Some nurses make you sick!!! - page 5

hello everyone!! so here is my vent!!!:angryfire, i work at this lovely ltc , anyway i just got off working 11-7 shift, the supervisor calls me as i am goin home and tells me that the day nurse... Read More

  1. by   EmmaG
    Well, I see the OP edited the initial post for clarity. It helped a little, I guess, but I'm sorry no one had quoted the original because I could swear she said she started what was already hanging then added another 200. I do remember it saying the feeding might have been beeping empty between 5 and 7 while she finished up her shift.

    In any case...

    this resident gets 600 ml every 12 hours and the feeding is supposed to start at 2am, so at 2 a.m I go to start the feeding but there is 400ml in the bottle from the previous feeding,which finished at 12MN the feed is Diabetic resource which comes in a 1000ml bottlet!
    ok..

    It would appear it's running at 60 cc/hr.

    400 cc started at 2 am should have lasted until almost 9am.

    And yet:

    seeing that I started it at 2am and my shift ends at 7am, anyway she calls the supervisor on me and the supervisor calls me on my cell phone, couldnt the day nurse have spoken to me first?? If the feed ends 15 min after my shift ends am I still liable??
    I don't blame that nurse for calling the supervisor to question you about the feeding...
    Last edit by EmmaG on Nov 16, '07
  2. by   Hellllllo Nurse
    She did say she saw there was 400cc in the bag when she initially checked, and she restarted it.
  3. by   EmmaG
    Quote from Hellllllo Nurse
    She did say she saw there was 400cc in the bag when she initially checked, and she restarted it.
    Yeah I know, but I could swear in the post before it was edited she said that she'd added another 200. I know for sure she said she may have missed the pump beeping empty between 5-7 as she was finishing up her shift; I know because that caught my eye that the pump would have been beeping for two+ hours.

    In either case, if the feedings were running over 10 hours (going by the previous one being 2pm to 12mn), it should not have been empty at 7 am.
  4. by   Hellllllo Nurse
    Aside form how much feeding was left in the bag, etc. This post expresses what disturbs me the most about this situation:

    Quote from NursingAgainstdaOdds
    Indeed, every day is a learning experience. I think the OPs first mistake was focusing on how this situation would effect their standing at work, rather than focusing on what could have been learned from the situation. The knee-jerk response was "Oh, SOME NURSES!!!" and not "Perhaps I am missing some knowledge here". Certainly a new grad should not be written-up for every mistake they make, but the actions described by the OP indicate an unsafe knowledge deficit which warrants some counseling and further education.
  5. by   EmmaG
    Quote from Hellllllo Nurse
    Aside form how much feeding was left in the bag, etc. This post expresses what disturbs me the most about this situation:
    I agree. My point is, if I'd followed her, I'd have called to get this clarified too.

    I would love to know what the order actually says, though.
  6. by   Hellllllo Nurse
    Me, too.
  7. by   Nrs_angie
    Quote from Emmanuel Goldstein
    Yeah I know, but I could swear in the post before it was edited she said that she'd added another 200. I know for sure she said she may have missed the pump beeping empty between 5-7 as she was finishing up her shift; I know because that caught my eye that the pump would have been beeping for two+ hours.

    In either case, if the feedings were running over 10 hours (going by the previous one being 2pm to 12mn), it should not have been empty at 7 am.
    I remember what the OP said... she mentioned that she restarted the 400... and she was going to go back and set the pump again to add for another 200... but she also mentioned that she may have forgotten to go do that with it being the end of her shift and being busy with 40 patients... her main squabble was that the day shift nurse called and reported her rather than talking to her personally...

    according to one of her recent posts... it ran out at midnight...

    her shift started at 11PM...

    if the order is 600 mL q 12 hours... that tells me that it is a continuous feed...

    so I am still not understanding why a Diabetic doesn't have the feed going from midnight til 2AM... what happened in those 2 hours...

    AM I MISSING SOMETHING HERE?? ANYONE HAVE ANY IDEAS?
  8. by   EmmaG
    Quote from Nrs_angie
    I remember what the OP said... she mentioned that she restarted the 400... and she was going to go back and set the pump again to add for another 200... but she also mentioned that she may have forgotten to go do that with it being the end of her shift and being busy with 40 patients... her main squabble was that the day shift nurse called and reported her rather than talking to her personally...

    according to one of her recent posts... it ran out at midnight...

    her shift started at 11PM...

    if the order is 600 mL q 12 hours... that tells me that it is a continuous feed...

    so I am still not understanding why a Diabetic doesn't have the feed going from midnight til 2AM... what happened in those 2 hours...

    AM I MISSING SOMETHING HERE?? ANYONE HAVE ANY IDEAS?
    Confusing, isn't it. I was looking at it as an intermittent feed, since it said q 12 hours. That's why I've asked a few times over how many hours was this supposed to run. The 10-hour thing was what I gleaned from her post, assuming the prior feed started at 2pm.

    I'm used to most continuous feeds being ordered as ___ cc per hour. Never worked LTC, though, so the way it's ordered there might be different.
  9. by   LesMonsterRN
    What I want to know is whether the feeding is continuous for 24 hours or just 12. Even so, if there were 400cc up at 2am, there should have been enough for 8 more hours. I'm wondering if the rate was set correctly on the pump in this case. Or if it's just a 12 hours/day feed, that bag may have just been sitting there since the feeding was stopped at 2pm. In that case I would've hung a new bag/bottle with new tubing, etc.
  10. by   FireStarterRN
    What I want to know is:

    Is The sum of the square roots of any two sides of an isosceles triangle is equal to the square root of the remaining side?
  11. by   EmmaG
    The answer is 42.
  12. by   FireStarterRN
    Quote from Emmanuel Goldstein
    The answer is 42.
    [s]According to this website, The scarecrow was wrong[/s]
  13. by   Hellllllo Nurse
    I used to work on a LTC unit where I had nine tube feeders. Some were bolus feeds, and some were continuous. Some continuous ones were ordered as ml/hr, others were ordered as total amount in 24hrs, and the nurses did the math.

    For continous pts, no more than 400 ml could be in a bag at one time for reasons of infection control.
    All got an entirely new set-up of equipment q 24 hrs, on nocs

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