give NOW medication 1.5 hr late, what kind of trouble I am in

  1. 0
    I work on a rehab unit, pts come to us from med-surg floors. One of my pt had run A-fib around 100 for over two weeks and she is on Cardizem 240mg q day. Today the doctor put in a NOW order for 120mg additional at around 9:30am and I didn't give it till 12p. I did checked the pt's HR after one hour and it went down to 90, pt had no s/s throughout the shift.

    Just wondering whether the DON will have a talk with me soon and what kind of trouble I will be in.

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  2. 19 Comments...

  3. 6
    First recognize 9:30-12 is 2.5 hours....

    At my hospital 1.5 isn't a big deal as it can take pharmacy up to 30 min to approve and 45-1 hour to receive on the floor.... but 2.5 is long.

    I would try to recall what the delay was from and just be honest about it.
  4. 2
    Quote from treeye
    I work on a rehab unit, pts come to us from med-surg floors. One of my pt had run A-fib around 100 for over two weeks and she is on Cardizem 240mg q day. Today the doctor put in a NOW order for 120mg additional at around 9:30am and I didn't give it till 12p. I did checked the pt's HR after one hour and it went down to 90, pt had no s/s throughout the shift.

    Just wondering whether the DON will have a talk with me soon and what kind of trouble I will be in.
    When I worked in the hospital, it would be highly unlikely that a manager level person would even notice this. 9:30-12 is 2 1/2 hours not 1 1/2 though.

    Why was the medication given so late? Did the doctor call you when he put in the order? I know there were times when I worked in the hospital that if I wasn't advised "I just put in this stat order", I might not see it for several hours if it was a busy day. Not to mention, though pharmacy's turnaround time for stat meds was supposedly fifteen minutes, an hour and a half was more likely.

    You won't necessarily be in any trouble.
    Stcroix and loriangel14 like this.
  5. 1
    I figured one hour is appropriate turn around time for NOW medication, so 10:30 is on time and 11 is 30min late. Anyway, I don't deal with this type of order often since our floor is not considered acute care. I got carried away when it became busy. Hopefully I won't get in trouble, and hopefully I learn my lesson this time. thanks
    chevyv likes this.
  6. 2
    Quote from treeye
    I figured one hour is appropriate turn around time for NOW medication, so 10:30 is on time and 11 is 30min late. Anyway, I don't deal with this type of order often since our floor is not considered acute care. I got carried away when it became busy. Hopefully I won't get in trouble, and hopefully I learn my lesson this time. thanks
    Does your floor have a protocol for these type of situations? When I worked in the hospital, pharmacy was required to physically hand a stat medication to a nurse, so that it couldn't be overlooked.
    brillohead and loriangel14 like this.
  7. 0
    It will depend in protocol as others stated...One facility I worked for, a STAT had to be given no later than 30 mins, a NOW order no later than 90 mins. At this place, a pharmacy was on site, and a policy was in place.
  8. 5
    I highly doubt anyone will notice or care. Do better next time and let it go.
    chevyv, loriangel14, PediLove2147, and 2 others like this.
  9. 1
    would never be noticed where i work.
    chevyv likes this.
  10. 1
    Not too big of a deal. The patient had been hanging out in a fib for a few weeks and 100 is not that high. Plus I am having trouble thinking of a scenario where a PO med is urgent enough to be ordered stat. If the patients HR was 130s with a low blood pressure and the order was for 10 of dilt IVP then that's a different story. I don't think you will get in any trouble for this, just don't make it into a habit
    loriangel14 likes this.
  11. 0
    Quote from treeye
    I work on a rehab unit, pts come to us from med-surg floors. One of my pt had run A-fib around 100 for over two weeks and she is on Cardizem 240mg q day. Today the doctor put in a NOW order for 120mg additional at around 9:30am and I didn't give it till 12p. I did checked the pt's HR after one hour and it went down to 90, pt had no s/s throughout the shift.

    Just wondering whether the DON will have a talk with me soon and what kind of trouble I will be in.
    It's a medication error and needs to be reported as policy requires. I doubt you'll hear about it again other than the required "Don't do that again" talk from the NM.

    However, I think that brushing it off as "merely 1.5 hours late cuz I don't count the first hour" is not ok. The MD ordered it now for a reason.


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