OMGosh...she wrote me up! Update about the Narcan! - page 3

For those that didn't see my post, I had a patient come in after surgery who was very sedated, however...didn't meet the criteria for using narcan. He had serious sleep apnea so his pulse ox went... Read More

  1. by   Celia M
    Quote from Tweety
    By "written up" are you talking about what she documented in her nurses notes?

    Or did management give you a written warning that is in your personnel file?

    I'm sorry this happened.

    (What about Bipap for the apnea? Was the MD aware?)
    I was going to ask about Bipap, that is certainly much more appropriate than narcan for someone with sleep apnea, and Noc shift nurses should be well aware of that. I think your night shift cutie needs some classes on documentation, one never assigns blame or voices an opinion in the nurses notes. i expect there is a lot of inssecurity here as you are doing all the right things and are a great assessor, patient care provider and patient advocate too. Glad the supoort is on your side, where it should be.
    Good luck.
    Celia
  2. by   Antikigirl
    Thanks guys!!!!!!!!!!!

    Actually we did want a bi-pap but the MD was being "MR. I can't be bothered" guy and wasn't really behind us..."it can wait till morning!". UHG!!!!!!!! So I kept my pulse ox on him (it was our spare), and was in the room doing my charting and what not so I could notice any change. Again, I was lucky I had that time...my other patients were stable and sleeping.

    BUT...I did run into a karma deal yesterday! The same nurse turned down the PCA I had for another pt, and he was in pain screaming all night and it took her a lot of time to get him contolled painwise! The wife was with the pt (stayed) and was in tears. The family told me this when they saw me during my inital assessment of a patient, and I told them I would be their nurse again...they were very happy!!!!!! I had them explain what happened and WROTE HER UP under patient/family complaint (not a personal one by me, that would be too obvious that I was trying to make a stink! LOL!)...and management will handle it..in fact, management told me to do it!

    Lets see how it goes...she'll proably find out it was me that filled the report, but...my manager is going to say she found out and had to take action.

    This gal needs a lesson in pain management specific to nocs! Us during the day handle the weening so we can closely monitor...but keep our patients up in pain all night...no way can we even ween them because they spent all their energy at night painful and trying to sleep! I know she wanted to start the weening process...but first..get to know the patient and the day they had...this one too was a fresh late night post op! Poor guy!
  3. by   Cherish
    Quote from TriageRN_34
    Thanks guys!!!!!!!!!!!

    Actually we did want a bi-pap but the MD was being "MR. I can't be bothered" guy and wasn't really behind us..."it can wait till morning!". UHG!!!!!!!! So I kept my pulse ox on him (it was our spare), and was in the room doing my charting and what not so I could notice any change. Again, I was lucky I had that time...my other patients were stable and sleeping.

    BUT...I did run into a karma deal yesterday! The same nurse turned down the PCA I had for another pt, and he was in pain screaming all night and it took her a lot of time to get him contolled painwise! The wife was with the pt (stayed) and was in tears. The family told me this when they saw me during my inital assessment of a patient, and I told them I would be their nurse again...they were very happy!!!!!! I had them explain what happened and WROTE HER UP under patient/family complaint (not a personal one by me, that would be too obvious that I was trying to make a stink! LOL!)...and management will handle it..in fact, management told me to do it!

    Lets see how it goes...she'll proably find out it was me that filled the report, but...my manager is going to say she found out and had to take action.

    This gal needs a lesson in pain management specific to nocs! Us during the day handle the weening so we can closely monitor...but keep our patients up in pain all night...no way can we even ween them because they spent all their energy at night painful and trying to sleep! I know she wanted to start the weening process...but first..get to know the patient and the day they had...this one too was a fresh late night post op! Poor guy!


    WOW ....OUCH...does that nurse wear black and walk around with a scythe geesh (just being sarcastic people) . If managements telling you to write her up more obviously they know she's not that competant. I mean we don't know her side of the story yes but still...WOW!!!
  4. by   CarVsTree
    I'm sorry to hear you had to go through this. Glad you doc'd so well and that mgmt is on your side.

    Poor patient - Narcan x3. I cannot even begin to imagine what that feels like.
  5. by   lyceeboo
    Quote from TriageRN_34
    This gal needs a lesson in pain management specific to nocs! Us during the day handle the weening so we can closely monitor...but keep our patients up in pain all night...no way can we even ween them because they spent all their energy at night painful and trying to sleep! I know she wanted to start the weening process...but first..get to know the patient and the day they had...this one too was a fresh late night post op! Poor guy!
    A LESSON IN PAIN MNGT SPECIFIC TO NOC.....EGGGGXACTLY!
    I onced worked worked a floor they called Ortho/Trauma/med/surg where we did a lot of those "huge back surgeries" (Ant/Posterior spinals with hardware). Anyway one of the noc RN's was VERY stingy and judgemental about the use of pain meds. She kept complaining that "all we do on this floor is give narcotics." Hello! These are fresh post-ops......we're not getting them hooked on opiates for life.

    The day RN that followed this night RN would often hear from the pt about how much pain they had been forced to suffer. Sadly the day RN's would turn the pt complaint over to the Nurse Manager & she never bothered to tell this night shift nurse about proper pain control/night. (I think maybe the NM was more afraid of upsetting this staff nurse because she was one of the few experienced staff we had on nights. Our night shift was only able to attract travelers.)

    Luckily a pt finally c/o uncontrolled pain/noc to his doc & the doc was able to get this RN to understand the use of opiates in the management of short-term pain. Funny thing was a yr later this same RN had a difficult delivery with C-section & I remember her telling me how "The percocet saved my life."

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