NO way! Narcan deal part III!

  1. OMGosh..okay for those following the thread about my pt that had narcan when I really think he shouldn't have...you will shutter when you hear this!

    The poor man and family have been freaked ever since the surgery and found out that the pt had sleep apnea! But because of that nurse that narcan'd him instead of monitoring him...they think that narcan is a cure for sleep apnea!!!!!!!!!!

    I guess the family is mad at me because I didn't use this wonder drug called narcan! And the RN that gave it was accusational towards me TO THE PATIENT (not just the chart!). OMGosh...he needed to sleep of the narcs after a huge back surgery at 2300, not narcan...and stip his opiate receptors! Now the family thinks his oral pain meds are going to kill him in his sleep, and they want an Rx for narcan to give him at night!!!!!!!!!!!!!!!!!!!!!!!!!

    They think that it is JUST the medications causing the sleep apnea (not the fact he had it for years...and I asked them to have it checked out!), and he was not allowed to sleep (family woke him up if he snored..which means NO sleep!), and not allowed to take pain meds...so he wound up in the PCU for dehydration, pain issues big time, sleep apnea, and the family feels that a narcan a night will solve this!!!!!!!!!!!!

    A smart doc that took the time to monitor the pulse ox for more than a few seconds caught on to what I had already said...and said "this guy is fine, nothing a bi-pap won't solve...why is he here!?!?!?". Exactly what I would say! But no..the family wants an order for nightly narcan!!!!!!!!! OMGOSH!!!!!!!!!!!

    Now I just want to strangle that nurse, even though she obviously thought it was what she needed to do...which if she had taken time didn't absolutely DIDN"T need to do! SO here is this poor guy, his freaked out family...spending the medicare dollars on sending him to the hospital if he snores for narcan!!!!!!!!!!! What a waste, and what a serious pitty!

    The management is still on my side...that I was a good nurse for watching the pt carefully and not using narcan for something I could monitor. Plus, the other nurse gave narcan to a man with heart history and didn't have him transfered to a tele unit which should have been done just on resps alone if you thought it was so bad to narcan him X 3!~ (she did NOT wait for titrate of effect...this was given in 20 minutes time and she gave it till he knew the date and time! OMG!!!!!!!!)

    I just feel that this whole thing was a mess, and it started AFTER my shift..but eyes fall on me...and even though it has been said I did exactly the right thing...the questions still stay about it all..and my name is still in the mix!

    OH GRRRRRRRRRRRR! Poor guy, poor family! Not to mention SCARY!!!!

    When did nursing tx fall on pulse ox machines instead of actually tx the PATIENT!!!!!!!! All of this started from taking a one second pulse ox, and not waiting on a snoring man to see things go from the 70's to 95's in 10 seconds between snores?!?!?!?

    I re-upped my volunteer inservice on "treating the PT, not the machine" yesterday! And management and admin is SOOOOOOO for it!!!!!! WHEW!!!!!!!
    Last edit by Antikigirl on Dec 2, '06
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  2. 10 Comments

  3. by   Halinja
    UnBELIEVEable! the part that freaks me out...no, wait, it ALL freaks me out. But aside from documenting opinion in the chart, it just seems horrendous that she discussed you with the patient! That is just amazingly unprofessional. (Of course, everything she has done in this case is unprofessional)

    Can a doc talk to the family and get their misconceptions straightened out?

    You must feel like you've fallen down the rabbit hole into 'alice in wonderland' type circumstances.
  4. by   sunnyjohn
    A doc or APN needs to straighten on this man and his family ASAP. He's running around misinformed.

    Your nursing 'collegue' is unprofessional. What's even sadder/scarier is that she is weak in an area (monitoring) and too proud to admit her error and improve her skill.

    Sheesh!
    Last edit by sunnyjohn on Dec 2, '06
  5. by   Lacie
    Really as where is the Doc in all this. Shouldnt he/she be explaining and educating his patient and family on this issue. The primary physician needs to jump in here and let this family know "Narcan is entirely an inappropriate choice". My mother has sever sleep apnea and if I wake her due to snoring it's only to shut her up LOL. She recently was hospitalized for a triple A repair and I couldnt get it through to the nurses in the PACU when her sats were in the 86-88% range that this was normal for her on room air even at home, particularly when she is laying flat. She's also a 3-4 pack a-day smoker. They quickly withdrew her pain meds initially due to her sats and I was furious to say the least. Once I got this in thier heads her PCA was resumed. This nurse needs to be put on a reality check not only in regards to patient care but her attitude related to coworkers before she causes a liability suit on you and the hospital.
  6. by   TazziRN
    I agree with the others, a meeting needs to be held with the family and the doc so that s/he can educate them about narcan. They also need to be told that you're the one who did the right thing, not the noc nurse!
  7. by   gauge14iv
    Next thing you know they'll be on Oprah talking about how Narcan cures sleep apnea and people all over America will be begging their providers for Narcan so they go off their CPAP or Bi-PAP.

    Sorry couldn't help myself.
  8. by   TazziRN
    Quote from gauge14iv
    Next thing you know they'll be on Oprah talking about how Narcan cures sleep apnea and people all over America will be begging their providers for Narcan so they go off their CPAP or Bi-PAP.

    Sorry couldn't help myself.
    Harpoon, I love your sarcastic sense of humor, it's great!!!
  9. by   PANurseRN1
    I would get an attorney. Do not depend on management to have your back. If you can find a nurse atty., more's the better. The nurse and the family sound unstable, and it wouldn't surprise me if either or both would go after you. Management cannot be trusted in this sort of situation; I would have someone else on my side.

    Sorry if that sounds negative but you never know.
  10. by   banditrn
    Triage - I can sympathize with you - that nurse sounds like a couple I've met up with over the years!! Dangerous.
  11. by   UM Review RN
    Man, I had an idiot berate me in front of a patient once about a nursing judgment that I made. In the middle of Report, this idiot got up and went in to the patient, and "corrected" something she thought was wrong, all the while talking over me in a loud voice. Eventually she realized that she was wrong.

    But that never came out in front of the patient as loudly as her eagerness to "correct" me. I was FURIOUS.

    I had a good relationship with the patient prior to that, and I could see the doubt in his eyes when she started in. I had him again after that, but what kind of nurse destroys the patient's confidence in his nurse?

    ---In the patient's room, I calmly told her that yes, she WAS wrong and she'd better not EVER do that to me again. To finalize the deal, I wrote her up.

    She never did that again. But I was still seething because of the effect that had on my patient's confidence.

    WRITE HER UP, TRIAGE!! PLEASE!! You are probably not the only victim of her unprofessional behavior and this nurse needs to know that she was WRONG. And don't forget to throw in an incident report to Risk Management so they can deal with her nursing notes.


    I'm so sorry this happened to you and hope you and the doc are successful with damage control!
    Last edit by UM Review RN on Dec 2, '06
  12. by   GatorRN
    You have got to be kidding me? OMG, that mans doc needs to straighten those ppl out. I can't believe the trouble this nurse has caused, seeing as how she was WRONG from the get go!!! Unreal!! How very inappropriate for her to have placed unwarranted doubt in your pts mind about your nursing abilities, when she was the one that jumped the gun..totally unacceptable.

    Please tell me somebody, anybody has tried to get through to them that Narcan is definately not the answer. This poor man is now sleep deprived, painful, dehydrated, and not treating his sleep apnea, all because this nurse can't/won't admit to her mistake...instead of learning from it. I sure hope this nightmare ends for you soon. Hang in there. Good luck with your inservice.

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