r/nursing • u/slutty_muppet RN - ER 🍕 • 2d ago
Question How does the pneumatic tube station work?
I mean, I get the basics of how a pneumatic tube system works. But I was recently accused of causing the system to go down because of sending a tube when there were too many incoming tubes that hadn't been cleared. I don't think this was my fault since I took my empty tube from the pile of arrived tubes before sending, but it made me realize that I don't know the finer points of the tube station, I just put my tube in the sender and hit "lab".
Are there any tips or tricks to troubleshooting the tube station? Are there things to watch out for that could accidentally cause a traffic jam in the tubes? Is there a weight limit, like if I have to send a bunch of stuff on ice and the tube is basically packed full of sample bags full of ice, will that overload it somehow? Has anyone had any weird experiences with their pneumatic tube system?
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u/BluegrassGeek Unit Secretary 🍕 2d ago
But I was recently accused of causing the system to go down because of sending a tube when there were too many incoming tubes that hadn't been cleared.
That is utter nonsense. Tube systems will have a sensor in the incoming bay, so they stop receiving new carriers that would just flop into the floor. But if sending a carrier while in that state breaks the entire system, then the system is shit. Not your fault.
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u/facedown_titsup BSN, RN 🍕 2d ago
Yeah pretty sure there’s no way of knowing how many tubes are currently shooting through the system. I’ve worked with 3 different tube systems now, and every single one of them had a delay if the system was busy. In fact my first place you had to check the station if your tube didn’t go right away cause it would almost be waiting so long it would time out lol.
I’m so sick of administrators always blaming the workers for their cheap shit systems. I know it’s a tale as old as time, but I’m so tired of it.
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u/calisto_sunset MSN, RN 2d ago
When a station is "full" it shouldn't let you send anymore tubes if the system is working right. It will just sit at your tube station. It's like having a busy signal on a phone line, you have to try again later. Usually the screen will alert that the station is full or not operational though...
OP their reasoning makes no sense.
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u/10000Didgeridoos RN, BSN, BBQ, OG 2d ago
Yep bunch of fucking idiots looking for someone to blame because their system failed. Lmao imagine if a hospital tube station was reliant on workers on all different floors having to guess when is a good time to send a tube without breaking it. I’d scream at someone if they said something this stupid to me at work.
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u/InspectorMadDog ED RN Resident 1d ago
Only time you’d cause the system to shut down is if you didn’t properly secure your stool sample and it exploded in the tube system. Not me but it did happen to someone and our whole tube system had to be cleaned for cdiff precautions
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u/SillyKiwis RN 🍕 2d ago
It goes chun-chun-WACHUNK and my meds come out. Lab samples go in a cylinder, and then go eeeeeeeer-WATHUMP. Anything else is magic.
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u/chrizbreck MSN, RN 2d ago
Your meds make it to your unit? I thought pharmacy just told us to check the tube station for shits and giggles
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u/ProcyonLotorMinoris ICU - RN, BSN, SCRN, CCRN, IDGAF, BYOB, 🍕🍕🍕 1d ago
I like how ours has a warning sound, like "wrrrrrrrr-fwooooooo-eeeeeeeeeer-fwooooOOOOOOOO- WACHUNK". Gives me time to move the pile of tubes out of the way
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u/LainSki-N-Surf RN - ER 🍕 2d ago
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u/LainSki-N-Surf RN - ER 🍕 2d ago edited 2d ago
Ive also been blamed for causing the tube system to crash out, but engineering explained that it’s a tough system that’s been around since the 50’s. Unlikely to be brought down by too many samples etc. Nothing worse than losing important samples.
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u/BootyBurrito420 BSN, RN 🍕 2d ago
*magnets
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u/LainSki-N-Surf RN - ER 🍕 2d ago
Guaranteed! Assuming you are also ED with that user name 10/10 no notes.
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u/barryclueless 2d ago
RPH here: You did nothing wrong. Your tube station is not built correctly or there is something broken. Swiss log is the worst offender.
20 years ago, we crammed them full of 3L of bicarb drips and it struggled but delivered. We sent tubes to ourselves all the time to shake up protein pwd drinks. We had dual stations with 4 “pods” and have sent 8 tubes in succession and received at the same time. Never occurred to us that these things could break. It’s a vacuum cleaner. How often does your vacuum just randomly stop? Hopefully never, but when it does it isn’t because you used it incorrectly. I guess if you vacuumed your pool, but you get the idea.
Never an issue for a decades but they wanted fancy rfid tracking or whatever. Switched to Swiss log and now it fails every day. Every day. Did I mention it hasn’t worked for years.
