Lesson Learned!!!!

[procrastinator911, BSN, RN]

Hello All,

I graduate soon, May to be exact...excited.

As a student nurse on my clinical floor I usually constantly ask my nurse or clinical instructor if I'm doing something right (not necessarily a lack of confidence, i would just rather be safe than sorry). Old saying: don't believe everything you hear and half of what you see. As nurses/student nurses you are responsible for everything and anything, always verify and document.

Scenario: At clinical the other day on a cardiac floor. I was listening to report from the night nurse to my nurse on my 2 patients. My one patient was going down to the cath lab for a procedure sometime later in the day and was NPO from the previous night. Night nurse stated patient is NPO but only takes meds with applesauce.

I thought nothing of it, apparently neither did my nurse (relatively new, 7 months). 9 o'clock rolls around and I'm going through meds. I decided to look up the NPO order on the computer and it says NPO only sips of fluid/water with meds. So i ask my nurse if I am to give her meds with applesauce and she says yes she only tolerates meds with applesauce. So i let my instructor know what the nurse stated b/c she questioned the NPO with applesauce.

So I'm in my patients room with my instructor giving the meds with applesauce (small amounts) . Patient says she may need a sip of water after to help them go down. OK? So as my patient is taking her last pill WITH APPLESAUCE AND THEN A SIP OF WATER, just as luck would have it 3 doctors walk in followed by my nurse. One immediately questions me and asks "what's going on, applesauce and water? she's NPO for surgery." So I explained that was the order passed down from the previous nurse. Thank god my instructor was there to jump in, b/c this Doc was getting pretty hostile. My instructor told him I was a student and that the order was confirmed and verified by my nurse. Keep in mind my nurse was in there the whole time. It wasn't until the Doctor asked who my nurse was did she actually say anything.

The doc asked the nurse if she verified this with cardiology, she said no. Moments later she called cardiology to let them know, they said it was fine.

Lesson learned: always verify regardless of what another nurse or anyone tells you. CYA.

Just thought I would share my experience :-)

[procrastinator911, BSN, RN]

also thoroughly assess your patients, the whole applesauce thing was just a preference for my nice but demanding patient

[tamale29, MSN, RN, NP]

That would be scary!! Yea any time anyone tells you something that is directly against a doctors orders I would always double check that someone specifically asked that doctor, and get thier name and when they asked. If noone had make sure you do it thmeselves. Then document "given with applesauce per md".