I had a "situation" on my unit today and looking for some insight.. I work on a sub acute rehab floor in a skilled rehab, I have 18-20 patients with admissions/discharges and all the usual stressors of a shift... Many of my patients are tube feeds and trach/vent. I have a new patient, I am unfamiliar with, he was admitted on my weekend off and he has been having difficulty tolerating his tube feed. I noticed this soon as I did rounds, and held the feed. I had went to check the order but didn't make it back right away. My intent was to hold it for a little while and let him digest anyway as it was apparent he was not tolerating it and I felt the rate was too high for someone new to tube feeds in general. He was @ 55cc/hr in the hospital and they have him @ 85cc/hr here, why I have no idea. I consulted dietary for an answer. So of course in the 15-20 mins the feeding is on hold the family comes in (the wife is a medical lawyer!) and is furious as to why he is regurgitating AND why his feed is on hold , little do they understand I am trying to help him by holding it and figure out what might be better for him.
In my research I find out the WRONG formula was hung 7-3 and was infusing all this time...which is my fault too yes, but I trust when I am getting report I am getting the correct information...learned that is not always the case... to get to the point I wrote my note that I notified the MD of the situation, that one formula was feeding and I held it and resumed the correct feeding without incident. We have a new per diem supervisor that seems to think I made a huge mistake by putting this in my note and should have not informed anyone of this. I feel like that is wrong and even though I am implicating myself, I need to report the correct information. I understand that there is an INCIDENT report but the medical record should contain what happens with the patient as well, or am i just completely wrong about this. It's not like I am writing "bed alarm was not in place and patient fell unknown to staff with sustained injury" I feel like I am trying to take responsibility but I need input from more experienced nurses. thank you for reading!!