just blowing off steam...

[nursedawn67, LPN]

I just hate feeling questioned by another nurse. I had a resident at my nursing home that had been ordered and started on Zpack. The next morning about 3am complained of SOB, the res did not physically appear to be SOB, but did complain of it. She has a history of anxiety for which she recieves xanax prn and had gotten about 8:30pm . This res tells me at 3am to send her over for a chest xray....to which I explain I have to have a doctors order for. Her o 2 sat was 95% room air. She had some audible congestion which was cleared some by coughin and lung sounds clear on the left and some upper congestion heard on the right. I explain that at 3am with her symptoms I cannot call the Doctor...this isn't an emergency...during all this she is taking her self to the bathroom and in and out of bed with ease. I give her a xanax...because she is getting all worried and anxious despite the staffs efforts. so anyhow.....I tell the oncoming day nurse at 6am all of this and she says "isn't xray next door open all night long??" Come on!!! HELLO!!?!?!? I still have to have an order......can you imagine if I call a doctor at 3am, who IS aware the resident is picking up a upper resp and has been started on zpack and has no emergency symptoms to tell them the resident requests and possibly needs an xray?!?! We are always told not to call a doctor in the middle of the night unless and emergency. anyhow...just blowing off steam...the day nurse did sort of agree with me....but then said Oh I'll call in a few minutes...It's 6am......anyhow. Thanks ya'll for listening. :kiss

[RNforLongTime]

I agree with you. Docs do NOT like to be called at 3 am for something non-emergent. Now had the resident been going into CHF or Pulm. Edema, that is a different story all together. And as always document, document, document. Gotta cya!

[hoolahan, ASN, RN]

It sounded like you used good judgement. She was being treated w the Zpack. Doesn't sound like it was an emergency, you did a proper assessment, checked lungs and sats, and there was nothing other than what you would have expected to find, no need for a STAT CXR.

[sweetnurse11]

I want know how can I post my question in nursing discussion . Thank you.

[judy ann]

This is the place to blow off steam, or, as my uncle said, "vent your spleen". Sounds like you "dun gud". This is a situation where , if you had called at 3:AM with this lady's condition and symtoms, that doc might have a just reason to holler! And you certainly can't just do a CXR because the patient wants one, or even because you think it's advisable until you have that pesky doctor's order. Don't you just hate that?

[thisnurse]

i would have told her that she didnt need an xray cos i have xray eyes.

as for the stupid nurse ..yes that xray is open all night but xray without orders closes at 5

you did the right thing...

[Paprikat]

Hi there. What is Zpack? I am assuming it is an antibiotic, but just curious. Thanks. Just wondering if it has another name.

[CountrifiedRN]

Hi Paprikat. Zpack is also known as Zithromax. (antibiotic)

[cbs3143]

Hi Greer128,

It sounds like you did an excellent job of assessment and documentation. Had the patient been visually dyspneic or had desaturated, I'm sure that your actions would have been different. The day nurse apparently hasn't had the opportunity to wake a doc up in the middle of the night for a "non-event". You did the right thing.