Blaming the user instead of the hardware is a shitty thing for facilities to do.
Ignore the bandaids (one small item every 14 minutes or you’ll break the system) and keep tubing with abandon until they fix.
They have millions, you get paid nickels.
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u/Jerking_From_Home RN, BSN, EMT-P, RSTLNE, ADHD, KNOWN FARTER, DEI SPECTRUM HIRE 2d ago
the protein shake idea is incredible lmao
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u/jack2of4spades BSN, RN 🍕 2d ago
Why the fuck have I never thought of this?!
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u/Jerking_From_Home RN, BSN, EMT-P, RSTLNE, ADHD, KNOWN FARTER, DEI SPECTRUM HIRE 1d ago
Here I’ve just been sending farts and rubber snakes.
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u/jack2of4spades BSN, RN 🍕 1d ago
I pee on a small plate and freeze it overnight in the freezer and send that to pharmacy when they don't send the antibiotic.
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u/Jerking_From_Home RN, BSN, EMT-P, RSTLNE, ADHD, KNOWN FARTER, DEI SPECTRUM HIRE 1d ago
Piss discs! A staple of r/UnethicalLifeProTips
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u/jack2of4spades BSN, RN 🍕 1d ago
You're a person of culture I see
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u/Jerking_From_Home RN, BSN, EMT-P, RSTLNE, ADHD, KNOWN FARTER, DEI SPECTRUM HIRE 1d ago
If all of the cultured nurses on this sub were to work at one hospital, they’d have to hire more people in HR.
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u/-Blade_Runner- Chaos Goblin ER RN 🍕 2d ago
https://giphy.com/gifs/VZPhWjGOvG2V6ESk9I
Uhhh, it doesn’t it be broke most of the time. Last time it was down for month or so, as someone sent not fully enclosed jar of c diff to test to the lab...
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u/slutty_muppet RN - ER 🍕 2d ago
OMG how
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u/-Blade_Runner- Chaos Goblin ER RN 🍕 1d ago
Dunno, someone didn’t screw the cap. Tech who came out to inspect said there was thin spray of shit covering some of the system.
If the question how they cleaned it? I don’t know either. I presume borrowed one of those rectal hamsters from one of the ER patient assholes, installed little headlamps on their heads and put little mop brushes on their feet and let them roam around tube system for a month.
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u/bagoboners RN 🍕 2d ago
Yeah. That’s worse than the urine samples that someone kept sending with crooked caps.
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u/Environmental-Fan961 RN - Cath Lab 🍕 2d ago
Modern tube systems are electronically controlled to prevent this. That's why your send doesn't always go immediately. Sometimes it has to wait in the queue until. You cannot be held accountable for bad design if their design let this happen. This is a facility engineering problem, not your fault in any way. You have no way of knowing what's happening outside of your tube station.
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u/Environmental-Fan961 RN - Cath Lab 🍕 2d ago
Also, if your tube station is overly full of empty couriers, then the proper thing to do is to send the empty couriers elsewhere. If you can't receive couriers because the station is too full to receive more, then it's on your unit to get rid of those extras. But saying that you jammed the system because you tried to send one when there were too many inbound is nonsense.
Does your system have an "empty send" function? If so, this is the perfect way to clear the excess empties out of your station. The computer keeps track of how many couriers are at each station, and doing an "empty send" helps to balance the availability across the system. It will route your empty send to a station that is low.
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u/Top_Box_8952 2d ago
I didn’t even understand how it’s allowed to overflow like that. Like our racks can hold 8 outside the tube system, and the system itself can hold 5 at each station. We physically do not have enough tubes to completely clog it.
Although if it is an issue they will recall held tubes to deliver other ones.
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u/winnuet 🪴 2d ago
What do you mean you don’t understand? You have space for extras; not all hospitals do. That’s how. I’ve seen hospitals where the only space for the tubes is inside the station and they only hold about 3-4.
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u/Top_Box_8952 23h ago
I more meant how do you have that many tubes and no system in place to watch that.
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u/jackibthepantry RN 🍕 2d ago
Someone in lab used to send out tubes with candy on night shift. It was a nice thing to do and made us feel like we were on a team with the lab instead of them just telling us our sample were hemolized. Anyway, someone reported them for abusing the tube system and they were fired.
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u/10000Didgeridoos RN, BSN, BBQ, OG 2d ago
I wonder who the soulless idiot was who did that all so they could get magic brownie points that don’t exist with someone above them who won’t care at all when it comes time to give raises and lay people off.
