Please let me VENT!! - page 2
Ok..I am a new nurse with less than 4 months total in the field and currently in LTC. A couple of weeks ago, I get a call from dialysis letting me know that my pt hct is steadily dropping... Read More
0Nov 17, '05 by 1TulipWow. I haven't been in exactly this position... but let's think about this.
If your patient is failing, they are in a dynamic process. Things are going on. Symptoms will worsen. New ones will start to appear. Now, maybe this is passive aggressive, but I'd probably be on the horn with each new assessment. (Whilst documenting, documenting, documenting.) I'd probably be "sharing" each observation with my nurse supervisor. I mean, they can't exactly tell you "...I don't want to hear any more about how sick the patient is!"
Squeaky wheel gets the grease.
0Nov 17, '05 by papawjohnAdvocate! Advocate! Advocate!
I agree with all those here who point out that calling the NP is not the end of our responsibility and that the character flaws of the Med Director are not sufficient reason to stop short of doing everything we can do for our Pts. No one told us it was all going to be clear or easy.
Stand up for yourself and your Pts, Alibaba!!
0Nov 19, '05 by ZASHAGALKAYou'd be surprise how much this works - in a calm voice, state:
"I disagree with you. If YOU disagree with me, then you need to immediately come in and assess this patient. Oh, and bring your doc along with you, because otherwise, I'm just gonna call him in, anyway."
Whenever I have said this to an intern/resident, the answer is always a resigned: "What exactly do you want?"
In your case, you want an order to transfer these pts to an ED for a thorough, immediate evaluation. (and I can't imagine a guiac positive pt w/ dropping HH wouldn't be admitted for observation and probable EGD/colonoscopy.)
And the previous poster is correct - it isn't a matter of document to cya. The standard of care is what would a prudent nurse do? You already know that just documenting isn't enough. A prudent nurse would do more. You are a prudent nurse, and that is exactly what you want to do - more. Now advocate for that. Passing meds isn't your primary job - advocacy is.
Timothy.Last edit by ZASHAGALKA on Nov 19, '05