Hi! I am not a nurse yet. I start an accelerated BSN program in August. I have been a lab tech for five years. I read urines and run the machines that do coags and blood gases and chemistry panels and all that fun stuff. After college, I lived with two roommates who were nurses, and before I became a lab tech, they would always come home from work and talk trash about the lab. It was helpful to me to be able to talk to them when I got this job, because I feel like there's a lot of miscommunication between the nurses and lab techs, and it's nice to talk to someone on the other side. Anyway, here's my rant of the night.
When we have a critical value on a patient, or a value that seems suspicious, we call the nurse. They have to accept the value before we enter it in the computer. Once they accept the value, give us their last name and we end the call, that value is getting entered in the computer and we are not allowed to take it out. I can not tell you how many times I've called a nurse, gave them the value, asked them if they accepted it, gotten their name, and entered the value in the computer only to get a call back in the next five minutes saying it was wrong and asking if we can take it out. We can't!!!! That's why we're calling in the first place!!!! Whyyyy does this happen?
Tonight I had a critical vanco trough on a patient. A lot of times, when that happens, the patient actually has vanco running when the trough is drawn, so I called the nurse to check. I told her the value and said that it was really high for a trough and asked if the patient had vanco running. She started freaking out about how nobody told her the patient had a trough drawn and asked when it was drawn. I said 2040. She said now she was going to have to call the doctor and she can't believe no one told her he had a trough done. I said, "so you're accepting it?" She said yes and gave me her last name. I hung up, entered the value, and five minutes later I get a call back. "Did you just call me about a vanco trough? What time was that drawn?" "2040" (I already told her that the first time.) "Oh, that patient has had vanco running since 2000. Can you take it out of the computer?" "No, I can't, I'm sorry." "Ok fine bye" (in a cranky voice.)
I know that she probably had fifty million things to do and this value was the least of her worries, but this happens so often that it just gets annoying. I needed to vent. Thanks for listening!
Apr 4, '10
by Kim O'Therapy
You did nothing wrong. If the lab calls me about a critical value, there is NO choice if it is entered or not, the lab enters it into the system. Where I work, by policy, the lab documents all lab values, calls the nurse with any critical values and I call the doctor and document that I called the doctor. I simply would have stopped the Vanco and called the doctor. Having said that, as a nurse, I don't hang Vanco until I check for any possible orders regarding a trough/bag# order. If I think a critical lab value called into me by the lab technician may be inaccurate d/t dilution (not wasting the initial draw from a central line, etc.) or concentration (drawing while Vanco is running), I STILL notify the doctor and get an order to redraw. Let's say that I made a mistake and had hung the bag without checking labs first. OK, I will probably get a slap on the hand or maybe written up, or worse. However, it is not the lab technician's job to cover up my mistake by removing the critical value from the computer. Just my opinion.
Last edit by Kim O'Therapy on Apr 4, '10
: Reason: clarification