Hi. I am a new nurse working my first job in LTC (RN) for about 4 months. I am older (second career---know some of you younger ones question my motives for second career), but it is the job I wanted...anyway, in clinicals we were never to pass pain meds/narcs without full set of vitals, specifically respirations....so here is question. In my facility, I have been watching and NO ONE but me seems to follow that protocol. Specifically resident on Dilaudid.... I always do and chart it. Any answers or responses????????? Thanks in advance!
Quote from manusko
I have seen nurses give meds and not know their pt crashed bc they were out with other PTs.
Say your floor does vitals every 4 hrs and you are giving meds at hr 2, what happens if your pt codes shortly after and dies? How does it look in court if you say, "well they were fine 2 hours ago and our floor doesn't check vitals before we give meds". You probably will being paying out.
I as well didnt say not to check on them for 2 hours.
You indicated that the nurse wouldn't see the patient for another couple of hours after administration because the VS were q4 and the meds were q2.
My point is that even if that were the case, the nurse should at least check on the patient post med-admin (15 min for IV, 30 min for PO per my ward's protocol) and every hour. So no, you wouldn't be paying out if your patient mysteriously coded after the med admin because you followed protocol and something abnormal happened.
Eyes-on the patient is an effective assessment tool that can pick up changes in patient condition before the physiological indicators show up. If the nurse is curious, they can always check VS, but that isn't standard practice.
And a patient crashing while you're in another room? That happens. It isn't necessarily the mark of a "bad nurse" or a nurse who isn't paying attention. You can't sit on your patient for the whole shift. That's why teamwork on a ward is so essential along with a good eye for assessment.
Last edit by SoldierNurse22 on Jul 9, '13