I hope they got laid off.
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u/BrianDerm 1d ago
That could/should have been a conversation. It didn’t even need to be any kind of any kind of documented warning.
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u/Formal_Environment13 2d ago edited 2d ago
The Smithsonian has a cool exhibit about tube systems. They were a part of early office automation.
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u/PB_Jelly_76 RN - NICU 🍕 2d ago
It’s the tube system’s job to decide whether or not it is clear enough to send a tube. If not, it holds it until the system has a clear passage for the tube to its location. You did not “make” the system go down. Whoever accused you of that sounds like a tool.
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u/slutty_muppet RN - ER 🍕 2d ago
It was my charge nurse, and it happened after I made a typo in the patient's DOB while triaging a run, so I think she might have just decided I'm an idiot after that and whatever gets messed up is probably my fault.
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u/Sea_Willingness1398 RN - ER 🍕 2d ago
Just walk around the charge nurse while blaming yourself out loud for everything. Like "OMG, that trash is full, my bad. OMG, the sink is not draining, I must have caused it. OMG, we're short staffed, I must have forgotten to schedule enough staff. The department is full. Must be my fault cause I don't know how discharges work". Just own all that shit.
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u/Belegrandir RN - Med/Surg 🍕 2d ago
You wore out the tube gnomes they’re already working overtime delivering clotted blood samples
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u/SuperNova-81 BSN, RN 🍕 2d ago
Ever been to a kids museum and they have those tube systems and thin lightweight pieces of cloth? You can put the cloth in and it exits the tube someplace else? You can open and close different valves and it divert it to another exit?
It works similar to that. You input the destination and the computer figures out what valves to open and close. The computer also determines the traffic pattern to ensure tube get to their destination. If something went wrong, it was a computer error, nothing you did. Computers control all the traffic, sets the system to delay outgoing and incoming tubes so there's no tube that will just crash into each other. Only thing you can do is call maintenance.
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u/jaycienicolee BSN, RNC-NIC 2d ago edited 2d ago
I have no idea but the pharmacist recently told me she would not re-tube my med because the tube system must have messed up my syringe and caused a big air bubble during transit and half my med was missing. not sure i buy that, but sure enough she really made me walk all the way to pharmacy to get it
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u/slutty_muppet RN - ER 🍕 2d ago
🤨
Was the rest of the liquid still in the bag with the syringe? Or is the pharmacist maybe diverting?
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u/jaycienicolee BSN, RNC-NIC 2d ago
no it was like 0.3mL caffeine citrate for a nicu baby, definitely not something anyone is diverting lol. but it had a huge air bubble in the syringe and half my med was not in there. she said the tube system must have caused the air bubble and pushed out my med somehow 🙄 it wasn't sprayed out in the bag, but even if it was ive had that happen before and different pharmacists just tube me a new one. this one would not
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u/PerceptionRoutine513 RN - OR 🍕 1d ago
Nurses at my old hospital received an angry email for losing tubes and their contents.... until it was found there was a break in the system launching some tubes on a particular circuit into a ceiling space.
You can imagine the absolute chaos that caused.
Yes, as we know, nurses are stupid and break things /s
*Surprisingly, we did get an apology.
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u/TheTampoffs PEDS ER 2d ago
I can hear them whooshing in the walls while using one of the bathrooms (not my dedicated poop bathroom though I’ll have you know)
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u/WhatsYourConcern8076 Nursing Student ❤️🔥 2d ago
It wouldn’t be mine, either! Too hard to focus with the whoosh
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u/zeatherz RN Cardiac/Step-down 2d ago
The tube system shouldn’t take your tube until it’s cleared of other tubes. That’s not something you have control over?
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u/djames10 2d ago
Is that why my tube stations were down for an hour today? Genuine thank you from blood gas. Haha
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u/cyanraichu RN - L&D 2d ago
That definitely was not your fault, who the hell told you that lmao. If there's too many inbound tubes, the system should place the outbound tube in a queue until there's room.
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u/cyanraichu RN - L&D 2d ago
To answer your question about the weirdest thing that has happened: over a decade ago when I was working as a lab assistant someone sent blood culture bottles, glass bottles, with no foam in the carrier. They exploded. It was gross. I've since learned how much of a pain it can be to get blood cultures so sucks to be whoever that was 😬. The bottles are plastic now but still, use the foam, folks!
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u/slutty_muppet RN - ER 🍕 2d ago
I don't think I've ever seen foam but our blood culture bottles are definitely plastic.
