Accepting verbal orders from another nurse? - page 2
I'm a new RN a little over a month into my orientation on a busy med/surg unit. Tonight at a few minutes before the end of my shift I had finished reporting off and was sitting at the nurses station... Read More
Mar 20You definitely did the right thing! But it seems like things are still up in the air unless you verified that the order was put in and for the correct dose. As of now, it seems like you pulled a narc and someone else went to supposedly give it. If she forgot to enter the order, or worse, she diverted it for herself, then there is a morphine out there under your name. Follow up on this ASAP.
Especially because she is someone on another unit you dont really know.
If it were me I would be panicking still until i got verification that this discrepancy has been rectified.
If you havent been back yet I would call the unit, make sure. Once this is cleared up you can take home a valuable learning experience: ALWAYS check an order is in PRIOR to pulling a narc. And just cement this in your brain so that the next time someone gets huffy and bossy, you will have a firm no that is not up for debate.
Mar 20In fact, OP, the more I think of it, the more this smacks of diversion. And now YOU are involved, because they will see that you pulled morphine out of the Pyxis, on override, without an order, on a patient that is not your patient, at the end of a shift, and didn't administer it. PLEASE talk to your manager about what happened TODAY so that you do not get implicated in this.
Mar 20I agree with what you did absolutely, and that nurse should have been able to understand your reasoning without question. It sounds like she was stressed out to begin with, but again you did the right thing!
a) You have no way of knowing if she miss heard the order
b) You definitely have no way of knowing if you are even giving the drug to the right patient since there is no order
c) If something happens to the patient from the medication or you give it to the wrong patient it's now on you and not her
d) She could forget to put the order in the computer before she leaves and forget to put that it was given to the patient so now you have a patient who has been given a medication with no record of it and a narcotic that was taken out of the pyxis with no record of administration!
** As someone else noted NEVER EVER take narcotics out of the pyxis and then give them to someone else to give! Next time take the Morphine back and have someone witness you put it back in, and that nurse can get her own. I would strongly recommend you let your nurse manager know what happened so that she can make sure that the Morphine was infact given and you are in the clear!
Always remember it is your license that you worked hard for, and if you are smart and don't want to risk it then make that decision and stick to it no matter what someone else says!
Mar 20Quote from not.done.yetYep. Exactly my thoughts.You were right in not giving it. You were wrong in pulling it without an order and then letting it get into her hands. Decent chance you just got played.
Mar 20Quote from kloneYep. You are new and green and they read you like a book. This is serious. Talk to your manager right away.In fact, OP, the more I think of it, the more this smacks of diversion. And now YOU are involved, because they will see that you pulled morphine out of the Pyxis, on override, without an order, on a patient that is not your patient, at the end of a shift, and didn't administer it. PLEASE talk to your manager about what happened TODAY so that you do not get implicated in this.
Mar 20The float nurse was wrong on all counts, where was you preceptor? You would bring her/him into this.. instead of strangers on the internet.
Mar 20Quote from CrushEw... yeah. I reread your initial post, also.Ok, so I just reread this. You pulled the morphine for an order that was not in on the MAR at the time. So you did an override on the Pyxis? When she snatched it from your hand did you witness her giving it? What did the other nurse getting report from her say? If you are still orienting (?) what did your preceptor say about this?
Pulling a controlled substance by override and allowing someone else to administer without it not being on the MAR is a big deal. I've done this sort of thing, but do the administration and solely take full responsibility if push ever comes to shove.
It's okay if everything is above board and all comes out in the wash, but I will only override and administer if it's a situation which requires immediate action, like the administration of an antipsychotic and/or a benzodiazepine during a code green.
I do not color outside of the lines when it comes to something like a narcotic analgesic for pain. The amount of time saved in entering the order and waiting for pharmacy verification isn't worth the hassle of what might be.
Please allow this situation to be a big learning process, amberrenae! I truly hope everything does come out in the wash!
Mar 20Thanks everyone for the responses. I did not do an override to pull the morphine, it was still available to the patient in the Accudose from a previous one time order so I didn't realize there wasn't a current order until I got in the room. Because there was no override and the whole thing happened so quickly and right before walking out the door, I wasn't thinking about my name being attached to a drug that may or may not have been given so I appreciate everyone bringing it up and I will definitely be talking to my manager about the whole thing today.
Mar 20Quote from dudette10I smell a big uh-oh here!You pulled it under your name with an override from the Pyxis, then she took it from you to give it. Did she really give it? Has there been any follow up on your override without a corresponding order and administration under your name?
Good for OP to be questioning this.
Mar 20If a co worker asked me to give their patient morphine because they were busy and the patient had it ordered - I would check the MAR and give it no problem. But if it wasn't ordered and not on the MAR, no way Jose. As others have said, make sure to discuss this with your manager. You don't need anything to come back and bite you later.
Mar 20You were absolutely correct to not give it. But I wouldn't have pulled it, either. I would talk to your preceptor and unit manager ASAP about the situation because I can almost guarantee
'they" will come looking for you wondering about the morphine you pulled but didn't give.
Mar 20Certainly hope to hear that when you talk to your manager today that you are not in a great deal of trouble over pulling the med. Good luck with the interaction.