I’ve discussed 15 other types of counting basics. From what is counted, sponges, needles, and others to what happens if there is a miscount. Today I am going to write about the stray sponges and instruments.
One would hope that when a room is opened and prepared for a surgery that there are no stray sponges and instruments. In fact, the patient is depending on the counts being an accurate snapshot of all the countables.
A stray instrument is a not counted instrument. A stray instrument is also an instrument that is just hanging out on the computer desk, or in the marker tray under the white board. Or even used to hang the irrigation fluids. Or in the computer desk drawer.
This instrument is NOT included in the count.
Some of my coworkers call them the bonus instruments.
I call them a liability.
This goes for the sponges that are not included in the count but are just hanging out on the equipment boom, or on the shelves above the computer desk.
Some of this is to be saved for the worker in the room. I know I am of the thrifty sort and put aside sponges that have been passed off and not included in the count. For use at home.
But…
These stray sponges are not to be left in the room for the next surgery.
I’ll type it slowly. This is a liability!
Last week, after I took over for the day shift nurse and completed the surgery, and did the RF wanding (remember that?) prior to the closing of the incision. Like I’m supposed to. Well, when we were taking down the drapes, a raytec was taped over the foley catheter. Why? I don’t know!
But the scrub tech and I both looked at it, knowing full well I had RF wanded the patient not fifteen minutes before. I don’t know how they felt, but I felt sick.
This raytec was definitely not included in the count. We had done a relief count, and a closing count and a skin incision count and all 10 of the raytecs were accountable then.
Mystery sponge.
I will be discussing this with the nurse I relieved. And the manager.
My brain goes straight to the possibilities. None of them good. I cannot be alone in this.
These are new RF machines and apparently they are not as sensitive as the previous ones. I will be testing them this evening when I go into work.
No matter how you describe it, this is scary. And thoughtless. And leaves the previous nurse and tech as open to a lawsuit as myself and the evening tech.
Word to the wise, DON’T DO THIS!
And take the stray sponges and instruments out of the room prior to the surgery. Or count them. I don’t care which. But they have to accounted for. Our patients are vulnerable and they are depending on us to do the right thing.
Being accepting of stray instruments is not the right thing.
Ever.
Dispatches from the Evening Shift 