I am a pre-nursing student. I have a question that has been bugging me for a while, and I hope maybe you out there in cyberspace can answer it for me. The end of May I had surgery to remove some fibroids and clean up my endometriosis. Unfortuantely, I ended up with a major infection. I had 3 separate abcesses; one in my uterus, one near my liver and one in my abdomen. I was also severly anemic, and required blood transfusions. Now, let me just say that the majority of nursing care I received was exceptional, but there were a few nurses that were, IMHO, not the best. This is where my question comes in. The first 2 days I was back in the hospital, I was NPO and since I was running a fever, that meant suppository meds to reduce my fever. Such fun! Well, the 3rd day I was finally able to eat and drink and take meds orally. The Dr.'s treating me (a total of 5) all came in and OK'd that. During that day, the day nurses gave me the oral meds, I ordered food, etc. Well, when the night nurse came on I was still running a fever so she came in with the suppository. I told her that I had been OK'd to take oral meds now. I am assuming that the Dr.'s had written this in the chart as the day nurses seemed to know this. Well, she wouldn't take no for an answer. I kept telling her that I wanted the regular Tylenol and not the suppository. I absolutely refused. I was tired of things being stuck up my rear!
Plus it hurt to turn on my side because of the JP drains. She said, "So you won't let me give this to you?" as she is opening the package. She was very flustered that I would let her give this suppository to me. I said NO! Finally, she said, "Well, I will call the Dr. and I guess I will have to waste this" (meaning the suppository she opened after I repeatedly told her I wasn't going to take it), and threw it in the trash. She came back in about a 1/2 hour later all happy as can be saying she called the hospitalist and he had OK'd the oral Tylenol. Then she said, "Aren't you happy I called?" Like it was her idea and I should be so grateful to her.
Here is my question, what kind of leeway to nurses have in administering medication? In a case like this, I am sure it was in my chart, even though I never saw my chart, because all of the day nurses allowed me to eat, drink, take meds orally. I am guessing that it was overlooked to actually change the medication order from suppository to oral med on the chart. So, in this case, would a nurse be able to go ahead and administer the oral med rather than the suppository WITHOUT having to call the Dr. for permission. I mean, I could understand if it was a medication that was "dangerous", but this was Tylenol. I just don't understand why the nurse couldn't just give me the Tylenol without having to call the Dr. for permission. I would think it would just be common sense, if the patient is now able to take things in orally, the patient will not need the suppository. Why would she need Dr. permission? It just seemed wierd to me. Any input?