[Zee_RN]

OVERHEARD:

NURSE A: "I just gave him his K-Dur." (Pt. is intubated with dobhoff in place with tube feedings.)

NURSE B: "We can't crush K-Dur."

NURSE A: "I know but that's what the doctor ordered, so that's what I gave. It's not my problem."

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Personally, this frightens me. I do not, will not, crush a sustained release med just because the doctor wasn't smart enough to realize he was ordering it for a patient on tube feeds.

[TriageRN_34]

Oh boy have I seen this one a million times! I worked ALF and most of my folks were on this and couldn't even swallow a lasix pill! UHG!!!!!!! I had to spend sooooo much time calling or faxing docs to please change it to a more PO friendly or totally different route!

I would have called the MD first before giving to change it to a reasonable form if possible (and with KCl you can). Considering this patient is NPO...ummmm I kinda would check with the MD for all the meds that are listed as PO and let them know which is crushable or not so I save time not having to call again!

Nurses in my med surge unit (including me) have substituted the power form mixed in water given slowly via the NG or J/G tubes and flushed well with MD permission. There is also a liquid form. If one has an IV...that is a way to go also. Most tube feedings have KCl in them so some docs will be willing to forgo the oral KCl and just retest the blood to see if that is working (not that people on tube feedings don't get a ton of bloodwork anyway..LOL!).

As far as it 'not being her probelm'...um yes it is! A route of a medication that isn't working for a patient or contraindicated is a responsiblity of us all! The MD must be told, and not to mention she disobeyed a no crush rule which is very dangerous and she could be held accountable for that...maybe then she would realize..it is her problem!!!

[Marie_LPN]

NURSE A: "I know but that's what the doctor ordered, so that's what I gave. It's not my problem."

Good Lord, it WILL be.

[TazziRN]

And that is a scary nurse!!!

[Marie_LPN]

If the doctor order the pt. to be shoved out the window, is she going to do that too??

[earle58]

isn't k-dur that God-awful, fat yellow EC pill?????

[Marie_LPN]

It's also a giant white pill that can be easily confused for a suppository.

[earle58]

Originally Posted by Marie_LPN

It's also a giant white pill that can be easily confused for a suppository.

i think i know what you're talking about.
doesn't that pill easily crumble?
and wouldn't that be crushable?
i'm thinking of the yellow pillow that's enteric-coated, which should be obvious to any nurse that it's non-crushable.

and this nurse worked in icu?????

[Marie_LPN]

No, this one's EC and also plainly says on the bottle "do not crush".

[chadash]

Originally Posted by Marie_LPN

If the doctor order the pt. to be shoved out the window, is she going to do that too??

I just love your posts~