Building Confidence and Moving Forward

Proud and Discouraging Moments Sharing Your Stories and Advice The Stitch

By: Leah Goldberg, BSN, RN, CNOR

Published: 2/2/2024

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I knew the right thing to do for patient safety was to notify the circulating nurse and surgeon.

 

As a new nurse, I began by learning to scrub. I would check my instruments carefully for bioburden on a checking station before bringing them to my field. After I had set up for a complex case with many unique loaner trays, the patient was brought into the room and anesthetized. Unfortunately, this was when I noticed bone debris in an instrument. My heart sank. I knew the right thing to do for patient safety was to notify the circulating nurse and surgeon, breakdown the sterile field, and set up again. I also knew this would delay the start of the case and, therefore, prolong the anesthesia time for the patient. I motioned the circulating nurse to come over and showed her what I had found. We calmly discussed next steps.

Setting Up Again

The circulating nurse, surgeon, charge nurse, and my peers who all came in to help us set up a new field were very supportive and encouraging – I had spoken up and caught contamination before it reached the patient. However, in that moment, all I could think was that I had done something wrong and, therefore, had ruined the case for the patient and the day for the surgeon. But I listened to the comments of “Good catch” and “Thank you for speaking up” from my peers and focused on transitioning to fixing the problem, rather than dwelling on it. The best thing I could do in the moment was to work to efficiently set up a new field.

Protecting the Patient

Looking back, I have more confidence that I was thorough in my original inspections and grateful that I found the bioburden before the surgery began. I can confidently say I am glad I was able to prevent the contamination from potentially leading to a complication for the patient. Now, it is my turn to encourage other staff members to speak up and have confidence that they are doing the right thing and the best thing for their patients. Checking instruments before placing them on the sterile field is so important, as is speaking up if problems are found at any time, staying calm in the situation, and working together for a solution.

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