation about all these at the end of the day. My biggest heartache was the failure of this nurse to recognize that her actions were harmful or cause potential harm to the patient. I wish I can tell you this is an isolated incident. I’m sorry to say that I have seen this many other times, in different settings, with other nurses of all ages. Yes, its not just the “older” ones but somehow I expected more from them. They are older (age/experience), they should be wiser, right? You tell me!!
BTW, take a look at the syringes at work, you will see “single use” printed on the syringe. The definition from the CDRH (Centers for Devices and Radiologic Health, a division of the FDA) of a single-use device, also referred to as a disposable device, is intended for use on one patient during a single procedure. It is not intended to be reprocessed (cleaned, disinfected/sterilized) and used on another patient. The labeling may or may not identify the device as single use or disposable and does not include instructions for reprocessing. 1
1. Labeling Recommendations for Single-Use Devices Reprocessed by Third Parties and Hospitals; Final
Guidance for Industry and FDA (July 30, 2001), available at http://www.fda.gov/cdrh/comp/guidance/1392.html.