I made a boo boo!!! - page 2

Just before finishing up after a hectic 12-hr night shift the other morning, the charge nurse asked me to witness a waste. She told me what she was giving, how much she was wasting, drew it up in... Read More

  1. by   meownsmile
    I would say the charge nurse is the one that may feel the heat of any hot water. You followed policy as far as wastage. She administered and she gained access and signed it off after given so she is ultimately responsible for its use and administration. True it would have been good had you thought about what you were wasting and why it was being given, but if you did and you mentioned the policy and circumstances do you really think she would have said "oh thats right ok i wont give it" even though someone called the doctor and gotten the order and she made the extra trip to the supervisor pixis to get the med? She was giving it, it didnt matter who signed off the waste. I wouldnt worry about it until and unless someone with authority mentions it to YOU.
  2. by   MALE*RN*777
    You did nothing wrong and if the doctor ordered it for a normal reason then there should not be a problem. More than likely if she would have said no we can't give it, the doctor would have been on the phone to the unit sup or manager and it would have been given anyway. You did nothing wrong...
  3. by   lauralassie
    Wouldn't imagine that you would get in trouble for witnessing a waist. The nurse that gave it would be the one in hot water. I would say something to your manager though. Even if this nurse has a lot of experience, she should not be doing consious sedation meds on the floor even if a Dr. is admin. it. That should be the time that she needed to stand up to the Dr. and say , I won't be involved. If you want the med you need to go to pharm. and get it yourself. Call supervisor if needed. There are places for consious sedation, the floor isn't one of those. Was the pt on a monitor. was o2 avalible, could a nurse be with the pt until baseline was reached etc... way too risky. Through the years I've been asked to do things by dr's that arn't proper. However, it means my license. No Way I'll do it. Any way just to reinforce, I can't imagine you would get blamed for her actions.
  4. by   GardenDove
    Quote from lauralassie
    Wouldn't imagine that you would get in trouble for witnessing a waist.
    Especially if it were part of your abdominal assessment.:chuckle
  5. by   mediatix8
    I am most sure that you will not get into any trouble at all... ESP if there was no bad outcome as a result of the versed. And maybe for all you knew there was a doctor in the room. I'm sure a doctor can override hospital policy in certain situations. What if a patient needs an emergency intubation... you give versed for that. It might not be you who gives it but someone in the response team... but it would still be given "on your floor" in that case wouldn't it? All you did was verify the waste... it's not like you were the other nurse's preceptor.
  6. by   Kyrshamarks
    Pre operative meds ARE NOT CONSCIOUS SEDATION. Many times you may give a med pre operatively that you normally would not give. it was ordered for something other than concious sedation.
  7. by   Spidey's mom
    Quote from wtbcrna
    I would also look up your units policy for yourself on giving Versed. I am sure you probably give Ativan on your floor and don't consider that conscious sedation. There is a difference between preoperative uses, anxieolytic uses, and conscious/moderate sedation. Just because someone is using Versed doesn't make it conscious sedation. Versed is usually only used for preoperative uses and sedation because of its short half-life. I could see the physician/provider ordering it if the patient was getting a very short procedure and they just wanted them to relax for a short time/anxieolytic giving them a longer acting benzodiazepine.


    Hope this helps...
    This is how it works for us too . . . . look up your P&P on this.


    steph
  8. by   meownsmile
    Quote from Kyrshamarks
    Pre operative meds ARE NOT CONSCIOUS SEDATION. Many times you may give a med pre operatively that you normally would not give. it was ordered for something other than concious sedation.

