[Chloe'sinNYNow]

Originally Posted by sleepyndopey

I have patients who get upset with me because I won't leave the pills like "other nurses" do. I flat out tell them I could get fired for doing that and that it's just not worth it to me. I will gladly bring the pill back when they want it. It is wrong for your preceptor to tell you to do this. It's never ok and can get you into big trouble.

Dang! I knew in my gut this was wrong!!! Are they hiring where you are sleepy n dopey? Like I said, I quit yesterday morn. But not in time to prevent physical illness. Just got word fr doc's office of occult bleeding to accompany what sent me to ER last Friday night of straight pee bleeding!!!

Scared and out of work and determined to watch pills go down,
Chloe

[Aprilhere]

Originally Posted by TheCommuter

Giving antihypertensive meds without first obtaining the patient's blood pressure is rather dangerous. The consequences to doing this should be obvious.

Never assume the new LPN working with you on a team knows this. You might have a beta blocker given to a pt with a HR of 48, and SBP in the 80's.


Never assume the shift before you knew what they were talking about. If you can't remember what arm/leg the IV/bruise/etc is on....look the next time you're in the room before you chart. It might not seem big...but you sure look like a dope when you...along with 3 other shifts all charted the wrong site.

[Chloe'sinNYNow]

Originally Posted by Aprilhere

Never assume the new LPN working with you on a team knows this. You might have a beta blocker given to a pt with a HR of 48, and SBP in the 80's.


Never assume the shift before you knew what they were talking about. If you can't remember what arm/leg the IV/bruise/etc is on....look the next time you're in the room before you chart. It might not seem big...but you sure look like a dope when you...along with 3 other shifts all charted the wrong site.

April raises a good point here. Too many lazy nurses just chart what previous shifts chart without accurately assessing or remembering how to accurately assess a pt. I've seen MANY seasoned nurses do this. As well as be the pt and have the nurse not know how to take a BP on me.

Just last Friday night in the ER, I had a LPN take my BP w/ a wrong sized cuff and raised not supported at heart level and got a read of 157/110. EXCUSE ME??? My last read days before was 80/42. Try it again lady!
I was so upset esp when she wouldn't listen as I told her my highest EVER was 120/80. It was suddenly back to 110/90. Duh!!!

Why don't medical personnel listent to their pts? Makes me wonder how they passed their boards.

But when passing meds, defintely know what the hell you are doing! Those cardiac meds should have written parameters by the MD. Again my last lousy job had me guessing and asking and guessing more when they had written parameters but not numbers to go along w/ them!! Outrageous.

sorry, more vent!

Chloe

[Aprilhere]

Originally Posted by ChloeinAtl

April raises a good point here. Too many lazy nurses just chart what previous shifts chart without accurately assessing or remembering how to accurately assess a pt. I've seen MANY seasoned nurses do this. As well as be the pt and have the nurse not know how to take a BP on me.

Just last Friday night in the ER, I had a LPN take my BP w/ a wrong sized cuff and raised not supported at heart level and got a read of 157/110. EXCUSE ME??? My last read days before was 80/42. Try it again lady!
I was so upset esp when she wouldn't listen as I told her my highest EVER was 120/80. It was suddenly back to 110/90. Duh!!!

Why don't medical personnel listent to their pts? Makes me wonder how they passed their boards.

But when passing meds, defintely know what the hell you are doing! Those cardiac meds should have written parameters by the MD. Again my last lousy job had me guessing and asking and guessing more when they had written parameters but not numbers to go along w/ them!! Outrageous.

sorry, more vent!

Chloe

I came into CCU last week (new nurse..still orienting to CCU)....got report...pt admitted..BP fine in ER...but in the low 70's now.

I went in...took a look. Hmm....avg size lady...adult large cuff...on so loose I could loosely fit 3-4 fingers inside the cuff with her arm....she was turned onto her OTHER side (arm in the air).

changed cuff...put on snugly...retook BP. Wow- suddenly it's in the 100's over 60's. I was much more comfortable with those numbers.

Parameters yes....even as a new nurse...I quickly learned to just call the dr. I'd rather rightly explain WHY I wanted parameters....than to be the nurse chewed out for either holding...or not holding a med the dr. wasn't happy about.

[Quickbeam]

1. Never sign off on a narcotic waste that you did not see with your own eyes. Classic addicted nurse trick and then you get dragged into the problem. As a new grad, my refusal to sign off on a waste I had not seen led to the uncovering of a massive addicted nurse problem.

2. Never give patients money of your own or involve yourself in their outside lives. I know it is tempting but it is an express ride to loss of objectivity and professionalism.

[Emmanuel Goldstein]

Never allow patients to keep their own meds (particularly narcs and sedatives) at bedside without an order. Send them home or lock them up until the patient is discharged. Nothing like finding out your patient has been self-medicating along with what they've been given by staff because they felt we weren't giving them enough.

Along those lines, never assume that what is contained within those bottles are the meds listed on the labels. For example, you might find your patient is attempting to pass off Mentos mints as Dilaudid 4 mg tabs so that his doc doesn't find out he's taken a month's worth of pain meds in less than two weeks...

[Sassy5d]

Hmmm.. How about.. Never pre pour your pills... I have yet to figure out how that worked. I tried doing it one time and I ended up giving the wrong cup of meds to the wrong person.. Not to mention, I noticed a lot of my coworkers who do that, can't remember the right way to do it when they get inspected.I know it's sometimes hard, especially when you're really busy and you're giving a lot of pills.. But pay attention to each pill you're giving... It turns your cheeks quite red when a pt asks you what the lil red pill is and you just give them the deer in the head lights look because you have no idea.Don't ever give insulin BEFORE you check the blood glucose..Yup seen someone do that...I've also seen a nurse, I kid you not.. add water to a pureed meal and dump it in a tube feed bag.. The pt was a feed and got a bolus if they didn't eat 50% so they just watered it up and dumped it in their bag.. Yuck!Never chart on something you've gotten in report unless you HAVE to! I had an order to straight cath a pt and I got in report from 2 nurses that they both attempted without luck. It wasn't charted and I went ahead and charted that straight cath was attempted previously x2 without results... Another nurse asked and the pt said it was never attempted.

[TheCommuter]

Originally Posted by Aprilhere

Never assume the new LPN working with you on a team knows this. You might have a beta blocker given to a pt with a HR of 48, and SBP in the 80's.

During my time in the LVN program, we were all taught to obtain BPs and pulses on patients who took cardioactive meds prior to administering them, and to obtain apical pulses on patients who were receiving digitalis therapy prior to giving the Lanoxin. And we were instructed on the precise reasons for taking these actions.

[jlsRN]

Never give more than one pill of something without checking the original order, or verifying what a normal dosage is. Three or more pills is a real red flag!

[showbizrn]

Never give a med you don't know. Never medicate a patient you don't know. Never administer meds when you don't know YOUR name, date, place, time and circumstance. AMEN.