Can anyone help with this situation?

  1. Please read this situation and respond to the questions below, with your title (LPN, RN, ect.)...it would really help me out ....

    You enter a patient's room to answer a call light and are very surprised to walk in on a physician who put on the call light because he needed help. The doctor is doing a procedure unknown to you that involves IV solutions and medications. You are a new LPN graduate and have not yet been certified in IV Therapy. There is an LPN student in the room looking frustrated and possibly frightened. The patient appears to be in pain and looks at you as though she hopes to be rescued.

    The doctor seems frustrated and is tense and raising his voice. He appears to be unable to complete the procedure he has undertaken because both his hands are full, and he needs one more thing done. You wonder if he asked the student to assist with the IV medications and became frustrated when she said she couldn't. All of these observations and considerations race through your mind in seconds. In addition, YOUR blood pressure and pulse rate increase because of the adrenaline release caused by the situation. Then the doctor says to you, "Finally, a nurse! Grad that medication (a syringe filled with "something" sitting on the over bed table) and give it in the second IV port."

    1. What do you do, and, more importantly, how do you think it through?

    2. What are the considerations that you must factor in to your decision?

    Ok now...send in the replys!!
    •  
  2. 13 Comments

  3. by   Lacey
    Don't become rattled just because the situation is tense. Ask the doctor exactly what this procedure is. If it's something that you're familar with, then proceed to assist BASED on unit policy. If the physician is asking you to do something outside of your scope of practice or against policy, go get the charge nurse and make them aware of the situation. Also, never administer a "something" in a syringe, the person that drew it up, can administer it. I am an RN and have walked in on situations like this!
  4. by   OBNURSEHEATHER
    Ditto what Lacey said.

    Heather
  5. by   Lela RN
    I also agree with Lacey. Don't ever give something that someone else drew up no matter what the route. If they get mad then SO
    WHAT. Anyways, tell us what you did. Did you give it or didn't you ? What was the outcome ? Another thing- don't ever be afraid to question a physician, they don't like it, but you to are responsible for the patient, and have a right to know what's going on. Again if they get mad- SO WHAT- your doing what's in the best interest of the patient.
  6. by   jenac
    Hmmmm- I definitly don't like the thought of administering something unknown in a syringe! Big No-No, and a possible heap of trouble, not to mention your license. Aside from that, I'd have to kind of evaluate the situation. I agree with Lacey. If the procedure is within your scope, and you can safely and legally do it, go for it. But I would be concerned at the situation at you have presented it. I'm an LPN.
  7. by   renerian
    Need I say more. I agree with everyone........

    renerian RN
  8. by   UKRNinUSA
    you think "lack of preparation on your part does not constitute an emergency on my part"
    and
    you say "let me get the charge nurse to help you out as I am not qualified to help you with this procedure"
    RN
  9. by   BadBird
    I agree with the above posts, never do a procedure that you are not trained to do, never push a unknown medication that someone else drew up even if that someone else was the Dr. If the Dr. gets mad,so what! He/she should know better than begin a procedure without properly trained nurses to assist. After the situation is over I would write a statement of concern and let the charge nurse/nurse manager know about what occured.

    Critical Care RN.
  10. by   LasVegasRN
    Originally posted by BadBird
    I agree with the above posts, never do a procedure that you are not trained to do, never push a unknown medication that someone else drew up even if that someone else was the Dr. If the Dr. gets mad,so what! He/she should know better than begin a procedure without properly trained nurses to assist. After the situation is over I would write a statement of concern and let the charge nurse/nurse manager know about what occured.
    Ditto.
    LasVegas RN, CCM
  11. by   Shopgirl2262
    WOW...thank you all so much for your responces!! This is a project I am doing in nursing school. I needed references from other nurses. If anyone else would like to add to this....PLEASE POST
  12. by   kmchugh
    Ok, so the doc is frustrated, the student is rattled, and the situation looks tense. Time to calm it down. If you are not qualified to perform a procedure, then simply let the physician know that (though you may perform almost any procedure on HIS license, under his direction and supervision).

    More importantly, though, NEVER, EVER give a syringe of "something" when you don't know what "something" is. Nothing bothers me worse than nurses who give medications with no idea of what they are really giving, the basics of how that drug works, and why it's being given to this specific patient. I've actually heard nurses say "I'm too busy to know what every drug I'm giving is." Weak, flimsy and stupid excuse. Mistakes happen. Pharmacists misread orders. Doctors have brain cramps. He may have written neosynepherine nasally, and the pharmacist read neosynepherine IV. There is a huge difference in what the same drug will do via different routes. If your patient is already hypertensive, you may induce a stroke or MI giving the drug IV.

    Kevin McHugh, RN, MSNA, CRNA
  13. by   NurseDennie
    I think I understood from what you posted that this is a hypothetical situation, and didn't actually happen to you, right?

    It brings up an interesting point, in that some nurses seem to think that if the doctor point-blank tells them to do something, it's okay to do it, even if it's outside of the nurse's scope or something along the lines of your scenario, where he or she has drawn something up he or she wants you to give.

    But the nurse is indeed NOT home and dry just because a doctor told her/him to do it. So don't get trapped into something you're not comfortable with/capable of just because some doc told you to do it.

    I feel unhappy (not uncomfortable) if someone asks me to administer something I didn't draw up. I feel like I'm INSINUATING that I don't trust that person. Quite rude. But that's just life. I've never lost a friend from doing that.

    Where I work now, I see syringes full of clear liquid laying around - I'm not kidding!!!!! Drives me nuts!

    Okay, that's my two cents.

    Love

    Dennie
  14. by   Youda
    If my understanding is correct from the last time I read my state Nurse Practice Act, the only time the doctor's license covers what I do is when I am in his/her employment (such as his office nurse). I am not automatically covered "just because" he/she is the doc and I'm a nurse. IN FACT, it goes the other way, legally. The nurse is considered the last 'line of defense' against errors, and is held legally liable even IF a doctor has told the nurse to do something and the nurse did not stop/catch the error. You're responsible for what YOU do, not what the doctor says to do, if you can appreciate the difference.

    So, saying that, I agree with the comments above. This was not a life threatening situation, just a tense one as far as the doctor was concerned. Doctors are tense all the time, it's part of their job description. That doesn't give me a freebie to NOT follow procedure or standard nursing practice.

close