Just Gotta Vent

  1. Hello everyone!
    I just had to vent a little here, hope you don't mind.

    I had a pt Monday night (7p-7a) that came to me from OR. He had a fem bypass and was on a cont. epidural. I was never given report from his prev. nurse ( he had been on another floor pre-op). He had an order to start a heprin gtt when he got to me. The epidural orders plainly state in bold type...not to give any hep, lovenox, etc. for 24hrs after the insertion of an epidural. The nurse giving me report from PACU said we were to hold the hep that night. I was so busy with the 3 fresh post-ops, and one addmission that I didn't get to do the 24 hr chart checks until 0500, when I found the order for the hep gtt was there to begin that night. I called the Dr. on call and she told me to write myself up for not starting the gtt. I had already called the Anest. that had inserted the line and he said, "Good thinking, I'm glad you didn't start it." He also told me it had been discused in OR that the pt. would not be started on the hep that night. When I went back to work last night I found the Doc had written me up herself. My NM was very supportive and pretty much said not to worry about it, but I do! I ended up crying last night for the second time since becoming a nurse 2 years ago. Not only because of this, but I had 2 getting blood, and one fresh gastric bypass, which if you have had any of these you know they can take a lot of your time. I really try to do everything a good nurse would do, but I sometimes wonder if I was cut out for this??? I love my job and where I am, but I guess the stress finally hit me last night and I lost it!! I'm much better now, thank you for listening.
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  2. 9 Comments

  3. by   Sarah, RNBScN
    First of all...you are being too hard on yourself. You did the CORRECT thing by calling and verifying with the anaethetist. Their orders re: epidural are first and foremost before the DR. It sounds as though your DOCUMENTED all occurences...BRAVO!! I'd work with you in a flash...you are very committed and concientious. Remember...we have all shed tears...and tomorrow is another day. That learning episode is another notch in your belt.

    Very best,
    Sarah
  4. by   Shebra
    Thank you Sarah!

    I guess I just needed to hear someone else tell me it was okay. You guys are great and I love this BB!!!!!!

    Thanks again!

    P.S. I go back to work Sat. night and I will take with me a new lesson.
  5. by   live4today
    THAT dumb doc who told you to write yourself up for not starting that heparin gtt should be the one written up for telling you to start something on a patient that had already been defined as something NOT to give a patient within so many hours post epidural.

    I would have written her up, too! Then provided her with a copy. :chuckle

    The gall of some docs! And there's a thread.......no less....on allowing docs to eval nurses???????? We'd better think twice about this mistake!

    Imagine her evaluating you for using critical thinking and holding that drip. Docs heads are big enough. No need to pump more helium into their airheads.
  6. by   Tweety
    (((((Shebra)))))

    Hope that you're feeling better.
  7. by   Furst
    "....I was so busy with the 3 fresh post-ops, and one addmission that I didn't get to do the 24 hr chart checks until 0500....,
    ....I had 2 getting blood, and one fresh gastric bypass....." did anyone else pick up on this? Does anyone else think that that pt load was more than a little bit beyond reason? remember its YOUR LICENCE
  8. by   ainz
    Sounds like you were very observant and did your job well. Also sounds like you were overwhelmed and had too many patients.

    I also think 12 hour shifts are just too long. The days off in between were nice but the 12 hours is too much mental and physical stress. I think this is one of the things that is contributing to so much burn out and dissatisfaction with nursing. After 8 hours my productivity, attention to detail, motivation, etc just fell off to almost nothing, especially if you are running up and down a busy med/surg or telemetry floor.
  9. by   Rapheal
    Shebra,

    You did all the right things. What was this doctor thinking?
  10. by   Furst
    Thanks for the support ainz;and I agree 100%. Nurses need to realize, especially new grads that the more you are willing to accept [work load tht is] the more the heirarchy will expect; learn to set your limits, we will ALL benefit, especially the pts!! Nurses need to band together. What is anyone else opinion?
    Last edit by Furst on Aug 22, '03
  11. by   RNonsense
    I was so busy with the 3 fresh post-ops, and one addmission that I didn't get to do the 24 hr chart checks until 0500
    Yes, I agree it sounds like too many! Unsafe, really. You did the right thing.

    The doctor who gave you a hard time is a quack. Unfortunately, you'll deal with many more like her in your career. Take care and know you did well.

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