The story that belongs to the next post

 

In 2014 I had a position in a very busy Diagnostic Cardiology unit. We did pre-op and post-op care and recovery for persons having Cardiac procedures such as Angiograms for heart and peripheral studies as well as acute MI emergencies. Our services also included Dysrhythmia ablations, recoveries for Radiology procedures and also procedural sedation for Bronchoscopy. Strangely, we were not designated as an official surgical recovery area, but we did all kinds of recoveries following general anesthesia. It was crazy. We were also doing recoveries following all kinds of catheter-based heart valve replacements like TAVR, MVVR, Watchman, etc. At the time I was hired, I became the 2nd "ICU" experienced nurse for the unit. 

My story here is regarding a fresh-new-just-graduated RN with no prior hospital experience; this person was completely unqualified to work in our unit. I admit it was hard to find qualified nurses to work in our area; people needed a lot of cardiac experience. So I can't understand at all why this person was hired, except that Management was desperate and the newbie seemed sweet and nice. 

On the day of the event I came to work at 0930, immediately hearing a Doctor demanding to talk to the Charge nurse about the nurse who had been present during a Bronchoscopy. One of our Administrative Charge nurses (she made the decision the day before) and the person who was filling in for her, apparently thought it was reasonable to assign the new inexperienced nurse for the Bronchoscopy. No wonder the Doctor was flaming mad!

I did some precepting with this new nurse and that was a role I was commonly assigned and enjoyed. This new person was the type that always replied "Yes" when asked if he knew how to do a task. One busy evening when I was occupied with a new sedation-recovery, the newbie was staying late to help us. I had a patient that needed to ambulate before discharge to go home. A foley-catheter had been inserted during their procedure. I asked newbie if he knew how to remove a Foley-catheter and he replied, “Yes”. I handed him an empty 10-cc syringe which is necessary to remove the sterile water from the inner tip of the catheter that is located in the bladder. Okay; a few minutes later I noticed him standing at the door of the room I was in. He said, “I need some help, the catheter won’t come out”. I wondered about that and followed him into the room. I asked him if he had removed the water from the catheter balloon, since I did see the syringe out of its package at the bedside. Newbie had a vacant look on his face so I knew he didn’t know jack about removing a Foley catheter.

 Unfortunately, there were quite a few more events just like that, where he had originally said, “Yes, I understand how to do that”. One day he had been assigned to administer sedation for a Cardioversion and the patient became apneic. He didn’t know what to do. Well of course he didn’t; he was untrained, unqualified and had not even had a procedural sedation class. But who was in Charge? Mother-Charge-nurse who loved him.