Excuse Me?? - page 3

OK, who's heard of this one. I was taking care of a woman s/p ORIF of the hip. In ICU for cardiac monitoring (needs a new pacer generator). Hgb post-op = 9, which is down from 13 two days ago. ... Read More

  1. by   P_RN
    BackInSchool where do you work? The PRMH used the tube system for that . Unless they've come to their senses I assume they still do. You at USC?
  2. by   mattcastens
    Originally posted by BackInSchool
    Well, being the pessimist that I always am, I can think of a number of bad scenarios. Where I used to work the tube system became jammed about once a week and would be unusable for hours. Also, anyone could pick up whatever was sent on the other end. The third thing that bothers me about tubes is that things don't always go where they were supposed to. People sent things to the wrong floor or unit or the gremlins in the system did. The last thing that bothers me may be really farfetched, but can you imagine the cleanup if blood or specimens "leaked" while in the tube system?

    >SNIP<

    I guess that I really believe in that old motto "better safe than sorry" and kinda freaked when I heard of a facility that would send blood through the tubes. It may be SOP but I think it's SNAFU
    Interesting. As I said, we've never had any problems. I guess my theory is that until you do, go with what is most efficient.
  3. by   LLDPaRN
    I also work at a facility where we use the pneumatic tube system to send blood to the patient care units. The unit of blood usually comes in two plastic bags. We have not had any problems that I am aware of (thankfully). I can understand Backinschool, who expressed a variety of concerns, all of them valid. Especially about the blood leaking. Anyway, that's my $.02 worth

    Laurie
  4. by   hogan4736
    maybe he was ensuring that you weren't housekeeping...

    just playing devils' advocate
  5. by   mustangsheba
    This has never happened to me, but I can tell you that holding back lab values unless you provide a diagnosis is not acceptable practice. Unless the lab needs the diagnosis for billing, they have no reason to have this information. In my geographical area, there are signs at every nurses' station stating that unless you are caring for a particular patient, it is a breach of confidentiality to access their information. I assume that goes for all hospital personnel, not just nurses who might actually have a use for it.
  6. by   Sleepyeyes
    by mattcastens....he started painting the ceiling
    Matt, does that mean what I think it means??? --as in bright red arterial-colored "paint"?
  7. by   RNinICU
    In our hospital, it's not the lab so much as the pharmacy that gives us this kind of problem. Many times we have had patients crashing and called down to have them send a stat drip. Most of the pharmacists know we will send the order down as soon as we have a minute to spare, but there are a few who will not send the med until we fax them a written order. This of course takes precious minutes that the patient may not have. We keep some premixed drips on stock, but there are a some, like neo and Levophed that have to be mixed by the pharmacy. Our cardiac surgeon likes to use epical for his patients with low BP, and one pharmacist just has a fit every time we ask for it. We have gone to the head of the pharmacy about this, but he supports these obstinate people, and says they need to cover their practice. Our cardiac surgeon has even spoken to him, but it has done little to change the situation.l
  8. by   shay
    Oh, do NOT get me started on the *@#!! LAB!!! Never had one demand a dx for a result, but I guarantee if they had tried that crap w/me, a very nasty, very looooooooooong incident report would have been filed, and my very strong nm would have marched herself down there to rip somebody a new one.

    Ugh. I also have the problem w/STUPID lab techs not knowing the meaning of stat. Idiots. My only prayer is that one fine day, these buttheaded lab techs will be pts themselves, in desperate need of the lab's services for some reason or another, and THEY will fall victim to their own practices!! AAAAAAAAARRGGHHH!

    I have only had experience with ONE hospital that had a good lab.........ONE. It was at a very large teaching hospital, and I guess these lab techs knew that the pts here were *******' sick and most likely DYING, so they didn't mess with you...if you said STAT, it meant STAT. If you needed blood, they didn't fiddle fart around with you over how much you could take at a time.

    ALL THE OTHER LABS I HAVE DEALT WITH ARE SLOW, BACKWARD, AND SUCK BIG TIME.
  9. by   mattcastens
    Originally posted by Sleepyeyes


    Matt, does that mean what I think it means??? --as in bright red arterial-colored "paint"?
    Yup. That's what it means.
  10. by   BadBird
    I have had the lab ask if the patient had surgery because the count was down but no specifics, sounds like a nosy person to me. Definately write a statement of concern .
  11. by   shygirl
    INCONCEIVABLE
  12. by   nursegoodguy
    A lab tech wouldn't tell you a lab value until you explained what procedures a patient had done... Hmmm Just who does the lab tech think s/he is anyway? If you didn't tell them what the patient had done and they had critical values would you have gotten in trouble for not contacting the doctor? I think the lab thought they made a mistake and wanted to make sure the patient did have something done to cover themselves? Hey Matt I lived in the Twin Cities for about a year back in the mid eighties!
  13. by   ChemoRN
    I actually have had people in the blood lab suggest treatment!!

    I had a patient who was bleeding. Not gushing or anything, but bleeding and we couldn't get it stopped. The plt count that AM was <10 Patient had gotten a 4 pack (gone are the days of 6 packs ) 8 hours later, patient had a nosebleed that wouldn't stop for hours. Had done packing, pressure, ice EVERYTHING. Dr orders another unit of platelets. Chic in the blood bank calls and tells me that it is MY responsibility to get the MD to order another platelet count and coags!

    HELLO?!?!

    Cancer patient... No platelet count for days and coags were normal at 5AM. It is not a shock that this guy needs platelets. Besides, the last time I checked, nurses carried out orders, doctors gave them. (OK, OK, I know the power of suggestion, but still...)

    So I told the lab that I would be happy to charge my patient for the above labs that they requested. HOWEVER, the patient was still bleeding and the platlets were ordered STAT.. So irrelevant of what the lab values are I NEED THOSE PLATELETS!!!! So would you mind sending them while I draw those labs? Oh and by the way, could I have your name to give to the MD so that he knows who's orders to countersign?

    Platelets came up pronto. Labs never done - per MD. Platelet count next AM - <10 - and we gave him some more!!

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