[optimal] Re: When to remove needle
- From: angiolith@xxxxxxx
- To: optimal@xxxxxxxxxxxxx
- Date: Tue, 14 Jun 2011 07:34:06 -0400 (EDT)
All of the discussion raises good points regarding when (and when not) to
remove the needle. But the initial inquiry brings up 2 bigger issues: 1) when
to pick your battles, and 2) how to keep a problem you can control from
escalating.
If the institution is one you work in exclusively, you should definitely have
some say as to how the injection procedure is run. However, the nursing staff
will probably have the FINAL say. You have made your case. You can try making
your case to the physicians and let THEM order the nurses. But, if you are
unable to persuade the MD's to pull rank, you need to let it go.
You then work on solving the part of the problem that affects you directly:
keeping the patient from pulling out of the headrest when the needle comes out.
And the solution to that problem is, of course, fairly simple - communicate
with the patient. Warn the patient that the needle will come out right after
the injection, but to remember that the pictures are continuing. This will
work on all but the most difficult patients, and they will be pulling their
head out anyway. I walk my patients through the testing like an airline pilot:
calm, cheerful, unflustered, in control. I also tell first timers what to
expect from each phase of the test; i.e., that the light will seem brighter
when we switch eyes, that they will see colors for several minutes after each
series, etc.
I work with multiple nurses in multiple offices. I don't agree with all of
their methods, but once I have given my opinion there is nothing else I can do.
Since the responsibility for the injection and subsequent management belong to
the injector, you just gotta let it go. Be aware that patients will pick up on
any bad vibes in the room.
It is a known medical fact that the only people more rigid than ophthalmic
photographers are nurses.
Good Luck,
Marty Rothenberg
Chief, Operations
Angiographics, Inc
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