Am I In trouble?

  1. 0
    I worked last Tues,night shift (7pm - 7am). An lvn was the one who endorsed me the patients that i will be taking care during my shift.One of the pt has an order of vancomycin iv q tuesday and it was written at 02:00 pm by the pharmacist?The lvn told me that it was given already so the next dose will be next tues.Vital signs were taken by the cna.by 1200am the temperature was 102.8 as reported by the cna.I gave the pt tylenol 650 mg.By 4am it was 103.8 so I called the doctor and told that the pt has a high temp.I also told my supervisor the pt's condition.My supervisor even checked chart for present/past orders,labs,etc.Until the end of my shift,the doctor didnt call back so I endorsed it to the am nurse.wednesday afternoon,the am supervisor told me that the pt had a sepsis beacause the vancomycin was not given and is now in ICU.The pt is not in distress,just a high temp because of sepsis.Am i in trouble??!!! Hope the experienced nurses here will give me an advice..
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  4. 1
    Isn't there some kind of med sheet you guys sign when the medication is given?
    leslie :-D likes this.
  5. 0
    Quote from LaneyB
    Isn't there some kind of med sheet you guys sign when the medication is given?
    the mar? It was wriiten on the mar but it was not signed.The lvn told me that it was given already.I should have doubled checked if it was given or not.The order was 0200 pm,they should have given the vanco by that time.Am I right?
  6. 4
    My guess is that it is one of those learning experiences we all have. If the order was written at 2pm, then of course it should have been given by your shift. However, you did have a responsibility to check and see why it was not signed off and ask questions. Old experienced nurse would have caught that and caught that early. I would say that several people messed up here. The shift before yours, the supervisor that didn't catch it and unfortunately you. Antibiotics usually come up with the time written on them, if you saw two doses it would be a clue. Once I caught a mistake like that because I saw antibiotics piling up in the frig. When Ilooked to see what was going on there was an order that had not been taken off. Always be on lookout. You can't assume that it was given if not signed off. I would of called even if I was told it was given by previous shift and supervisor would have made me call. Don't forget you have no proof of what the previous shift said to you.
    elprup, ♪♫ in my ♥, leslie :-D, and 1 other like this.
  7. 0
    Quote from oramar
    My guess is that it is one of those learning experiences we all have. If the order was written at 2pm, then of course it should have been given by your shift. However, you did have a responsibility to check and see why it was not signed off and ask questions. Old experienced nurse would have caught that and caught that early. I would say that several people messed up here. The shift before yours, the supervisor that didn't catch it and unfortunately you. Antibiotics usually come up with the time written on them, if you saw two doses it would be a clue. Once I caught a mistake like that because I saw antibiotics piling up in the frig. When Ilooked to see what was going on there was an order that had not been taken off. Always be on lookout. You can't assume that it was given if not signed off. I would of called even if I was told it was given by previous shift and supervisor would have made me call. Don't forget you have no proof of what the previous shift said to you.
    It was written on tues at 2pm by the pharmacist.I worked at tues(7pm - 7am).Am I the only one at fault?
  8. 4
    I would be surprised if one weekly dose of Vanco could have kept this person out of the ICU. Sounds like overall they needed more aggressive therapy.

    As far as the dose being given if someone tells me they have given the medication, whether they have charted it or not, I do not give it again. I would have documented that I was given a verbal report that the medication was given by the previous shift.

    Situations like these are almost NEVER one single persons fault. Sounds like a combination of decisions.

    Best of luck,

    Tait
    wooh, KellyCCRN, kanzi monkey, and 1 other like this.
  9. 0
    It should have been given by the am shift ( tues 7am-7pm) if the order was written by the pharmacist at 0200pm? Its really hard to avoid mistakes to a newbie nurse like me.
  10. 0
    Quote from gwafuh_rn
    It should have been given by the am shift ( tues 7am-7pm) if the order was written by the pharmacist at 0200pm? Its really hard to avoid mistakes to a newbie nurse like me.
    If the day nurse wasn't aware of it, missed the chart, or didn't see it on the MAR then she very well might not have given it. Didn't she tell you she did give it though? Or was it assumed because it was prior to your shift?

    Tait
  11. 0
    The lvn was the one who gave me report. All I remember is that she said that the vanco was given and the next one will be next tues because it was q tues.When the pt was transferred to icu on wednesday,the vanco was not given.Am I gonna lose my licence?????? My fault is I didnt do do 24 hour check..
  12. 6
    Quote from gwafuh_rn
    The lvn was the one who gave me report. All I remember is that she said that the vanco was given and the next one will be next tues because it was q tues.When the pt was transferred to icu on wednesday,the vanco was not given.Am I gonna lose my licence?????? My fault is I didnt do do 24 hour check..
    First off, stop stressing. Breathing is good, do it often and do it s l o w l y.

    These things happen. Chock it up to a learning experience to always double check your information, do your chart checks and always document. Like I said in an earlier post this ICU trip was a combination of things, most of which probably had nothing to do with nursing care, or even potentially MD care. Because we don't know the whole story about the patient (and no we don't need a detailed report because we still have HIPPA to consider on this website) we don't know exactly what was going on with this patient to put them where they were getting Vanco once a week (which seems really odd to me). Heck we aren't even clear on if you work hospital, LTC, hospice, homecare or what have you. And that is OK.

    Mistakes happen, and it isn't even very clear if you even made a mistake here. If the dose wasn't given by the prior shift, but they reported it given then it seems pretty clear the mistake was theirs. Not yours.

    One thing nurses, myself included, need to be reminded of so often is the following: Just because a patient gets worse, does not mean we did something wrong.

    People are sick, they ebb and flow, rise and fall and the only thing we can do is be there to offer the most competent care we can and a watchful eye.

    Take care,

    Tait
    Fairemaid, KellyCCRN, kanzi monkey, and 3 others like this.


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