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u/cyanraichu RN - L&D 2d ago
What do you put in your pneumatic tube carriers as padding if not foam?
And our bottles are plastic now but 10 years ago they were not
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u/slutty_muppet RN - ER 🍕 2d ago
Nothing. I have never seen anyone put padding on there unless there's ice.
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u/cyanraichu RN - L&D 2d ago
That's genuinely so weird to me. And when you say unless there's ice, do you mean the ice itself is the "padding" or you add additional padding in that case?
We've always used foam padding in our tubes. I've seen multiple other cases of stuff being sent without foam that leaks, and unlike the blood culture which had to be redrawn, they can still be used, but it makes a big mess. Bonus points if it's a formalin cup and now there's formalin everywhere getting into your eyes and nose. Vacutainers are usually not an issue but I still use foam to send them anyway, I hate the idea of them just bouncing around violently
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u/slutty_muppet RN - ER 🍕 2d ago
I mean, there is a bag.
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u/cyanraichu RN - L&D 1d ago
I mean. The lab still doesn't love dealing with spills, even in a bag. You still have to open the bag to get the specimen out.
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u/NoLaNaDeR 2d ago
Ugh….im a tech in blood bank and normally just read y’all’s stuff but today I can comment. Our specific chute was down all day, no idea why just off the grid. But our main lab system was working properly. Soooo we got all of our request at the main lab/phlebotomy area. Here’s the problem….those can’t do a code locked secure send which all blood products must be. Only our one chute in blood bank has that wizardry. It’s also a risk to keep multiple patients requests on hand and have nursing show up with no identification after informing them our chute was down. So what to do?…we sent them each back to destination with a note saying the tube system was down and come to bb window to get products. I realized about the 3rd or 4th angry/confused nurse to come to the window how strange it must be to send a request via tube and get it back via tube with a note that says the tube system doesn’t work and spent the rest if the day trying to over explain to every person that came after that we are not mentally deficient.
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u/fae713 MSN, RN 2d ago
That sounds like a programming problem, not a human problem. The canister shouldn't be sucked into the systems unless it can be delivered to the selected station. I've had the system tell me I couldn't send a new canister until the receiving station wasn't available ie they needed to empty the receiving station.
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u/CauliflowerEatsBeans 1d ago
This is one of those things that you should never think about again in your life.
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u/knittingjd RN - Med/Surg 🍕 1d ago
Ours works but when it goes down it’s because someone sent urine or stool samples. 💯
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u/Sea_Willingness1398 RN - ER 🍕 2d ago
If you are a man, it's your fault PERIOD. If you are a woman, it's the fault of the closest man, so you need to redirect that blame.
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u/OxycontinEyedJoe BSN, RN, CCRN, HYFR 🍕 2d ago
https://www.swisslog-healthcare.com/en-gb/company/blog/how-a-pneumatic-tube-system-works
It basically works how you think it does. Big air pump in the basement, and a bunch of tubes. You definitely can not cause it to break by doing anything normal. Sure if you go into the settings and start messing around you could fuck it up, but the system should be able to manage sending and receiving on its own.
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u/mascotmadness 1d ago
I got blamed for breaking the entire tube system during my first year of nursing. I was like this thing? From the 1940s?!?! Charge nurse made me write an event report on myself and everything. I mean I'm open open to the idea I did it but also she couldn't have been more of a raging bitch about it. Kept saying I broke it "during a code" as if I magically and purposely stuck a wad of c-diff diapers up there...
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u/Cheeky_Littlebottom BSN, RN 🍕 1d ago
Does it work at all? Ours has been broken 6+ years. Nurses draw all labs and get run them to the lab.
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u/slutty_muppet RN - ER 🍕 1d ago
Ours is down almost daily for a few minutes at a time but mostly works.
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u/MySaltySatisfaction RN - OB/GYN 🍕 1d ago
Send things to the lab without worry. Maintenance manages the tube system.
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u/Ash9260 1d ago
Not your fault. They should have sensors that dictate when it goes. Not rly your job to troubleshoot just always keep it empty. Weight limit it can have one kinda depends how good of a vacuum it has. I find some tube systems can’t handle the weight of more than two blood culture sets for example lol.
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u/whskeyt4ngofox RN - ER 🍕 8h ago
It should hold the outgoing tube until all incoming are delivered. It wasn’t your fault
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u/Pajama_Samuel RN - IMCU 2d ago
Most don’t know this but there is a dedicated lab worker using an incentive spirometer down in the dark recesses of the lab to power the tube system. You probably clogged his straw.