    Years ago we used to give an IM dose of Versed pre-op. At least i think it was Versed, its been so long ago. We dont do that at all anymore and most of the reasoning being it shouldnt be administered without cardiac monitoring and one on one care. We havent given a pre-op medication in i dont know how long. We give pain meds, but they are ordered from admission. All pre-op meds that my facility gives are given in holding as far as i know. What a wide variation of practice.
  9. by   classicdame
    The error occured when the first nurse drew up the medication without you witnessing the draw. That is what you should insist on in the future. Let me see the whole event because you might have to answer for it. Your signature indicates you witnessed the waste of THAT DRUG, not just what might have been in the syringe. Girl, I have been there too. Nights can get to you, huh?
  10. by   AlbertaBlue
    I'm sorry to be the one to disagree...but...I don't agree with a few things about this...1) Just because it's a 12 hr shift doesn't mean that you should relinquish your responsibility to follow the P & P's of your unit, if you;re tired get someone else to crosscheck the med, 2) The fact that you were not the one who was administering the medication does not mean that you should not question the purpose of the medication being drawn up especially when you know that you are not supposed to deliver it on your unit, 3) the five rights of medication administration is there for a reason...the purpose of which is to avoid situations such as these. I understand that things can get really busy...but the fact remains that signing for a waste means that you should know what it is you are signing for, otherwise the action is simply a token gesture and not what it is meant to be, which is verification of the drug and the amount being wasted. We give Versed on our ward for palliative sedation...but we always use the Riker's scale to gauge the level of sedation that the family and palliative physician have agreed on. I know you would like to feel less awful about this...and believe me...I can relate...but I think that you have learned a very valuable lesson...we are all responsible for the patients we care for. I'm sorry to have been the naysayer...I really was trying to find a positive spin...but having experienced this myself...I just can't!
  11. by   wtbcrna
    Quote from AlbertaBlue
    I'm sorry to be the one to disagree...but...I don't agree with a few things about this...1) Just because it's a 12 hr shift doesn't mean that you should relinquish your responsibility to follow the P & P's of your unit, if you;re tired get someone else to crosscheck the med, 2) The fact that you were not the one who was administering the medication does not mean that you should not question the purpose of the medication being drawn up especially when you know that you are not supposed to deliver it on your unit, 3) the five rights of medication administration is there for a reason...the purpose of which is to avoid situations such as these. I understand that things can get really busy...but the fact remains that signing for a waste means that you should know what it is you are signing for, otherwise the action is simply a token gesture and not what it is meant to be, which is verification of the drug and the amount being wasted. We give Versed on our ward for palliative sedation...but we always use the Riker's scale to gauge the level of sedation that the family and palliative physician have agreed on. I know you would like to feel less awful about this...and believe me...I can relate...but I think that you have learned a very valuable lesson...we are all responsible for the patients we care for. I'm sorry to have been the naysayer...I really was trying to find a positive spin...but having experienced this myself...I just can't!
    I am sorry, but I totally disagree with you. This nurse witnessed the waste on a drug with another nurse on a patient that is not their patient or were they involved in their care. Following your logic where I work in ICU and occassionally recover patients I sign off wastes with the anesthesia providers quite frequently. I am to be held liable for their choice in medications because I signed off their waste..? No...I am not. The liability ends with proper documentation of the waste. I often witness other nurses wastes and unless I am the charging I don't go into the proper medication admistration or review their patients care with them. Who has time to take of their patients, delve into other nurses patients (unless you are the charge nurse/supervisor etc.) and do all the other things that you have to do during a normal shift.
  12. by   AlbertaBlue
    Quote from wtbcrna
    I am sorry, but I totally disagree with you. This nurse witnessed the waste on a drug with another nurse on a patient that is not their patient or were they involved in their care. Following your logic where I work in ICU and occassionally recover patients I sign off wastes with the anesthesia providers quite frequently. I am to be held liable for their choice in medications because I signed off their waste..? No...I am not. The liability ends with proper documentation of the waste. I often witness other nurses wastes and unless I am the charging I don't go into the proper medication admistration or review their patients care with them. Who has time to take of their patients, delve into other nurses patients (unless you are the charge nurse/supervisor etc.) and do all the other things that you have to do during a normal shift.
    I am interested in reading the chain of responses to the initial posting. I can see your point...however...the point that I was trying to make is that if you know that the medication for which you are co-signing as a waste is a medication that you know you should not administer on your ward, then why sign for it at all without questioning its intented purpose? Purely out of curiousity...do you think that this rule should apply differently for the varied practice areas? In other words...I work on a med/surg floor where there are very specific medications that are disallowed for administration by RN's. It sounds to me that RN's practicing in critical care areas are more accustomed to administering medications that would otherwise be verboten on a med/surg ward. Also, I wonder if nurses practicing in different countries (where personal liabilities are not an issue) would answer this question differently. As a Canadian nurse, I do not require liability insurance. My understanding is that nurses practicing in the US do...do you think this influences the responses to this question? I'm really interesting in your perspectives.
  13. by   angel's RN
    hey -- all you did was witness a waste, not witness was she gave, so i really don't think that you made a boo-boo in this case. i think that the charge nurse made the bo-bo!!!! but next time, maybe you should look at what you waste??

close