I Feel Like The Most Incompetent Nurse Ever! - page 4

Hello Nurses, I feel like the most incompetent nurse ever right now because of an incident that took place yesterday. I work on a Tele unit. I was on vacation for 12 days and yesterday was my... Read More

  1. by   Nurserton
    Quote from mcleanl
    I've been racking my brain over this........in the OR and in ICU we give paralytics all the time for various reasons. This medication can only be given to intubated patients since it is a neuromuscular blockade....... patients cannot breath sponateously when receiving this medication. This man (your patient) was not only breathing but he was talking to you as well.
    I am wondering what med it was........paralytics don't come in piggybacks.......and they are almost always labelled "for intubated patients only".
    I am thinking your manager may have given you the wrong class of medication.
    Maybe precedex? Not your typical paralytic, would allow for the pt to carry on...hmm.
  2. by   Nurserton
    Okay I just saw the latest post and apparently it was precedex. We just had an inservice on it and it's this drastically different new sedative that allows patients to be arousable and functional, fully able to interact, with any sort of stimuli (talk, touch), and then easily drift back off into sedation. It doesn't cause respiratory depression, amnesia, or hypnosis, but sedates them well enough that it can be used on intubated patients. The irony of this situation..if you were going to accidentally give a paralytic to a non-intubated patient, THIS is the one you'd want to give. ;-)
  3. by   mcleanl
    Quote from NurseRivera
    Okay I just saw the latest post and apparently it was precedex. We just had an inservice on it and it's this drastically different new sedative that allows patients to be arousable and functional, fully able to interact, with any sort of stimuli (talk, touch), and then easily drift back off into sedation. It doesn't cause respiratory depression, amnesia, or hypnosis, but sedates them well enough that it can be used on intubated patients. The irony of this situation..if you were going to accidentally give a paralytic to a non-intubated patient, THIS is the one you'd want to give. ;-)
    Precedex is not a paralytic.
  4. by   tonet0908
    Quote from NurseRivera
    Okay I just saw the latest post and apparently it was precedex. We just had an inservice on it and it's this drastically different new sedative that allows patients to be arousable and functional, fully able to interact, with any sort of stimuli (talk, touch), and then easily drift back off into sedation. It doesn't cause respiratory depression, amnesia, or hypnosis, but sedates them well enough that it can be used on intubated patients. The irony of this situation..if you were going to accidentally give a paralytic to a non-intubated patient, THIS is the one you'd want to give. ;-)
    Hahahahaha, yah, I don't think you would want the patient staring at you while you are pushing a tube down their throat. Well, I guess that would explain why he was awake, talking and walking around. Thanks for the info.
  5. by   Roy Fokker
    Percedex isn't a paralytic. Might be more comparable to Versed or Etomidate. Sedation doesn't equal paralysis.

    OP: If it makes you feel any better, read through this thread, starting here (my story! As a sort of 'you're not alone' reminder... )

    And yes, I agree: You made a mistake. Incompetence and error are completely different things.
    And given your reaction to the situation, I'm certain you learned your lesson!

    cheers,
  6. by   tonet0908
    Quote from Roy Fokker
    Percedex isn't a paralytic. Might be more comparable to Versed or Etomidate. Sedation doesn't equal paralysis.

    OP: If it makes you feel any better, read through this thread, starting here (my story! As a sort of 'you're not alone' reminder... )

    And yes, I agree: You made a mistake. Incompetence and error are completely different things.
    And given your reaction to the situation, I'm certain you learned your lesson!

    cheers,
    Yes, I read your story, that was very scary. I try not to get the "cocky" attitude, lol. yeah! I will never ever make a mistake like that again and hopefully no other mistakes. I know now that Precedex is not a paralytic as I stated in an earlier thread. Also, everyone knows that sedation and pralysis are 2 different things. My misinformed nurse mgr is the one who called me at home the day after the incident and told me that it was a paralytic. I originaly did not know what it was so I said what she said. The next time I went to work I looked it up for myself.
  7. by   nurseprnRN
    "also, everyone knows that sedation and pralysis are 2 different things. my misinformed nurse mgr is the one who called me at home the day after the incident and told me that it was a paralytic. i originaly did not know what it was so i said what she said. the next time i went to work i looked it up for myself."

    lessons learned:
    1) not everyone knows that sedation and paralytics (neuromuscular blockers is the correct term) are the same; why, i have no idea. sure, you can give somebody so much sedation that s/he won't move much, and if someone is agitated you can sure as hell quiet him/her right down with a neuromuscular blocker, but hey. probably not what you should do in either case.
    2) not everyone has a clue as to what happens to patients in special procedures
    3) your nurse manager has no clue about either of these, and lacks critical thinking skills to boot. hello?? if he's up and walking he is not paralyzed. plus, she didn't look it up to be sure she knew what an unfamiliar drug was before she called you a whole day later, and now she knows that you know that she's given you a great example of how to look dumb.
  8. by   Nurserton
    Quote from mcleanl
    Precedex is not a paralytic.
    Well enlighten us, what class is it then? I know it's not the same as a traditional paralytic, but I honestly can't remember what class. Do you wish to share?
  9. by   tonet0908
    Quote from NurseRivera
    Well enlighten us, what class is it then? I know it's not the same as a traditional paralytic, but I honestly can't remember what class. Do you wish to share?
    Hi NurseRivera,

    Read post #38, it has the info I found about it.
  10. by   mcleanl
    Quote from NurseRivera
    Well enlighten us, what class is it then? I know it's not the same as a traditional paralytic, but I honestly can't remember what class. Do you wish to share?
    You can google it and get all the information you may need. As a previous poster mentioned, it has sedative properties.......but it is not a paralytic in any way, shape or form.
    Last edit by mcleanl on Jul 6, '11 : Reason: forgot a word
  11. by   Conquering Lion
    You are not the first person to make a medication error and with the current healthcare system the way it is.. you won't be the last. It is tough emotionally because all eyes are on you and people begin to question your judgement. Don't think for one second that the hospital will back you up, the nurse is the first person that the hospital will throw under the bus. Protect yourslef and protect your license.. good nurse liability insurance helps. The good thing is that no harm to the patient. As we say in the military trust no one..check it and check it again.

    Please seek counseling and talk about it (face to face) with a licensed professional within your community.

    Best wishes to you.
  12. by   blondy2061h
    I had a Precedex drip on a combative patient once. It didn't do anything it seemed like. Depending on what dose he was getting in these little boluses, I'm not surprised if he just had to nap and then was fine again a bit later. You and your patient are both very lucky it wasn't actually a paralytic.

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